Latest Likes For SoldierNurse22

Latest Likes For SoldierNurse22

SoldierNurse22, BSN, RN, EMT-B 46,902 Views

Joined Mar 29, '10. Posts: 2,217 (67% Liked) Likes: 6,984

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  • 5:12 am

    If I had a dime for every family member who thought this, I could retire!

    It's really rather sad, I've always thought, when you get some know-it-all family member with an iPad who thinks their 20 minutes of googling somehow trumps your education, CEUs and experience in your field.

    Oh, an they probably also want your input on their 5 or 6 self-diagnosed (of course) little problems. But God forbid you suggest they might be wise in seeking actual medical counsel for their issues, because the second you head in that direction, then *poof*! And you're just the stupid nurse again.

    **** you, WebMD!!!!!

  • May 22

    If I had a dime for every family member who thought this, I could retire!

    It's really rather sad, I've always thought, when you get some know-it-all family member with an iPad who thinks their 20 minutes of googling somehow trumps your education, CEUs and experience in your field.

    Oh, an they probably also want your input on their 5 or 6 self-diagnosed (of course) little problems. But God forbid you suggest they might be wise in seeking actual medical counsel for their issues, because the second you head in that direction, then *poof*! And you're just the stupid nurse again.

    **** you, WebMD!!!!!

  • May 18

    Nope, nothing I've ever seen, even in cases of severe maternal disease prompting a medically-indicated IOL (if anything, our docs are more aggressive about cervical ripening in those populations so as to increase the likelihood of vaginal birth. I mean, why not do it right from the start--the OR isn't going anywhere!). Our multips have to have a Bishop of 6 just to get an elective IOL, primips have to have a Bishop of 8. Even then, our docs usually use cervical ripening if mom is less that 3cm/50%.

  • May 18

    Nope, nothing I've ever seen, even in cases of severe maternal disease prompting a medically-indicated IOL (if anything, our docs are more aggressive about cervical ripening in those populations so as to increase the likelihood of vaginal birth. I mean, why not do it right from the start--the OR isn't going anywhere!). Our multips have to have a Bishop of 6 just to get an elective IOL, primips have to have a Bishop of 8. Even then, our docs usually use cervical ripening if mom is less that 3cm/50%.

  • May 18

    Holy contaminated field, batman.

    I'm good with "gentle" c/s practice in a non-emergent setting, but this...looks like you're asking for an infection.

    The natural caesarean: a woman-centred technique
    Interesting article, but with very little evidence behind it as this is clearly a new practice. Please note that the above article does not address an increased risk of infection at all.

  • May 8

    I know c/s patients at my hospital head over to PP with NS and pit running. However, I know most of our PP nurses take the NS down when the patient has shown that they are tolerating PO fluids/solids (usually about an hour or so after). We do maintain IV access for a certain number of hours after delivery, but it is saline locked and removed as fast as safely possible, as per our protocol.

    Pitocin, both intrapartum and postpartum, can cause water retention that can lead to swelling and breast engorgement and may interfere with mom's function and breastfeeding in the postpartum stage. Personally, I'd have no problem stopping the NS and maintaining a saline lock as long as mom is tolerating PO.

  • May 7
  • May 4

    As an L&D nurse, I can tell you a few stories about home births gone wrong. However, I could probably tell you even more stories about hospital births gone wrong.

    For all the concerns that people have about giving birth at home, people tend to forget that many of the emergencies that we see in a hospital setting are of our own making: aggressive induction, unnecessary induction, elective induction of an unripe cervix, jumping to start epidurals only to have mom's BP crash and baby circle the drain, excessively rough cervical exams, unnecessary episiotomies, impatient providers that can create traumatic birth situations, patients being bullied into c/s for the convenience of the doctor, postpartum hemorrhage from inadequate/poorly thought-out treatment plans, and a slew of other issues.

    What really amazes me is how many women these days (even in 2016!) blindly do whatever their OBGYNs tell them to do. One of our docs likes to induce primips the second they go past 39 and 6. Another one is an extremely aggressive cervical checker. Several prefer c/s cases to natural births, and another likes to scare her patients into "medical" inductions with her "11-lb baby" stories.

    Of course, on the opposite end of the spectrum, you've got the super-granola moms who want to deliver breech at home with a CPM, refuse Vitamin K, and absolutely will not hear the nurse/doc/midwife on why a c/s might actually be a really good idea. I've found there are very few women who fall in between these categories.

    Personally, I'm all for natural childbirth and home and/or birth center births with qualified, competent providers and a pre-determined, well-practiced emergency plan. However, I also wouldn't be sitting here writing this right now were it not for a very compassionate OBGYN who saved my life a few years ago, so I have no problem giving credit where credit is due when it comes to the vital, life-saving surgical skills unique to the practice of OBGYNs.

  • Apr 28

    It's certainly an art mixed with a science. Cervical exams take lots of practice. When I was a new L&D nurse, my preceptor would often check the patient, then have me check her. Within a few months, I was pretty confident.

