Clinical Rotations for Students
Because the nursery can be such a busy place, it can also be overwhelming. To get started, concentrate on the essential elements first (see below) and use this website as a resource. If in doubt, ask questions. The best educational experience is one that's tailored to fit an individual, so be your own advocate for what you need to learn.
About the Website
The Newborn Nursery website was created in order to enhance your clinical experience. We hope that you will find it to be a useful addition to your rotation. The "Photo Gallery" section contain hundreds of photographs and video clips of normal and abnormal findings in newborns as well as audio tracks of common heart murmurs, the "Clinical Guidelines" section provides a framework for approaching some of the more commonly encountered problems, and the "Breastfeeding" section contains photos, videos, and lots of practical tips. The two breastfeeding videos that are most relevant to your rotation are "A Perfect Latch" and "Hand Expressing Milk". We suggest you watch both early on as the topics covered will frequently be referenced on rounds.
About the Nursery
The Newborn Nursery is located outside of F2, in the main hallway between Stanford and LPCH. Occasionally, an infant will be physically present in the nursery, but usually babies are cared for in the rooms with their mothers on units F-1 or F-2. We care for about 16 patients per day, although there are wide fluctuations in census on a daily basis. Approximately half of our families are Spanish-speaking.
For security purposes, all newborns are required to be in a crib when moved through the hallways, even if a parent or family member is transporting them. Each baby also wears a security sensor that will alarm if taken out of contact with the skin or if the infant is taken out of the unit.
Note: elevators are off limits for the alarms. If you need to move an infant from one floor to another, have a staff member or attending physician assist you.
Professional attire with name badge is appropriate. White coats are discouraged. Bring a stethoscope and, if you have one, your own ophthalmoscope. Personal belongings can be left near the in the F-1 physician workroom (unlocked).
The Bottom Line
We recognize that, as students, you will spend a very limited time in the WBN. While we hope you are able to see a variety of physical findings and discuss various aspects of normal newborn care, there are a few skills necessary to survive and enjoy your rotation.
Know the normal ranges
- vital signs
- stooling / voiding
Perform a complete, careful physical examination
- develop comfort handling and examining infants
- learn some common rashes, birthmarks, reflexes
- what it is, how to explain it to parents
- how to assess risk and need for treatment
Understand normal breastfeeding
- distinguish "adequate" from "insufficient" feeding