New OB Nurses, Grads and Students, Please Feel Free to post your questions here: - page 41

Mugwump had a great idea offering services to new grads as a mentor (thank you for that!) So, I thought having a "sticky" for new grads, OB nurses, students, and others with questions who want... Read More

  1. by   1pinkrose
    CMCRN
    Registered User
    Join Date: Sep 2006

    Re: New OB Nurses, Grads and Students, Please Feel Free to post your questions here:
    permalink
    Originally Posted by 1lvnurse
    Can someone PLEASE help me figure out how to calculate bolus and maintenance doses for MgSO4? I have tried to find info online explaining the calculation but have had no luck, and I have three dosage calc books but they are of no help either. The handout we were given is just plain confusing....
    We do them separately. Bolus is 4 grams in 100 ccs given over 20 minutes which equals 300 ccs per hour. Maintinence is 50 grams in 500 ccs then at 2 grams per hour for 20 ccs per hour.

    The problem we were given is: prepare a 4gm bolus over 20 min followed by a maintenance dose of 2 gm per hour. Mainline is 1000 cc's D5W.
    We were told to know that each 10ml ampule of 50% solution of MgSO4 is equal to 5 gm -- so will need to add 8 ampules (40 gm to 1000cc's of D5W). We are suppose to figure out how many cc's per gram (would be 25cc's) then determine total cc's to be infused over 20 min (which would be 100cc's/20 min) then determine bolus rate per hour (would be 300 cc's/hr). From here we then determine the maintenance dose per hour which would be 50cc/hr. I am having a hard time trying to figure out the calculations for my next problem which is a 6gm bolus dose and 2gm maintenance dose. Any suggestions?
  2. by   AussieKylie
    Hi I just would like to find out what to expect when doing clinical practicals in Obstetrics. I am an Australian nurse who needs to upgrade by doing courses to become registered in Canada and would like to find out more about being a student nurse in this specialty and what is expected?

    thanks
  3. by   loboscon08
    I am graduating in May, currently doing my final capstone in L&D at a hospital in which I was almost positive I wanted to work at after graduation. I have done two night shifts so far and am so disappointed with my experiences as far as the unit and it's staff members. My preceptor did not let me do ONE task on my very first night and was never very friendly with me. My second night, she called in, so I was placed with a male nurse who was a pretty good teacher and allowed me to do some things. He sure did quiz me a lot on things, which is fine because it contributes to my learning, but when I wouldn't know something he would say "wow how did they let you come here if you don't know that, etc." I just wish that he would have kept in mind that I am a student and that L&D is a speciality and that I have had little exposure to it.

    The charge nurse would not let me chart on our patients while having my primary nurse sign off with me (which is what I have done since day one of nursing school). This was pretty frustrating considering that I am pretty comfortable charting at this point in nursing school, which I would hope that I would be since I will be done in less than 2 months. The charge nurse and other nurses were not very friendly are barely acknowledged that I was a person yet alone even in the same room as them. The only time that they would talk to me was when they needed me to be their "gofer" and run little errands for them or get them supplies, etc. I was completely shocked at one point in the night where one nurse asked me to help one of the tech's take a patient to the post-partum floor and I came back from doing so and the nurse asked me if I knew what her urine output had been...HELLO- I had never even seen the patient before that moment in my whole life?!

    My heart truly is in L&D and I would love to work at the hospital that I am at, but I just don't know if I can see myself fitting in on that unit as a new nurse. I did not feel welcome yet alone even appreciated when I would do something for someone. I was also exposed to some of the nurses "trash talking" some of the other nurses on the unit, which totally made me question the kind of things they say about me when I'm not around. I don't want to be apart of a unit that is like this.

    My question to all of you, should I try get hired onto this unit and hope that it gets better or go to another hospital here in town in which I have never experienced???

