Latest Comments by bbnurse

bbnurse 2,200 Views

Joined Aug 19, '00. Posts: 83 (0% Liked)

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    We test all patients without prenatal care or limited care. The state also will arrest mothers whose babies test positive at birth.

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    We have both meditech and OBTV. HP has a cable developed for Columbia/HCA but it is not available for other places...THIS is info' from the IS person where I work. It is a LTP? I believe.
    It was said to be bi-directional. Iatrix also is working to devlop one.
    We don't document in OBTV since it doesn't export to meditech at this time. HP did tell us that meditech can co-reside on the OBTV screens but they didn't advise it. It also depends on which revision of OBTV you have.
    It's certainly an issue to transfer paper info into meditech.
    I actually like the latest upgrades of meditech. It allows more ease of movement in the nursing module. It is more windows' based.
    I do not like HP but am surrounded by it everywhere I look.
    YIKES!

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    Hey everyone!! Thanks for the insight and the answers. I wasn't sure how other places did their meds.
    I don't like other people mixing my meds either so I know it's the control thing. I understand that it isn't the same level of care if I don't mix it in a laminar hood: BUT I DON'T REALLY CARE.... I know what I'm mixing and how.
    I, too have seen pitocin look like water then have a massive decel and tetany. Odd thing, the human body!
    Thank you again for the input. I wonder where your pharmacy get the premixed bags of pitocin. Our pharmacist hasn't found a source. Do you know the IV solution vender? I'm surprised that you have 40 in 1000 for the mag. Our director is having major palpatations about 20 in 500. Thinks it will get away from us and have fatal results(as well it could, but geez, what's my job if not to watch out for that kind of error?).
    What do you use as the vendors?

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    We just started using Pyxis and a recent survey we were told that nurses in LD should not be mixing pitocin, nor mag. We should use standard premixed bags of these meds.
    What mixture of pitocin do you use? Is it standardized?
    What strength of Mag sulfate is used as bolus and then maintanence doses?
    Obviously, who mixes it in routine situations? What does your hospital consider "emergeny" criteria which allows the nurse to mix these?
    We're really trying to find a way to comply with the new pharmacy standards the rules folks are pushing.
    Thank you for any help you can provide.

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    I went directly into Maternal Child many years ago and have NEVER regretted it at all. I firmly believe that most OB nurses are "born"...that we know from the first that we love it and will always find a place to work that allows us that expression of love. Many others stumble into OB and find they have the capacity to do it well and love it too.
    I worked in long term care, did consultation work and have worked in small hospitals requiring me to float to med/surg and ICU. I could function in all areas within reason, but I always asked questions and never assumed that I knew M/S as well as those who work it constantly. All these other experiences taught me valuable lessons but I did learn the art of prioritization, assessments and caring in Maternal Child. I think you take what you learn in school, use the basic principles applied to wherever you are and LEARN from others. You can learn anything anywhere with the right attitude and approach.
    I have and will always accept applications from new graduates if I have that option. They are eager and generally know WHY they went into nursing--meaning they went into it to be an OB nurse.
    I encourage new grads to try applying. You never know what might be happening in the unit, making the director open to hiring a new graduate. It at least gives you the opportunity to make a positive impression about your love of OB and maybe keep you in her mind at another time.
    I'm surprised so few people have responded to your question. There are lots of OB nurses who absolutely love it and their regrets are few.

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    Our nursery has been routinely performing a blood glucose test upon admission and in 2 hours. The majority of peds and GPs agree that this will diagnose and prompt intervention for the asymptomatic infants and prevent brain damage by quick treatment. One physician insists that only LGA, SGA and infants of gestational diabetic mothers are to be tested. Our standards and orders suggest routine screening at birth and in two hours whether at risk or not as well as PRN.
    WHAT does everyone else do? Is there a national SOC ? Where would we find literature to support one or the other of these practices?
    We are all very stressed when we forget and test his babies. And we need some data to support or delete our current practice. It would obviously cost less to only test those at risk babies as listed.
    What do you think? Any help would be great!!!! :hatparty:
    Thanks

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    So WHAT did the Pain seminar suggest as the best analgesia meds for active labors???
    We use Stadol and Phenergan combo and epidurals or intrathecals with fentanyl.
    Did you answer this thought or did I just flat miss it?
    Thanks.

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    Stable, to us, means not in active labor, in crisis for whatever the admission dx was or near term. May include controlled gestational diabetic, arrested preterm labor, pregnant with a medical or surgical problem or things of this nature.
    Unstable is active labor, bleeding, unconscious, seizing, etc.

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    We use fetal fibronectin but it has not been 100% accurate either. We start with Brethine and move into Mag if not successful. Our biggest issue is poor compliance by the patients when they go home. "I didn't like how it made me feel". Maybe they'd like to spend months in NICU instead. Drives me crazy that how "I" feel is more important than the health of my baby.

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    We use pitocin in the IV fluid rather than straight IVP, and bolus for about 500cc. The PDR and ACOG does not recommend straight IVP of pitocin. And it is after the placenta.

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    We do self scheduling and use a sign up sheet with only slots for the number of staff required for that day. No one else can work those days when it is filled in. We have fulltime people fill in first, then the part time , then the prn people. It works really well.

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    The yogurt remedy is supposed to be with the "LIVE" yogurt so the ones displayed on the wonderful full page colored ad, just won't make the grade....
    So that makes it really ineffective with the "fruit".
    Viva the difference!!!!!

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    use your AWHONN Guidelines for staffing to support the correct staffing ratio for acuity. Even if the state requires less, the national standard is what the lawyers will use.
    good luck

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    Age is irrelevant and rudeness calls for patience. Not that I think the question was appropriate but I wonder why she would ask it.
    My first instinct was to say that sort of confrontation was very childish on everyone's part. However, one must defend themselves. I think with time and with the suggestions you have read on here, you might agree that there are other things you might have said that were more gracious and less cruel which would have strongly made your point. Sometimes this type of experience helps us learn to practice the skills taught in nursing in all avenues of life, not just in the clinical arena.
    Just for the record, not as a criticism,why is the word "disrespected" used? There is not such word but I hear it a lot. Is this slang common among the people in nursing now?

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    Well, nurses don't do this type of "coding" or "classification". This is the physician's role to indicate the diagnosis.
    Nurse's record in the medical record the observations and measurements on the laboring/delivering pt., but do not make that type of notation.
    Good luck. The medical records coders might be able to answer for you. And your comment: "....Medicare does not deliver a lot of babies" fits the issues that all those 1000 codes have created.
    Too many rules by folks toooo far away from the bedside. I'm not trying to be rude, it just is part of the reason no nurses have answered your questions.
    Hope you find a system.Try a medical records coder for your answer.


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