Duties of OB nurses (and others) Please feel free to add!

mari31666 · Aug 20, 2007

All L&D nurses are ACLS certified, because we circulate surgeries and do postop care.
All surgical patients in L&D, be they Csections or cerclages, are on EKG monitors for a minimum of one hour postop.

we do circulate and scrub for c/s, d&c, d&e and cerclage removals. we all do recovery room also. we are required to have BCLS. the circulator also does baby care, but peds is always at every c/s (circulator must page them at the start of c/s). Anesthesia must be present in OR and is on the unit or the anesthesia on call room 24/7. they must respond to all codes.

they have to be available at all times and we page them prn. almost all our patients get epidural so they are responsible for the patient as well as the nurse and the residents. even for private patients, everyone responds to the emergencies and near misses.

it's team work. all of us are overworked and over burdened but we seem to get thru it.

MamaMadge, ADN, BSN · Aug 21, 2007

Passionate,

Yes we have two ORs where I work. We are all required to circulate as L&D nurses. We obtain our training through a Circulator course which is an 8hour classroom/reading course, taught by a seasoned RN with L & D and OR experience. Then we have to be proctored for 10 or so cases (more if necessary) until our proctor feels we are ready to be on our own. We are all required to be ACLS certified although this is a work in progress. We always have our CRNA in house during the recovery of our post-op patients so while we are responsible for the patients, they are a quick shout away if needed.

I really enjoy circulating, however, working on nights it is nearly always a crash section!

Irisinthemorning · Aug 29, 2007

It's after midnight, and I have just returned to look over some of the threads. I have read the list of duties and no one has added:

and ALL other duties as assigned.

Amazing, I have been in nursing over 40 years - the complaints are the same

and the overwork never ends. Pay does not compensate - EVER, so we continue

to look for the satisfaction of knowing we are doing the best we can for our patients under the circumstances we are given to work in.

When you look at it, we stay because we want to stay. As nurses, especially today the marketplace offers other opportunities. Yet, who would be there to catch those babies when their doctors aren't there, or help that gyn patient get up and about after her hyst.?

What we nurses need to do is learn to take care of ourselves. Do you have a hobby or something that will relax your body and mind? Do you spend time with your family? No, make time. No job is worth it, nor will your time ever be more well spent than with family. No family, spend time with friends, and preferrably not talking about work. Exercise, go for a walk, see a movie (even if at home), read a book - MAKE TIME FOR YOU!

Nursing is a rewarding and fulfilling profession, if and when you remember to take care of yourself - first.

To Mamababy Nurse- there is a reason why you are where you are, one that you may not have discovered yet. Look around and see if you haven't made a difference in someone else's life, that you wouldnt have had you still been up north. Look for something positive to hold onto each day. I too transported from up north, took me over three years to get used to it, and then I wouldn't go back. Hope things get better for you.

God bless you and all who read this.

:balloons: "God is good...all the time."

NurseShelly · Aug 30, 2007

Thanks! This is so helpful. I'll be making the change from Med-Surg to L&D very soon. This list really gives me something to go on in terms of review. I'm feeling a little intimidated however, any other advice you have to offer would be really helpful. Thanks again!

IrisZ · Sep 15, 2007

Thanks! Very comprehensive list!!!

I would like to add to your list:

Genetic termination

Amnioinfusion setup and assist

APGAR for newborns

General anesthesia assist (cricoid pressure application etc.)

Non-pharmacologic pain relief (sterile water injection, double hip squeezes, counterpressure, massage, etc.)

Giving report to colleagues, pp nurses

Taking photos for patients/babies/families.

ERGirl83 · Oct 9, 2007

I don't know how many times a patient has been "pushed" to breast feed when they where not interested. There is a line between teaching and bullying and though I am pro breast feeding I feel that the patients belifs and deires NEED to be respcted.
I totally agree with you. if it's a 1st time mom , i try to encourage her a little bit more (only because sometimes they are just afraid becuase they they think it will hurt) but for those that have other kids, i leave them alone.....these moms know what they are doing and dont need to be guiltied into one method or the other.....

If only you were at my bedside when I delivered my son...I am an educated, highly-intelligent woman who made the decision during my pregnancy not to breastfeed (for a myriad of reasons intensely personal to me) and after repeatedly stating this during my labor, I was still asked to breastfeed ASAP, and when I politely declined, a lactation consultant was sent to my room to "educate me," as if I hadn't done my own research prior to coming to a decision. I was even more offended when I had to call my nurse to request some formula, and was given yet ANOTHER lecture on attempting to breastfeed. It was tiresome, rude and offensive.