    Thanks for letting me vent! I would love to hear any suggestions or comments about my situation that anyone would like to give me, because I am so stumped on what to do.
  4. by   CMCRN
    This has always been a controversy in my unit, You are actually adding 80 ml with the MGSO4, do you remove 80 ml before adding? Or do you figure it in your calculation making it 1080ml? Never resolved, now pharmacy mixes our bags and I don't know how they do it but I do know if you set your pump to infuse 500 mls/ccs there is a lot left over in the bag..
  5. by   ladyinred667
    I am graduating with my ADN in May. Last month I spoke with a nurse recruiter that came to our campus. I asked her if her hospital took new grads directly into Labor and Delivery. She said they do, and they have a preceptorship program in place for it, but it is a much more intensive interview process. She told me to apply a month before graduation, and I plan to.

    I plan to get recommendations from some clinical instructors (especially my OB instructor) and to bring in my clinical evaluations for all 4 semesters (they have all been positive). I was thinking of bringing some of my OB paperwork as well (PP assessment, NB assessment, careplans, etc.) I am doing my preceptorship in L&D and plan to ask my preceptor for a recommendation as well, but I will just be starting that next week so I may not be far enough in by the time I interview.

    Is there anything else I can do to prepare? What can I expect in this "intensive interview process"?

    Thank you all in advance!
    Noelle
  6. by   hippienurse
    I just wanted to say I totally love this forum and have been *hiding out* and reading forums since I was still in nursing school. I posted a few times here and there and always got great answers. But just reading thru posts has given me a wealth of info. I am now a nurse going on my 2nd year. I have been in women's health since month three and just accepted a new job training into high risk OB at a new hospital. I am so exited! I just wanted to wish all the *wanna-be's* and new grads luck and if OB is your dream--keep at it! My last supervisor gave me some words of wisdom I will always carry with me.. "You can teach any nurse skills, but you can't teach them to be passionate about the job" Anyone can be taught fundal checks and all the in's and outs, but to truly love what you do and be passionate about it is a *skill* you can bring to the table that alot of other people may not (if this is your passion..) I have always been upfront about that to my prospective employers (altho some here urged me not to tell them I felt that this type of nursing was a "calling"..I did it anyway) Anyway, enough babbling. I will continue to lurk and read and maybe someday when my life slows down I will post again!
  7. by   hrobrnc
    Hi Just found this thread. I have been a L and D nurse for 30 years. Have gone thru the drawing up and the mixing of Magnesium sulfate for PTL and PIH. I work at a Level 3 hospital who averages 500 del a month, including a high risk population.. I also am a high risk ante partum RN.
    With the JACHO push toward patient safety. We now have premixed mag bolus bags and maintenance bags of 500cc 20gm mag sulfate. so the conversion is 25cc=1gm of mag. When I think of the mixing of the mag vs a standardized solution. It is much safer to have the pre mixed solutions.
  8. by   TRINI_RN
    Quote from loboscon08
    I am graduating in May, currently doing my final capstone in L&D at a hospital in which I was almost positive I wanted to work at after graduation. I have done two night shifts so far and am so disappointed with my experiences as far as the unit and it's staff members. My preceptor did not let me do ONE task on my very first night and was never very friendly with me. My second night, she called in, so I was placed with a male nurse who was a pretty good teacher and allowed me to do some things. He sure did quiz me a lot on things, which is fine because it contributes to my learning, but when I wouldn't know something he would say "wow how did they let you come here if you don't know that, etc." I just wish that he would have kept in mind that I am a student and that L&D is a speciality and that I have had little exposure to it.

    The charge nurse would not let me chart on our patients while having my primary nurse sign off with me (which is what I have done since day one of nursing school). This was pretty frustrating considering that I am pretty comfortable charting at this point in nursing school, which I would hope that I would be since I will be done in less than 2 months. The charge nurse and other nurses were not very friendly are barely acknowledged that I was a person yet alone even in the same room as them. The only time that they would talk to me was when they needed me to be their "gofer" and run little errands for them or get them supplies, etc. I was completely shocked at one point in the night where one nurse asked me to help one of the tech's take a patient to the post-partum floor and I came back from doing so and the nurse asked me if I knew what her urine output had been...HELLO- I had never even seen the patient before that moment in my whole life?!

