I was originally supposed to orient to OB-GYN for two weeks and now, the head nurse is dying to keep me; in fact, there are rumors that this will be my permanent home. I am happy about it because it is new and different. It is, however, yet, another overburdened clinic with many new uninsured people coming due to two neighborhood hospitals closing, increasing our catchment area.
There is so much to learn! We have high risk pregnancies, urodynamics, SPC (special procedure clinic), endocrine, diabetic and it is a normal day for me to treat 10 women in a row for chlamydia. As I mentioned earlier, I haven't had as much time to post lately because I try to make sure that I get as much rest as possible because I truly need rollerskates in that joint. Those nurses are phenomenal teachers. They are all quirky, but are very giving and willing to share. We have spatial issues, however, so, it is hard to keep up with the pace because we get many walk ins a day.
Some questions for the more experienced nurses:
1. I am noticing that there are many women that are spilling proteins in their urine, but are not hypertensive. Why is that? What I notice is if they are spilling proteins, the doctor will order a 24 hour urine. I give them paperwork about PIH, but I am wondering if I am doing the right thing if there are no other indications of preeclampsia besides the spilling of proteins.
2. Another question: for GDM...the doctors really want to see glucose testing logs. Some of the readings are not particularly high in my opinion (compared to the teachings I have had for DM...), like a reading in the morning before breakfast may be for one patient 107mg/dL, and two hours after a meal, 148mg/dL, and to me, this is not really high, but the doctor will tell the patient to see a dietitican for better glucose control. The patient will ask me why, and for now, I really don't have an answer, but will promptly escort them to the dietitican. Are there different parameters for diabetic pregnant women? I do intend to ask the providers and other nurses as soon as possible, but I tend to forget because there are so many things to keep up with that it slips me. I want to have the knowledge, for myself and to explain to the patients.
They seem to love how I am functioning. I am not as lost as I was as a brand new nurse, but there is a learning curve for me. I guess I am using decent judgement, but this will take a bit longer for me to master because there is just so much! It is exciting, however. Any information you all can share would be greatly appreciated (as usual).