Mermaidblues 846 Views
Joined Jul 14, '12.
Posts: 8 (25% Liked)
"Force" is a strong word. Circumcision is not the only thing that can put a baby at risk for a bleed. Head trauma at birth is the main reason for Vitamin K. Considering how babies get here, they are all at risk for that possibility.
I loved my birthing ball during pregnancy and still do! However, our Dept. Director and Risk Manager have had them outlawed at our hospital. I still encourage pregnant moms to use them for comfort at home.
I am a L&D nurse and I also teach a pre-natal parenting class. I have seen many a nurse cringe or roll their eyes over a birth plan--in fact, I might have even done it a time or two myself! However, this is how I explain it to the first-time parents in my classes: 1. This is a hospital setting, therefore, there are rules and regulations that are there for your safety. Some things may not be negotiable.2. Please make a plan! But before you go print something off the Internet, do your homework and then gather your info. Talk to your OB provider, take a hospital tour, take a birthing class, read about the subject. Talk to your coach/SO about what you feel is really important to you, then talk to your OB provider again!3. While making this plan, remember to include the words 'flexible' 'if' and 'just in case' somewhere in there. Also remember: "Life is what happens while we are making plans!".4. You will remember the birth of your children forever. Try to make it meaningful for YOU. Not just based on how someone else thinks it should be.5. Trust your body to do the labor part and stay out of it's way! Trust your medical staff but never stop asking questions.
I think that as OB nurses, we all struggle with outcomes that we feel might have been prevented by the Mom making better choices. Not all end in loss of life to be sure! I have and always will try to be honest and straight forward when discussing what some of those "choices" might do to alter a baby's health or the health of the mother herself. It helps to know that, while I have walked the walk and talked the talk for over 30 years, my patients have not. Do I have to swallow a little bit of anger, impatience, or bitterness occasionally in order to care for and educate moms to do what is right for themselves and the baby inside of them who cannot choose for him/her self? Yup. But because we know and see firsthand every day just how good and bad it can be, we are in a unique position to have an impact that just might change someone's whole way of life. That is what it's all about for me.
We call it "transition nurse". If L&D nurse only has one pt, she usually does it herself. We keep a baby cart stocked that gets brought to the LD room near delivery time that has everything but meds in it for the NB. after the delivery,once we have wt,time of birth, etc, the info is given to the secretary who admits the baby, then meds can be pulled from the Pyxis. Baby stays with Mom unless there is a low apgar score, or some other reason not to. We have a level II nurse who an attend deliveries if a complication is anticipated. Nursery has the chart made by secretary. Only thing babies go to the NSY for is hearing screen or illness. It does take preplanning and cooperation with other areas like pharmacy, admissions and Peds to work out all the kinks, but it can be done. The benefits for mom/baby and continuity of care speak for themselves.
Pay attention to the little things. Treat your patients as you would want your family to be treated. Listen to your more experienced peers--most got their wisdom and patience from making a few mistakes. Oh--and about mistakes, you'll make at least a few--we all do! Own up to them--learn from them, they will teach you valuable lessons. If you don't know, or understand something, or something makes you nervous, ASK FOR HELP. Take the time to advance your knowledge and skills on your own, don't wait around for someone to offer. Last but not least, smile, be kind, and try to remember that the one patient that you believe is causing you to have the worst day ever, is probably not having such a great day either. I wish you luck, organizational ability, and a long, interesting career!
Currently, whoever has the lowest acuity pt assignment at the beginning of the shift is assigned to take the next admit. But that can change on a dime if there are deliveries going on or epidurals being started. I guess what I'm asking is, how do you keep up with who gets the next one? Also, once you figure out who that is, I need some good strategies for for getting them to actually accept care of the pt in a timely manner. If the tech simply takes the pt to an LDR, I am still responsible until we can track down the person who will be accepting care. This can be time consuming, because most of the time we don't have a charge nurse in L&D. Sometimes the secretary knows who, but not where the lucky person is. Meanwhile, back at the ranch...I may have 2-4 other triage pt to deal with.
I am looking for ways to improve hand-off reporting from Triage nurse to L&D nurse. A little about our unit: We have a 5 bed Triage area staffed with 1 RN and a CNA from 7a-7p and 1 RN From 7p-7a. Our L&D has 9 beds with a staff of 4-5 RN's during the day and 3-4 RN's at night. We cover our C/S and recover them as well. We have a scrub tech dedicated 24/7 most of the time. We start mother-baby care at delivery (barring complications) which means we do most newborn transitions in L&D. We do have bedside/desk surveillance.So here's my question. When a labor or Antepartum pt needs to be admitted to L&D, how do you efficiently make the assignment to the nurse and make sure that report gets given when things are (always)busy? Often, I am sure stuff gets lost in the shuffle or too much time is wasted trying to find out who is supposed to get the next pt. I have been on both ends of this, and am aware of the frustrations and pitfalls on both sides of the coin. Anyone have any ideas on how to make the hand-off go more smoothly and safe for the patients?
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