Why do practicing CRNAs not like OB?

athomas91 · Mar 18, 2004

i loved OB in undergrad schooll

but here are some things that i have noticed on the OB floor that causes a little distaste in some of the CRNA and MDA's i am in clinical w/...

OB nurses will call and state that the epidural dose needs up'd because the pt is having breakthrough pain...when you get there - the pt is fully dilated and crowning...they should check stuff like that prior to calling us for dosing changes - there's nothing we can do now- it's just time to push.

there are other examples that i have been told of...but i don't want to bash any particular type of nursing...but i think the distaste comes when nurses don't use common sense.

kmchugh · Mar 19, 2004

While there is some truth to what AThomas says, overall I wouldn't say that practicing CRNA's don't like OB.

Oddly enough, I hated OB in nursing school, and could not wait to get away from it. I dreaded my OB rotation in anesthesia school. However, once I started, I loved (and still love) doing OB anesthesia. I get a lot of satisfaction from the help I provide to my patients.

Most of the "problems" I've found with OB nurses come more from a lack of knowledge than anything else. One of my personal demons are nurses who try to talk patients into epidurals when they are in strong labor. But, what I have found is that the nurses aren't doing it out of spite, or to relieve their "suffering" with the laboring mom. They too genuinely want to help the mom. The problem is that I have already talked to most patients. I have told the nurses once I have done this, if the patient refuses, they really shouldn't bring up epidurals again. If the patient brings it up without prompting, that's fine. But if the OB nurse "talks them into it," when the women are in full blown labor, that's a form of coercion. Not acceptable. Once I've explained this to the nurses, the problem ceases.

Kevin McHugh, CRNA

SmilingBluEyes · Mar 19, 2004

I Agree, Kevin. I always ask moms WAY early in labor what their preferred way to cope with the pain of labor is. NO suggestions, no "coaching" from me. 80% of the time, they already KNOW they want epidural anethesia. The others want to "see how it goes" or ask me WHAT is available. I discuss everything from guided imagery, tub baths/showers, ambulation, massages (I give them) to IV pain meds. Anesthesia should be but ONE of the options we discuss with patients, early on in labor, if possible, and then let them and their partners decide what is best. Coercion is definately unacceptable in my book. Sadly, so many nurses today don't employ other comfort measures for patient.....with epidural rates approaching 90% in many hospitals, it's becoming a lost art to be a true labor nurse in the strongest sense of the word. JMO.

TraumaCowboy · Mar 19, 2004

When I was a student nurse anesthetist, I really enjoyed L&D... especially learning at a 500 delivery a month hospital. Epidurals, SABs, STAT "sleeper" c/s were a novel thing... I graduated with about 300 blocks in L&D if I remember correctly... As I became comfortable alone in OB, I began to see trends in the nursing there... the nurses want epidurals in their pt.s so they can sit at the nurses station and monitor the baby from the computer! They are hardly in the room... and when they are in the room they don't check the pt. You get an unacceptable amount of pages and call backs for bolus doses... and if the pt. speaks a foreign language... the nurse assumes she is trying to say that she (the pt.) is hurting... another page for top ups... Don't get me wrong it's fun and satisfying... But the "neediness" of L&D nurses who want to fix "everything" with an epidural... Gee whiz...

I argued with a nurse who demanded I place an Epidural in her pt. with platelets of 70,000! She so bad wanted to "labor" her pt. from the nurses station... laziness... Little things like this wear on you a bit...

fergus51 · Mar 19, 2004

I don't know why i looked at this one;) I have only worked at one hospital with central monitoring, so my practice is not to get women epidurals so I can sit at the desk.... I have seldom worked with CRNAs in L&D, as it was mainly anesthesiologists where I worked.

deepz · Mar 19, 2004

Labor analgesia can be troublesome, but spinal C-sections are my personal all time favorite procedure to attend.

deepz

Joke removed due to inflamatory nature of it. By nilepoc.

jkaee · Mar 19, 2004

Joke quoted deleted. nilepoc

Even if you were only kidding with this, deepz, I really don't think that was necessary (or even funny for that matter).

We're ALL nurses, no matter what initials come after our names.

:nono: Shame on you for such a tasteless joke!

SleepyRN2B · Mar 19, 2004

Labor analgesia can be troublesome, but spinal C-sections are my personal all time favorite procedure to attend.
deepz
Joke quoted deleted. nilepoc

deepz,

I thought it was funny... of course anyone with common sense knows that not all nurses are fat.... really grow a sense of humor people... it was a joke

palesarah · Mar 19, 2004

Congratulations Deepz! This OB night nurse found your "joke" so disrespectful that you won a place on her ignore list!

Labor analgesia can be troublesome, but spinal C-sections are my personal all time favorite procedure to attend.
deepz
Joke quoted deleted. nilepoc

palesarah · Mar 19, 2004

Congratulations Deepz! This OB night nurse found your "joke" so disrespectful that you won a place on her ignore list!

Labor analgesia can be troublesome, but spinal C-sections are my personal all time favorite procedure to attend.
deepz
Joke quoted deleted. nilepoc

deepz · Mar 19, 2004

Congratulations Deepz! This OB night nurse found your "joke" so disrespectful that you won a place on her ignore list!

That's what the DELETE button is for. Sorry you took it personally. Perhaps you might ask yourself why you are so overly sensitive? Your BMI?

deepz