OBVsim3-Guided Reflection
Opening Questions How did the simulated experience of Amelia Sung’s case make you feel? • Honestly this VSim made me very excited to experience this in real life. I want to be a Labor & Delivery nurse, so this made me more aware of how I should be reacting during a normal birth and what I need to be able to do in case of an emergency. Describe the actions you felt went well in this scenario. • During my first attempt, I wasn’t even thinking about medications, so during my second attempt I felt that my mindset was more inclusive of all of the factors going on, especially the factor of how the Oxytocin could be affecting the baby. I felt that I was prepared for the shoulder dystocia and knew what to do for that, however the second attempt I was much more aware of the interpersonal communication that needed to occur, even though I was so focused on getting the baby out. Scenario Analysis Questions1 EBP What risk factors specific to shoulder dystocia were identified in Amelia Sung’s case? • Pt history included excessive weight gain and prolonged second stage. • During delivery, only the head was able to deliver – indicating that the right shoulder of the infant couldn’t pass through the birth canal. The positive turtle sign was the key indication that shoulder dystocia PCC/I Prioritize your nursing actions for Amelia Sung based on your assessment. • Non-reassuring FHR: d/c oxytocin & deliver 500ml bolus of LR, apply 10L/min O2 via nonrebreather • Shoulder dystocia: positive turtle sign identified by provider = immediate call to Charge & NICU • -> Pt put into McRoberts position & suprapubic pressur applied • Infant given to charge nurse for assessment and possible resuscitation EBP List potential problems for Amelia Sung and her baby related to the shoulder dystocia. 1 The Scenario Analysis Questions are correlated to the Quality and Safety Education for Nurses (QSEN) competencies: Patient-Centered Care (PCC), Teamwork and Collaboration (T&C), Evidence-Based Practice (EBP), Quality Improvement (QI), Safety (S), and Informatics (I). Find more information at:
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