Labor Cowboy

  1. I was given this nick name the other night , I guess it is a compliment. I was given that name because as the midwive put it , " I am willing to ride a lot of crap out and will do almost anything to get a patient to avoid a C/S and deliver a healthy baby." this conversation came about when we were talking of one of my patients who came in ruptured been ruptured at home for 12 hours was 2cm 50% on admit. baby had prolonged decels a couple times. midwife was in house had her come up, I had put FSE on she came in we started amnio infusion.also started ampicillin IV . by now patient ctx 1 to 1.5 minutes lasting 90 sec or better. baby had couple more big decels did all the usual things position change O2, at one point gave brethine to decrease ctx and had bed in trendelenburg. let baby rest then proceeded with labor. I never left the patients bedside the whole time,few hours later we delivered a healthy 7 lb baby 9/9/10 apgars. by this time they had ped and ob doc in house waiting for C/s to everones suprise. it never happened.
    I think i like my new nick
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  2. 21 Comments

  3. by   sunnygirl272
    ya know, mark, if i ever were in labor and in your area, i would definately want you to deliver me....labor cowboy...that's great!!!
  4. by   shay
    How apropos.
  5. by   mother/babyRN
    That is so cool! Does that make us labor cowgirls???
  6. by   mark_LD_RN
    I GUESS IT DOES! If the term fits use it
  7. by   luv l&d
    trendelenberg with terb????? pulm. edema waiting to rise up and smack you.
  8. by   NurseDianne
    Yeah Cowboy! Sounds like you did all the right things! You should feel proud and satisfied that you did a job well!
  9. by   SmilingBluEyes
    I ride w/caution. call me a wimp or the rodeo clown, it is just how I am. Experience has taught me that you cannot win 'em all. Oh and I agree about the terb/trendelenburg statement. gotta be real careful there. but Mark, more power to ya; you done good!
  10. by   mark_LD_RN
    i tend to be more careful than it seems, If i have a patient with any problems i never leave there side and will call for some sort of help. I agree can't win them all, but it try, and have won more than my share so far thanks to the delivery gods.
  11. by   mother/babyRN
    I have never seen pulmonary edema in conjunction with terbutaline either in delivery or cardiac care. Could someone please explain it to me....Boy, around here you learn something every day......Thanks.....
  12. by   mother/babyRN
    But then, I have rarely put a labor pt in trendelenberg unless there was a BP problem after an epidural...Imagine it has to do with the action of the terb on lung phisiology..Enlighten this poor tired night nurse....
  13. by   psychomachia
    I don't work L&D, but I would think putting somone in Trendelenberg position along with Brethine would be to help stop the labor process. Trendelenberg position would take the pressure off the lower uterus and perhaps disengage the head from the pelvis.

    But then again, I could be wrong...
  14. by   psychomachia
    Also, another possible advantage to positioning in Trendelenberg (burg?) might be to help with FHR and/or cord compression.

    Can't think of anything else right now...

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