NU143CL Unit 10 Final Rotation Reflection Example

Two Checklists Became One Plan: A Final Rotation Reflection by a Composite Student Tracing How She Moved From Assessing a Mother and Baby as Separate Patients to Caring for Them as a Couplet, Moment by Moment

[Student Name]

Purdue University Global

NU143CL: Maternal Infant Nursing Clinical

Unit 10 Final Rotation Reflection

[Instructor Name]

[Date]

The student, families and staff are composite; no records of time or evaluation are reproduced.

Where I Started

In my first week, I treated each couplet as two patients who happened to share a room. I had a postpartum checklist, fundus, lochia, perineum, breasts, bladder, and a newborn checklist, vital signs, feeding, diapers, skin, and I completed them one after the other. My first postpartum note found a full bladder pushing the uterus aside, and my first newborn note read a baby's weight loss beside his diapers. Both were good assessments, following the systematic approach I learned in fundamentals (Potter et al., 2023), but I wrote them on different days as if they had nothing to do with each other.

The Feed That Joined Them

The change came with a mother on her first day after a cesarean. Her son had fed twice in ten hours, and I had written him down as a sleepy baby with a feeding problem and her as a mother with incision pain. My instructor asked me to watch a feed. The mother could not hold him without wincing; she held him away from her body, and he slipped off the breast and fell asleep. Her pain and his feeding were the same problem seen from two sides.

When we timed her pain medicine before the next feed and used a football hold that kept him off her incision, he fed for fifteen minutes. Writing a couplet care plan afterward, I saw that the most effective feeding intervention for the baby was a pain intervention for the mother (Perry et al., 2022).

I had two correct lists and one wrong picture; the feed showed me that the problems lived between the patients, not inside each one.

The Discharge That Became One Conversation

Later in the rotation I helped discharge a family after a mother's hemorrhage and her son's jaundice check. A month earlier I would have taught the mother's warning signs, then the baby's, as two talks. Instead my nurse and I taught them together on one sheet, with both follow-up visits booked for the same week. When the parents' first teach-back on jaundice failed, we changed the method, demonstrating how to check his skin and writing three triggers in large letters, and the second attempt worked. Teaching the family as one unit took less time than two separate talks, and the parents asked better questions because they could see how the two plans fit together. It also made it easier for them to remember, because their life at home would not be divided into two patients either.

What I Believe Now

Couplet care is not two assessments done in the same room. It is one assessment of a relationship: how the mother's recovery affects her ability to feed and hold her baby, and how the baby's feeding affects her milk supply, her sleep and her confidence. Family-centered maternity care treats the mother, baby and family as a unit, and I now understand that as a practical way of finding problems, not only a philosophy (Perry et al., 2022). Reflection after each shift, asking what happened, what it meant and what to do next, is what turned these moments into a change (Rolfe et al., 2001).

What I Am Still Learning

I still find it hard to manage the timing when both patients need something at once, such as a mother's pain medicine due while the baby is finally awake and rooting. I want to get better at planning those overlaps before they happen. My instructor suggested asking the mother at the start of the shift when her baby usually wakes, and timing her medicine around that answer, so the overlap becomes part of the plan rather than a collision. I also noticed that I sometimes default to the baby, who is easier to assess, and leave the mother's assessment for later; I want to alternate which patient I start with, so neither becomes an afterthought, and I will ask my next instructor to check whether I manage that.

Next Step

On my next rotation, I will begin each couplet assignment by writing one question that connects the two patients, such as how her pain is affecting his feeds, and I will answer it before I finish my first round of assessments. I will also keep one shared page for each couplet in my notes, with the mother's and baby's findings side by side, so connections are visible as soon as I write them down.

References

Perry, S. E., Hockenberry, M. J., Cashion, K., Alden, K. R., Olshansky, E., & Lowdermilk, D. L. (2022). Maternal child nursing care (7th ed.). Elsevier.

Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2023). Fundamentals of nursing (11th ed.). Elsevier.

Rolfe, G., Freshwater, D., & Jasper, M. (2001). Critical reflection for nursing and the helping professions: A user's guide. Palgrave.