Just curious... what do you say to your patients so they don't panic when they have something ugly happening on their strip and you have to give 02/turn/bolus?
Nov 25, '06
I agree. If I'm not concerned (ie one variable after 5 hours of labor and a reactive strip), I'll explain to them that sometimes the way they are laying or the way the baby is laying could be pressing on the cord a little and to remedy that we're going to flip her over. Or I might say something like "Well, just like the baby's heart has these jumps, it sometimes has a dip. We're just going to have you lay on your left side for a bit because baby's tend to like that position better."
If O2 is needed, I'll explain that by saturating her blood, we increase the oxygen flow to the baby. I might say "The baby's heart is going a little slower at times than we'd like. Most likely there's no problem, but we just want to make sure that all our bases are covered--that way if there is a problem, we've addressed it as early as possible"
I will always tell my patients who show any nervousness, anxiety, etc (some just say 'okay', roll over and fall back asleep) "I'm not worried right now, the doctor's not worried right now. If it gets to the point where it's time to worry, I will let you know" and I hold true to that. I never pish posh a situation where I'm worried about mom's health or baby's health.
Last edit by KellNY on Nov 25, '06
Nov 25, '06
I had occasion to be in the delivery room recently when the infant's heartrate was 60 bpm. One nurse left to call the doctor, the other nurse stayed in the room, placed oxygen and put her on her left side. The other grandmother isn't a nurse and thought this was normal. The two nurses were very good, calm and efficent. My grandson is doing very well - he's beautiful!
I did not tell anyone I was an advanced practice nurse, but the doctor knew that she had seen me in the hospital during rounds but didn't know who I was.
BTW - my expertise is NOT OB so I kept my mouth shut.
Last edit by traumaRUs on Nov 26, '06
Nov 26, '06
I do the head-dunking imagery. Imagine you are playing in a pool and you are jumping up and down, in the water and out. When you start, you do fine----you have plenty of O2 reserves to handle it; you are having a great time! After a while, doing this over and over, you start to get tired and it becomes harder to keep up the pace. Soon, you want to quit being dunked altogether, and your breaths become more labored and faster. You naturally slow down!!!
The same goes for your baby; his/her heart rate is slowing down cause they are drawing down on oxygen reserves. Our job is to relax the uterus, and give you extra oxygen (e.g. stop the "dunking" )----so he/she can take a breathe and recuperate. And most of the time this alone is all it takes for your baby to get back on track. His heart rate is simply his way of talking to us from the womb, telling us BEFORE things get too bad. He is simply telling us what he needs! IF we listen, we will do ok.
That is the imagery I give them when explaining decels, particularly in labor. I have yet to have a patient freak out or become scared---rather, they seem to understand and are more than happy to cooperate with the interventions we have to do.
Last edit by SmilingBluEyes on Nov 26, '06