Where I am we have HR antepartums that are turned over to us from L/D once they are deemed stable. This includes everyone from previas, partial abruptions, bleeding for Obs, PPROM, PTL, (you get the idea) to moms whose OB stuff looks fine but they have some other medical problem needing attention and pregnancy makes tx more difficult. Any pg under 20 weeks comes directly to our floor from ER, after 20 goes through L/D. We deliver <20wk miscarriages on the floor. (Don't get me started on why I don't like that...)
Some difficulties I run into:
1) When I'm calling about a breaking antepartum, sometimes I have trouble getting the residents to take me seriously. I should say "we" as a unit have that problem. I was on the phone all night one night for 8 hours while a 27-weeker was contracting (toco wasn't picking it up but I could palpate). One of the residents checked her & because her cervix hadn't changed told her "sorry, hon. this is part of being pregnant."
I am enough of a PIA to them that 8hrs later when the attending comes along I convince him that she is contracting. He checks her & lo and behold, she has gone from 2 to 4.
That resident is very lucky I didn't deliver that 27-weeker in the bed. I would have written that up so fast....
2) Where I am the floor is not exclusively AP. We have APs, gynies, & mother/baby couplets. It is hard sometimes when you have a breaking AP to give attention to your other pts, depending on how long it takes you get that pt transferred to L/D.
Would you like to comment?
High Risk Ob Patients
I WORK ON A HIGH RISK OB UNIT WITH A BED CAPACITY OF 30 PATIENTS . WE AVERAGE ABOUT 20 TO 25 A DAY. I WOULD LIKE TO HEAR FROM OTHER NURSES WHO WORK ON A HIGH RISK AREA SEPARATE FROM THEIR L&D. WHAT KIND OF ISSUES DO YOU HAVE AND HOW DID YOU SOLVE THEM.
