Re: I've always wanted to work on the OB ward..
RE: What can a LPN do in OB:
This is typical of my assignments (not assuming other facilities work the same way)
Labor & Delivery: Baby nurse (NRP certified)
Set up warmer and equipment (suction, oxygen, scopes)
Prepare eye ointment, Vit K shot, have rectal thermometer ready in KY jelly. 2 tolwels under heat well before baby arrives. Set up delivery cart for MD> maintain steril procedure.
As baby is born, decide if stable or not...if stable throw towel on mom's abdomen for baby, if not stable...take baby in towel straight to warmer. Begin to stimulate baby by rubbing and drying vigorously. Assess your APGARs at 1 & 5 minutes. Counts heart rate, resp, temp, listen to lung sounds, decide if baby needs suctioning. Admin eye oint, Vit K, RN will do nb assess during this time, weigh baby, wrap baby in warm blankets to be handed to mom. set up monitor for vs, clean up, ect. usually about 45min to 1 hour for mom and family to hold baby.
Begin recovery of mom and baby. mom's vs are frequent, baby's is q1hour (place baby back under warmer)fundal massage, initiate NS c Pit by pump, change peri pads. when baby's temp is norm...bath baby, back under warmer while drying, measuring, dressing. Rewrap and hand to mom or family. Clear equipment not needed out of room. This usually takes an hour up to several hours. Assist mom to bathroom, shower is desired, change bed linens, (we put another mattress on our LD beds). There is alot of teaching that goes on and alot of variables. Breastfeeding, lacerations, episiotomy, Natural and epidural births. After baby is transitioned...we take the security picture and set up the security monitor on baby.
A transitioned mom/baby is to assess mom & baby during your shift and we weigh babies every night. I can suction a baby at birth but cannot lavage one later. I can decided if it needs lavaging. I help new mom's learn to breastfeed. I can cut a cord that is left too long after birth. I feed lots of babies. I can do everything an RN can do with Mom (really like Med/Surg) except initiate a PCA or do an IV push. Once the PCA is initiated, I monitor it and can d/c it. If my iv push is a narc and I cannot find an RN (we do get that busy) Most of my oders do allow for an IM. I give my pt the option of waiting for the RN or have me pop their behind.
I was taught to scrub for c-sections. I set up the OR and assist the surgeon with delivering the baby. This is not a biggy. Alot of LPN's serve as OR Techs because RN's mainly circulate.
I go to the NICU. Full assessment on my babies every 4 hours, monitor vitals and chart every 2 hours. Maintain strict feeding schedule. Some are straight gavage, nipple/gavage, or straight nipple. strict I/O/s, weigh the diapers. I monitor vapotherm or oxygen. I have taken IV babies when times were very busy. But, with these, they are stable. I monitor them & call an RN when something needs to be changed. (TPN OR Lipids) Site becomes red. I DO NOT take unstable or critical babies (vents, post surgery, ect).
This is not by any means all I do but a general overview. Hope it helps.
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