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monkeybug 8,218 Views

Joined Feb 26, '10. Posts: 726 (60% Liked) Likes: 1,614

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  • Apr 11 '14

    Hello,
    I am currently going through fertility treatments to try and conceive and have been a L&D nurse for 2 years. I won't lie some days it is really, really hard to be sympathetic and caring. Especially when people come in whining and complaining about being pregnant and that is all you want in the whole entire world. It is also very hard when you are taking care of the patients like the one you described or the mom who is having her 6th kid and either can't afford to take care of or doesn't have custody of the other 5. But on the other hand there are those absolutely wonderful families that you are so happy for and know that they will be wonderful parents, or the couple that battled with infertility and finally is getting to have their miracle baby...those days are WONDERFUL!!! It is all in how you approach the situation. I have had to learn how to be caring towards people that I don't always feel deserve it and I feel like I be a better nurse for that lesson. I do feel that you can be an OB nurse while dealing with infertility...it won't always be easy but the job is so rewarding that I feel that for me personally...it is worth it.

  • Apr 11 '14

    @monkeybug I did my clinicals during the LVN program in L&D, I remember it was such a great place. Unfortunately the hospital only hires RNs. But I remember I had the most fun in L&D than any other place I had clinicals.

  • Apr 10 '14

    Quote from klone
    I blame wine. Seriously, I'm not educationally superior. I just expect a modicum of respect for research among healthcare professionals. That said, where *was* that cut and pasted from? And really - your only response is to nitpick my grammar?
    Yeah, that was ****** of me, eh? Sorry. Really. It's that some of your responses sounded so condescending that I put my nice away for a minute.

    We're never going to agree on this subject so we should stop trying. I'm not trying to convince you, per se, anyway. I'm trying to give those who are on the fence about the subject some food for thought. I have both professional and personal experience with hospital vs home birth and my son's near-death birth experience made me an outspoken advocate for hospital births long before I became an L&D nurse (which only solidified my position). I see what goes on behind the scenes at the hospital and it isn't the conspiring to get a woman back to the OR like you are convinced of. I'll repeat myself by saying, the laboring mother is NOT out of control of her birthing experience at the hospital. You just have to do your research, choose the right facility and healthcare provider and be willing to ask for another nurse if the one you're assigned isn't supportive of your birth plan. Ok, the end (for me). The rest of you carry on

  • Apr 10 '14

    Quote from klone
    Did you C&P this from somewhere? If so, you are committing plagiarization
    Did you mean plagiarism Klone?

    I normally wouldn't point out such a blatant grammatical error but she comes across so educationally superior to everyone that I just couldn't help myself.

  • Apr 10 '14

    http://www.ajog.org/article/S0002-93...155-1/fulltext

    Homebirth 4 times more likely to cause fetal death. Please note that this is a US study. Any study conducted outside of the US is irrelevant because of the differences in education and health care delivery systems.

  • Apr 10 '14

    Which is why I am in support of all homebirth midwives being certified. Preferably, CNMs. Of course, for that to happen, homebirth needs to be decriminalized, with OBs and hospitals being willing to collaborate with them (like they do in Europe).

  • Apr 10 '14

    Klone, low risk women have babies who crump for no reason at all at or shortly after birth. Low risk women hemorrhage, have shoulder dystocias that DON'T resolve, no matter what maneuvers you perform and develop preeclampsia in a day when the day before they were just fine. Being very close (like across the street at a birthing center) or in a hospital is the only thing that will save some of these women. Why take a chance? You or your baby could be the next statistic.

    In your downtime, read hurtbyhomebirth.blogspot.com to see real faces, real names and real stories if you don't believe me.

  • Apr 10 '14

    Quote from SanDiegoCaliRN
    I guess that's a matter of opinion. I happen to think choosing to birth at home is extremely risky even for "low risk" women. They put themselves at the mercy of their midwife and her assessment skills and willingness to "throw in the towel" and finally admit this is a more critical situation than she can handle (and trust me, many throw in the towel way too late). But will there be time to get to medical help? Sometimes, no.

    No one ever sees shoulder dystocias or thick mec coming. And yet home births are usually post term, larger babies at increased risk for both). Add to that another unforeseen, a tight nuchal and you could have a deadly situation that spirals out of control very quickly.