    The Mystery That Is The Cervix – Cervix With A Smile

  • Apr 27

    It's certainly an art mixed with a science. Cervical exams take lots of practice. When I was a new L&D nurse, my preceptor would often check the patient, then have me check her. Within a few months, I was pretty confident.

    The Mystery That Is The Cervix – Cervix With A Smile

  • Apr 26

    To follow up to your story and springboard off my previous post, I had a patient a few months back who was admitted for an elective IOL at 39 weeks. She was a G1P0 and had a borderline favorable cervix, but overall, I felt it was probably best to wait, especially because her Bishop score was close to favorable, but it was definitely not good enough to indicate induction under our new policy. My charge checked her and fudged the numbers a bit, I think because she didn't feel like going toe to toe with the doc that morning.

    After my charge nurse left, I did exactly what you did. I advocated for my patient. I told her that if she kept her water intact, she could opt out of the induction at any time. I told her she could refuse an AROM and to make sure she stated to the doc that she didn't want to be AROM'd with a nurse witness present.

    Anyway, I left for the day and came back that night just as they were taking this patient back for a stat C-section for fetal distress and failure to descend. Apparently, baby had been having lates all day. They AROM'd mom when she was 2 cm and ballotable.

    As the icing on the cake, the doc had the gall to be in a huff and all pissed off that she had to section this lady because it was the doc's husband's birthday, and she was supposed to be eating out with him that night. Nevermind that this poor lady just had an unnecessary c/s because her doctor is a selfish, sad excuse for a human being. Nope, she was all mad because of the missed birthday dinner.

    OK, then don't set up an unfavorable G1P0 for an elective induction the morning of your husband's birthday and expect to be footloose and fancy-free that evening, you moron!

    UGH.

  • Apr 23

    Quote from apnurserock
    You must enjoy reading my post because you keep commenting with the same comment. once again I have none not in school trying to open up topics to network and get to know other nurses. As a nurse you shouldn't make dumb assumptions. Now if you don't like my topics don't read and don't respond. Obviously some people do because they have respond
    Actually, I figure other members of AN ought to know what they're responding to before they respond. You flooded AN with posts yesterday on many topics that already exist--and that is no "dumb assumption".

    Your posts are public. Anyone can respond. Please get comfortable with this concept as AN is a large and very diverse place and you will often get answers/replies that you may not like.

  • Apr 22

    Quote from jonnyvirgo
    statements like these as of late have really been beginning to irk me. Im all in favor of knowledge of pharmacology an pathophysiology, but you're not a low/mid level provider to act autonomously. CNAs MAs LPNs even RNs dont pass or prescribe meds based on their own findings. They assess, and pass it on to the all-knowing all-seeing docs from above that then tell us what to give. They know better, and if thats whats ordered, thats what we give. The knowledge only comes in handy if we're looking to make sure the doc hasn't overlooked something or made an error, which happens to just about anyone and everyone in healthcare at some point in time. Sure you could save a life, and sure it could cost a life, but the bottom line is, we're not nearly as autonomous as we'd like to think. We're merely extensions of the doc, being at all the places they cant be to free up time for them to Dx and Rx
    Wrong, wrong and more wrong. Your work is tightly connected with that of the medical care of the patient, but nursing care of a patient is inherently different than the medical care of that same patient. If you're merely an "extension of the doc", then how is it you can get sued for giving a medication that is contraindicated and the doc isn't implicated in the error?

    No, we don't prescribe. We don't write the "orders", we don't make the big decisions that people see. We're the ones who catch the errors, who make suggestions and collaborate with colleagues (physicians and other providers), hopefully for the good of the patient. How can we do that? Because we are educated and subsequently, we develop the ability to critically think by integrating our critical thinking abilities, bedside skills and knowledge of the patient, pharmacology, anatomy/physiology and pathophysiology.

    A very wise instructor once told us that patients don't get admitted to the hospital to see doctors. They get admitted for the skilled nursing care. After all, if you simply needed a gallbladder out and the doc was all you wanted, you'd get the surgery done and go home, right? Who needs dressing changes, vitals monitoring, assistance with pain management, etc? And while the doctor and nurse collaborate on many of the issues patients face post-procedure or during treatment while in a hospital, it is ultimately up to the nurse to assess, evaluate, advocate and carry through on behalf of the patient.

  • Apr 22

    Quote from That Guy
    It is just a job. Why should it be more?
    Every profession is a job, but not every job is a profession.

  • Apr 17

    I know c/s patients at my hospital head over to PP with NS and pit running. However, I know most of our PP nurses take the NS down when the patient has shown that they are tolerating PO fluids/solids (usually about an hour or so after). We do maintain IV access for a certain number of hours after delivery, but it is saline locked and removed as fast as safely possible, as per our protocol.

    Pitocin, both intrapartum and postpartum, can cause water retention that can lead to swelling and breast engorgement and may interfere with mom's function and breastfeeding in the postpartum stage. Personally, I'd have no problem stopping the NS and maintaining a saline lock as long as mom is tolerating PO.


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