    My heart truly is in L&D and I would love to work at the hospital that I am at, but I just don't know if I can see myself fitting in on that unit as a new nurse. I did not feel welcome yet alone even appreciated when I would do something for someone. I was also exposed to some of the nurses "trash talking" some of the other nurses on the unit, which totally made me question the kind of things they say about me when I'm not around. I don't want to be apart of a unit that is like this.

    My question to all of you, should I try get hired onto this unit and hope that it gets better or go to another hospital here in town in which I have never experienced???

    Thanks for letting me vent! I would love to hear any suggestions or comments about my situation that anyone would like to give me, because I am so stumped on what to do.
    I'm still in school and doing my externship in L&D as well. My advice would be to give it a little more time for them to be comfortable with you being there. Let them know how interested you are in being a part of the unit and volunteer to do tasks so that they can see what a go getter you are and trust you more. Say "hey, if you need any IV's or Foleys inserted I'd be glad to do that for you." Two shifts isn't enough time for you to get to know them or vice-versa. Above all hang in there, this may not be a place that is a good fit for you, but tough it out and do your best. Good luck!
  9. by   TRINI_RN
    Quote from ladyinred667
    I am graduating with my ADN in May. Last month I spoke with a nurse recruiter that came to our campus. I asked her if her hospital took new grads directly into Labor and Delivery. She said they do, and they have a preceptorship program in place for it, but it is a much more intensive interview process. She told me to apply a month before graduation, and I plan to.

    I plan to get recommendations from some clinical instructors (especially my OB instructor) and to bring in my clinical evaluations for all 4 semesters (they have all been positive). I was thinking of bringing some of my OB paperwork as well (PP assessment, NB assessment, careplans, etc.) I am doing my preceptorship in L&D and plan to ask my preceptor for a recommendation as well, but I will just be starting that next week so I may not be far enough in by the time I interview.

    Is there anything else I can do to prepare? What can I expect in this "intensive interview process"?

    Thank you all in advance!
    Noelle
    Check out this thread. Good Luck!!
    http://allnurses.com/forums/f224/1st...ew-294585.html
  10. by   Katusha
    I am so thankful I came upon this forum. I have lots of questions. I am currently in a community college doing pre reques (I can never get the spell right) for an RN degree. My one and only interest for now is being a Labor and Delivery Nurse, working in the Birth Center at the hospital. I have 2 kids under 3 and I think that would be my calling for a career. I read in another forum that you can take a 3 yr intense program for a nursing diploma without doing pre reques. Has anyone ever heard of that? That sounds pretty tempting, since I do no like taking pre reques (I amalmost half way done with them though). Where is this program available? Also is there such a thing as being a grad and going right into L&D or do I have to start somewhere else? And in being and L&D nurse is there such a thing as working while your kids are in school (or do they not choose their schedule?). Any advice from anyone in general from anyone? Anything would be greatly appreciated. Thank you so much. God Bless!!
  11. by   hrobrnc
    Katusha, Stay with the community college program, it will offer you more if you decide you want to continue toward a BSN. Work schedules vary from hospital to hospital. It is just a matter of how flexible they are. Best of luck . jan
  12. by   Katusha
    Jan, thanks for your reply
  13. by   jujejo71
    I have been a nurse for 10 months on a med-surg GYN floor. We also get PP overflow patients. One thing I have learned is the golden rule....NEVER DO ANYTHING WITHOUT A DOCTOR'S ORDER. The majority of our OB/GYN's use a standing post-vaginal or post-c-section order sheet, which is worded in such a way that the RN can use their nursing judgement as to when IVF can be d/c'd and how quickly a diet can be advanced, etc. As far as feeling slow and stupid and relearning things you learned in nursing school---trust me, we ALL have been there. In fact, I still have those days and probably will for a long time! I rarely EVERY leave work before the other nurses do, and that's even on a smooth day. Nursing school (in my opinion) is only about 25% of the learning experience (if that!) You will be as proficient as those nurses are some day! I wish you the best of luck and congratulations!:grad:

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