    I'm sorry, I just don't see the wisdom in potentially risking yours and your baby's lives and for what? To deliver in the comfort of your own bed? Apparently these women don't know how bad things can turn in the blink of an eye. Maybe I've just been in this business too long and I've seen too many bad things. Birth may be a natural part of life but it can also be deadly. Death is a natural part of life too. Why take chances?
    You know, women who birth in the hospital throw themselves at the mercy of whatever L&D nurse she gets, whatever OB happens to be on call, or if they aren't private, whichever resident happens to be there. There are plenty of residents who don't know when they're in over their heads, plenty of L&D nurses who rely on the monitor rather than actually hang out with their patients and labor them, and plenty of **** that happens in the hospital that's way less likely to happen at home. The numbers just don't bear out the assertion that homebirth is extremely risky for low risk women.

    Again, this is a great argument for making midwife-assisted homebirth legal in all 50 states so that women feel that they can freely choose and not be sanctioned (or risk exposing their midwife to jail time). What we have right now in my state when there is a homebirth transport is that either she dumps laboring mom at the hospital way too late and bad things happen, or she comes in pretending to be the doula. Make it legal, and it's a whole lot easier for a midwife to call an OB/hospital and say, "Look, I've got this patient and I suspect a breech, so I'm transporting to you," instead of going it alone at home ending up with entrapment. Or "She just ruptured and the fluid looks like pea soup, so we need to come to the hospital," instead of a baby with MAS on head cooling. Right now? Can't happen, and as a result there are poor outcomes that turn so many folks against home birth.

    I have two friends who between them had three home births in my state, with different CPMs attending the births (illicitly) and each time things came up that were unforeseen. All were able to be dealt with at home using emergency equipment that the midwives brought along, as they should. Two births (same patient) were postpartum hemorrhages r/t atony, managed by IM Pit and PR cytotec. Her third pregnancy was risked out because she was too anemic. My second friend's emergency was shoulder dystocia. Because she didn't have an epidural, they were able to Gaskin her, get baby out, and give him PPV when he came out depressed. He did beautifully. Ina May Gaskin, for whom the maneuver is named, reports never ever being unable to get a shoulder dystocia baby delivered when Mom is on all fours.

    It's okay to be personally uncomfortable with the idea of homebirth, but skilled birth attendants (and that is the key....skilled) do make the difference, whether at home or in hospital.

  • Apr 10 '14

    Quote from klone
    See the thread in nursing news regarding homebirth. More women choosing homebirth is not a bad thing, as long as they're appropriate candidates.
    I guess that's a matter of opinion. I happen to think choosing to birth at home is extremely risky even for "low risk" women. They put themselves at the mercy of their midwife and her assessment skills and willingness to "throw in the towel" and finally admit this is a more critical situation than she can handle (and trust me, many throw in the towel way too late). But will there be time to get to medical help? Sometimes, no.

    No one ever sees shoulder dystocias or thick mec coming. And yet home births are usually post term, larger babies at increased risk for both). Add to that another unforeseen, a tight nuchal and you could have a deadly situation that spirals out of control very quickly.

    I'm sorry, I just don't see the wisdom in potentially risking yours and your baby's lives and for what? To deliver in the comfort of your own bed? Apparently these women don't know how bad things can turn in the blink of an eye. Maybe I've just been in this business too long and I've seen too many bad things. Birth may be a natural part of life but it can also be deadly. Death is a natural part of life too. Why take chances?

  • Apr 10 '14

    Quote from caregiver1977
    And I don't want to be seen as someone who brings race into everything, but at some hospitals, especially in the South, black patients who want to ask intelligent questions about their healthcare and medical treatment are treated very, very badly. I'm not talking about patients who only want to argue, threaten, or curse. There are patients who merely want information and are treated badly for not just shutting up and taking whatever the hospital dishes out.
    Hate to tell you, but as a Caucasian woman and nurse who ended up with a very unpleasant AA OB, when I asked intelligent questions about my care or *gasp* refused certain treatments I knew were unnecessary at the time, I was treated like an idiot and given attitude too. So I don't know how much of it has to do with skin color and how much of it is just docs with God complexes.

  • Apr 10 '14

    The thing about birthing plans are that they are contracts as to what all parties will expect from each other. There is one signatory who is absent, however, and that is the one known in nursing parlance as "the passenger."
    I actually tell this to my patients. I tell them that I will read it, and then we discuss it. Every once in a while, it will be sensible, and just lets me know that these are people who have hopes, fears, and are cognizant of the fact that ultimately, the goal is a living mother-baby couplet. Sometimes, sadly, that is at the expense of having the birthing plan adhered to.
    One recent case of a mother who was trying for VBAC resulted in her baby's demise because she did not want a repeat cesarean delivery, and all signs showed that not only was the baby in distress, but he was running out of reserves.
    It wasn't her plan to have another cesarean. I don't think that it was her plan to have to make arrangements to bury her baby, either.
    On the other hand, an experienced and knowledgeable Labor nurse is also going to be helping her patient to change positions for maximum comfort and best placental perfusion. This becomes easier when the nurses are not to take on two laboring patients, and at least one of them wants to try for unmedicated childbirth. Between teaching, comforting, and finding the fetal heart tones again, and, oh, how could I forget, charting all of these things, such that a lawyer cannot find fault with them, being creative is a lot to ask. Flexibility and charting are mutually inimical to each other, if you have more than one patient, and we often have two. "Tying'em down," with the monitor means that while you are not giving everyone the best experience possible, you are able to do what you are supposed to do. Staffing ratios do not take the needs of the staff and patients in mind, especially when a little thing like happiness is concerned.

