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- Feb 8, '10 by noreenlStephB1213!!! OMG! i did the same thing in OB. I was in my first delivery ever! I had just gotten off after working overnight as a CNA @ a big public hospital (RN, 2 LPN and 2 CNA)on a busy med-surg/HIV unit 28 pts. I think I had maybe a cup of tea and a bite of a roll while diving from LI to St Mary's in Bklyn. Everyone was raving how this dr had a zero infection rate and rarely any bleeding issues. What they didn't tell me was she was this tiny little 4 ft 10 filipino woman who had to use a step stool and still all you could see was the top of her head across the table over mama's belly.
This pt was having a CS so I was really interested and she let myself and my partner come in pretty close. Everything went fine for the delivery and then the doctor put down all her instruments and put on fresh gloves and then proceeded to check the uterus for bleeding or whatever, I don't remember tooo much after that because once she raised the uterus out of the pelvic cavity to visualize I WAS OUT LLIKE A LIGHT!
Somehow I didn't hit a single piece of equipment or break sterile field, but I'm told I'm a graceful fainter!!
- Aug 3, '10 by friecpQuote from ElvishHello! I applaud you for diving into this subject topic. I am primarily an Antepartum RN, however, I frequently get pulled to women's health (med/surg for women), full term nursery, & post-partum care. Currently, our new mother's & their babies each have their own nurses. But, like you said, each specialty comes with it's own unique situations & challenges.I'm excited about blogging from the trenches of mother/baby. "Why 'trenches?'" you might ask. From the outside it seems as though mother/baby nurses have a cake job and in comparison to some jobs, we just might. But this is nowhere near 'easy.' Spending twelve hours caring for new families, getting/keeping breastfeeding going well, showing new, tired, overwhelmed parents how to care for their baby, making sure said new baby stays well, and any host of other issues are par for the course.
I also work with stable antepartum patients as well as in the newborn nursery. Each of these patient groups brings a set of challenges that is unique. With antepartums, the question is not generally 'if', but 'when' they will 'break.' Getting to know these patients is generally joy but their situations are often heartbreaking as they face a pregnancy with unexpected complications and did not plan on spending weeks on end in the hospital unable to get up except to the bathroom.
When I'm in charge in the newborn nursery, I may not see all 35 babies I'm responsible for but I'm responsible for them nonetheless. Most babies, very fortunately, have no problems and go home as expected. But on the occasion when things don't go as planned, it's my job to catch those things, which may be a subtle as 'this baby doesn't look right' and have to convince a pediatrician of that, or as blatant as having to resuscitate a baby who's quit breathing.
I'm hoping in this blog to convey some issues that nurses in the above fields face, shed some light on common (or not-so-common) patient conditions we face, and questions that we ask ourselves on a daily basis.
Come along for the ride!
Currently, I am struggling with what the justification & rationale is for being able to pile on 7-8+ postpartum patients onto each nurse per shift. I was told that it's ACOG's standard of care nationally that this can happen. But, I question if the number & rate of c-sections, which are considered surgical procedures like any other surgery, was taken into account whenever this "standard" was written & passed. Times have changed & c-sections are on the rampage!
I am particularly concerned with our facility's outrageous c-section rate & the postpartum care protocol that follows this procedure. I was told that our facility has a c-section rate of around 70-75% (if not higher). I was just wondering if this rate is as common in other places or just ours?
Please know that I have absolutely nothing against having a c-section. I've had one myself. In fact, it's what probably saved my son's life. But, I say use everything in moderation. Anyway, if there's anyone out there that can direct me to ACOG's printed standard of care for the postpartum nurse (specifically regarding they're patient assignments...etc) I'd greatly appreciate it!
Thank you & God bless all of you hard working nurses!Last edit by friecp on Aug 3, '10 : Reason: misspelled word
- Aug 3, '10 by LuvofNursingWow, 75%! That is quite high! I'd say my hospital is around 30% (although our hospital DID just put an end to mothers having an option for a VBAC). I think c-sections have become so common that we need to sit back and remember that we are performing surgery... and in our case, leaving that baby with that surgical patient to be cared for (in mother/baby). Surgical patients come with a plethora of additional potential complications that deserve a keen eye and careful attention. We need to perform hourly respirations, O2 and level of sedation checks on our c-section patients (not counting the post op vitals). If you have 75% c-sections, you are in and out of rooms without taking into account if the patients need anything out of the ordinary.
I, too, am not against a procedure that could save a baby or mom's life, but we need to consider the complications of surgery as well.
- Aug 29, '10 by BubbamellI work on a m/b unit and I understand they may increase our patients to 5 couplets...we are now at 4! Sometimes 5. We are primarily a cs unit, I am guessing about the same percentage as your unit. You know how it is trying to make people happy and give good care to 8 pts. let alone 9-10! Our ratings went down and I am sure if we take on another couplet it will go down again. I don't have to tell you what can happen and how fast it can go downhill...a baby goes bad, pp hemorrage or something. Mother/baby is nothing like CCU,ICU,MSURG,or the ER, but it is exhausting. Those new mom hormones with mine are crazy!
- Sep 23, '10 by NYtoPA2002Thanks for this thread, I have an interview with the M/B unit at my hospital next week and finding this post could not have come any sooner. I have once worked on the M/B unit at another hospital as an extern and I really enjoyed it working with the new mommies and families, teaching and educating on their new roles, etc.
My first experience in OB was during my clinical rotation, I was given the chance to sit in on a CS then the surgeon allowed only one student to assist him and I was the chosen one. My instructor always told us to eat before coming to clinical because we will never know who is gonna get pulled in for a CS, well I did not listen and I went into the OR, with a growling stomach pain, lightheaded and feeling faint. I dont know what happened that day, all the signs were there that I was going to drop but I guess my anxiety and anticipation of the unknown kept me afloat. With the first cut my heart pounded and I no longer worried about fainting, I worried about contamination. Then the surgeon asked me to participate and hold down a slit as he cut the sac and when I seen and felt the fluids rushing I was in love. I knew that I wanted to go into any part of Women and Children Health.
I now feel that this my time.
So thanks for this blog and I will continue to keep in touch.
- Sep 24, '10 by katebaby17I love this, cannot wait to become a labor and delivery nurse <3
- Sep 24, '10 by shusterman10I remember the days when i was still working in the hospital..oh i just love to watch those newborn babies...they are so cute...and when they cry , whoa what a noise