Anyway, that got longer than I intended, I just wanted to let you know that your efforts on behalf of your patient do not go unappreciated. I'm all for education, because I do believe in the benefits of breastfeeding, but there's a difference between educating someone and berating them. I'm glad to know at least your patients won't feel so belittled.

vandermom · Oct 9, 2007

There are so many patients that come to us that are "going to try" breastfeeding. We get this baby latched on and doing well then find each time we mention the next feeding the patient kringes then finally cry her heart out that she really did not want to breast feed but that her mother-in-law insisted that she would be hurting her baby if she did not.

Sometimes we need to advcate for the patien and not the baby. What kind of bond we we creating when this mother kringed every time she picked up her baby. This is her baby and they are her breasts and given the informed choices she chose to bottle feed. The change in this mother was like she gave birth over again and now was in love with her baby. This mother drops by to visit frequently and brings her very happy healthy baby with her so we can play!! She thanks us each time she visits for allowing her to make her own choice.

ktrot31 · Nov 9, 2007

For the benefit of new nurses and future/prospective OB/GYN nurses and doulas, midwives, others, thought I would try a sticky that discusses various duties/skills sets and other characteristics that make a "good", well-rounded OB nurse, doula, midwife or other professional dealing with Women's Health Issues. This question seems to come up now and again, so let's help em out.
I will start. Here are skills sets for OB nurses that I found apply in most areas. Again feel free to add to this; I want to learn as well!
***********************************
OBSTETRICAL ASSESSMENT SKILLS
Inbound facility tranfer unit
Outbound transfer to other facility
Identify fetal position (Leopold maneuvers)
Fetal heart tones
Severity of contractions
lady partsl exam, dilitation & effacement
lady partsl exam, station & presentation
lady partsl exam, culture collection
CLINICAL SKILLS
Set up tocotransducer
Intrauterine pressure catheter
Auscultate fetal heart tones
Intact/nonintact membranes
Nitrazine test
Internal fetal monitor
Interpreting normal/abnormal fetal heart patterns
Baseline interpretation
Early decelerations
Beat to beat variability
Late decelerations
Prolonged decelerations
Set up OB pack
Set up baby pack
Cord blood collection
Artificial rupture of membranes
COMPLICATIONS/FURTHER DUTIES
Pregnancy Induced Hypertension
Antihypertensives
Clonus
Diabetes
Abruptio placenta
Placenta previa
Prolapsed cord
Preeclampsia
Eclampsia
Malpresentation
Premature rupture of the membranes
Premature labor
Magnesium sulfate
Drug dependent
RH incompatibility
Herpes
HIV
HBV
Hemorrhage
Blood transfusion
Forceps delivery
Vacuum extraction
Precipitous delivery
Gestational Diabetes/Diabetes and its sequalae
Starting IV's
Cesarean section-circulate
Cesarean section-scrub
Central line placement, set up & assist
Epidural, set up & assist
Spinal, set up & assist
Local, set up & assist
Foley catheter placement
Pain control, narcotic
Intrathecal medication delivery
Episiotomy, set up & assist
Uterine massage
Lochia assessment
DVT
Induction of labor
Cytotec
Prostaglandin supp
Oxytocin infusion
PATIENT TEACHING
Relaxation/breathing techniques
Premature labor prevention
Phone triage
Also:
Labor coaching/support for birthing mother/family
Neonatal assessment/resuscitation as needed
Breastfeeding initiation/support/ongoing teaching
Self-care and baby care once you go home
Care of any surgical wounds/therapies
After-care telephone triage (answering questions once a new family has gone home)

I would also like to add uterine rupture, and cord prolapse, and actually doing the delivery when the docs don't make it.

ktrot31 · Nov 9, 2007

I would also like to add uterine rupture, cord prolapse and actually doing the delivery when the docs don't make it!!

MrsK1223 · Jan 5, 2008

Hi. I have been an RN for 7 yrs. I've had my ups and downs with nursing in general. I've been on a hiatus from direct patient care for a year now but have been in the education/consulting arena during this time. It has required lots of travel and I'm thinking of trying to reenergize my nursing career. The area I'm in is limited in it's offerings. There is an OB position opening in a local hospital which is rare. I'm very open to leanring a new type of nursing and thought I would check in to see how other nurses like it. My experience in nursing has mostly been outpatient surgery/endoscopy, some psych and dermatology, pharmaceutical education, infection control. I'd like to get into education but opportunites are not open in my area. I need a new area to explore and to get excited about. There are so many areas in nursing to do, I jsut haven't foound my niche'. Any suggestion?

cnovice · Jan 11, 2008

This is excellent info. I will definately brush up by reading on all these topics in preparation for L/D & M/B. Thanks.