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Discussion

Assigning Apgars....

I'm new to LD and I've been off orientation for a couple of weeks. We'll I assisted another nurse with a delivery and ended up being baby nurse.

So baby was born and the doc placed baby on moms chest and while there was a million people in the room I couldn't get to baby so the LD nurse was stimulating baby not a problem. So I'm like ok we'll I'm going to start doing the paperwork on the other side of the room and the LD nurse was like ok. And after about 5min the LD nurse brought the baby to the warmer and as I turn around to look at the baby he's retracting and pinkish blotchy but def not a good pink, crying but having a hard time so I deep suction him (in the mean time I forgot to "admit" the baby on the bed so I didn't put the temp probe on bc I was worried about his breathing) so another nurse was there and I'm like I need nicu can u call....well after a few min nicu came and the time is 14min after birth and they're like what happened, when was he born...so I told them and they're working up on him and I can hear them like snickering to each other like why we didn't call sooner and didn't do anything to the baby. So one nicu rn makes a comment about how we didn't call sooner and it's been 40min since time of birth and I'm like no it's been 14 min and I started suctioning him bc he was on moms chest for a bit and crying from what the LD nurse told me. And they're like ooooo we thought u said a diff time. Well anyway I had to do the Apgars and I gave the baby 7 &8 for color and breathing. But I'm just worried bc I really didn't see the baby the first 5min or so and I was just going based off of what he looked like when he came to me.

so idk if I just needed to vent to u guys or if I should have done something diff or if I did something wrong. I'm just really nervous for some reason bc I gave the baby Apgars 7&8.

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    I would not worry about it, honestly.

    FWIW, when I had my last child (born at 36 weeks at high elevation, a white boy), my best friend specialed me as my nurse, and my good friend specialed me as my OB. They tried SO hard to make him be well and ignore the fact that he was in respiratory distress (because it would mean that he would have to be transported to the NICU 90 miles away). I have a photo of me holding him at approx. 45 minutes of age, giving him blow-by. My friend gave him Apgars of 7 and 8, and when I saw a photo of us when he was around 5-10 minutes old, there was NO WAY he had 7/8 Apgars. More like 6/7.

    But you know what, Apgars really aren't that important in the grand scheme. I would not lose any sleep over it.

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    We work in L/D as the transition nurse (long story as to why it has to be a NICU nurse) but we have learned that we have to be a little pushy and be up there to see the baby. I will tell you that if anything ever goes to court times are very important and they do look at the APGARS. Don't sweat it but just be more assertive.

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    Since the L&D nurse was close enough to be stimulating him, I would have asked her for the Apgar. If you can't get to the baby, it's helpful to call out one and five min so the nurse who is with the baby knows to look for the scores. If there are a lot of people in the delivery, I ask them before the delivery to keep a path between Mom and thw warmer clear in case the baby has trouble and needs recusitation. If you ask nicely and present it as a safety measure, most people will clear the path you've designated.

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