  • Apr 10 '14

    Most of these birth plans are simply funny and I'm telling you why. Most of the people who choose a birth plan are new parents, never been through pregnancy, labor or delivery. To laugh or to smirk at a document is not making fun of the person. Most of these so called birth plans come from web sites in which people just click on boxes and they don't even know what they're clicking on or not clicking on. How can you say you consent the circumcision for your baby girl? Really? Do you even know what a circumcision is? Vitamin K is not a vaccine, it is used to help the newborn with clotting since their ability to do it doesn't come in for a few months and there are things that could happen that not having gotten vitamin k may result in the baby's loss. People are not educating themselves the correct way. Or the are over educating themselves totally the wrong way. Example "I'm 35 weeks already, I'm fat, I'm swollen, I want this baby out now, my sisters best friends cousins mom had a bay at 35 weeks and the baby is totally fine". Things and comments like that are the ones that get the laughs. Not being ignorant but choosing to be. Labor is a serious thing and when someone has all this expectations and denies even having an IV with saline water not even pit, it's when the problems start. It's like they say "it's not the same calling the devil but seeing it come", you could be having the best labor in the world, baby's heart drops and you continue to decline a c-section because it is not part of the "birth plan" keep that up and there will be no "birth". Also home deliveries with lay midwives who are not even nurses is another bad idea. But people still think it's ok. Yes, many, many years ago everyone was born at home, but how many of those mothers and/or babies didn't make it because in the middle of pushing they discover a prolapsed cord or that the baby turned and now it's breech. Now what? Birth plans can be ok. A woman should be ok to have her preferences but also needs to keep an open mind that things do go wrong and can change in a matter of minutes.

  • Apr 10 '14

    Quote from ratlady
    To be honest, the whole point of this thread makes me sick. To laugh at women and their birth experiences. It's not a laughing matter, and these women are very valid in their feelings. I think if nurses want to laugh at their patients maybe they need not to be a nurse in the first place. We need people who care, not people who obviously don't belong in this specialty if they are going to further drive up the c/s rate because they laugh at mom's requests. Maybe its not the mothers who aren't educated, but the nurses.
    I don't work in L&D but as a nurse I feel we need to be able to vent & have a sense of humor about things. If we don't, the job will eat us alive.

  • Apr 10 '14

    Quote from caregiver1977
    And I don't want to be seen as someone who brings race into everything, but at some hospitals, especially in the South, black patients who want to ask intelligent questions about their healthcare and medical treatment are treated very, very badly. I'm not talking about patients who only want to argue, threaten, or curse. There are patients who merely want information and are treated badly for not just shutting up and taking whatever the hospital dishes out.

    I have never seen this. I thoroughly enjoy when my patients ask me questions, regardless of race, because it sows they actually cae and want to do the absolute best for their babies.

  • Apr 4 '14

    I caught a little bit of a reality show the other evening, and one of the people on it said that if things didn't work out that she would have to return to finish her "medical assisting degree". And there lies the issue.

    There are many techinical schools that promise the sun moon and stars for people to obtain these certifications at a huge price, or the schools know that their students can and do get grants (and loans) to go through their programs. Further, some states have these certifications as part of the "welfare to work" and/or "get off unemployment" tactics. In theory, one could assume that once that is was thought of that there wasn't a whole lot of jobs, now the hospitals have come on board to offer alternatives. And literally, some certification programs (and not just exclusive to medical assisting training) do refer to this all as "a degree" and use language such as "your clinical practice". So really, people come out with a certificate that they believe are degrees. Which is scary on a number of levels.

    Medical Assistants, no matter what their cognitive ability, are not licensed, therefore someone needs to be responsible for their duties. A number of LPN's in search of the "coveted" hospital position, are more than willing it seems to take that on.

    I am not sure how in the world that is going to work out and at what cost to the patient. However, I am sure that the facilities will make a profit in the end...


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