Hello everyone-I am new to your forum and have found some very interesting reading here. I have been a nurse for 30 yrs. next yr. (OMG!) and with the exception of 2 1/2 yrs. spent in a NICU, my work has been with L & D, postpartum and nursery. As you can well imagine, I have seen a lot of changes come down the pike and am wondering if there are those of you out there having experienced the same are feeling as frustrated as I am regarding some of these changes? What am I speaking of in particular? Let me tell you...
Breast feeding-does anyone else feel that we have totally "clinicalized" (not really a word, I know) it? With "nipple confusion" and SNS supplementation and checking baby's sodium levels, etc. it really seems a miracle the human race is still around-we didn't worry about these things yrs. ago and I can't believe we sent all our nursing babies home on the verge of dehydration or unable to suck on anything but the real thing!
The routine use of internal leads, the impatience of doctors managing the process on THEIR time schedules, insurance companies dictating how we practice (specifically-doing away with VBACs), injecting infants less than an hour of age with vaccines and on and on.... These things bother me immensely and I am constantly met with the opinion that "there's really nothing we can do about it" so just shut up and do what you're told. The hospital I presently work at bases how well we are doing on how high our Press-Ganey scores are-which can go from 80 to 90% one quarter to 30 to 40% the next and so the nurses are alternatively congratulated or told we must try harder when we know that our care doesn't deviate as much as the scores might suggest. We follow ridiculous rules and regulations handed down to us from JACHO that have nothing at all to do with our maternity patients-requiring more and more documentation which takes us increasingly away from the bedside.
Maybe I am just needing a place to vent my frustrations, but are there others of you out there that feel the same? And just what can a person to do to get back to doing what we went into this career for in the first place-helping to make the birthing experience a positive experience? Any ideas?
Specializes in Mostly L&D/OB, some ED, Some psych.
My First L&D job was in 1985. Ahh, the good old days. Most women took Lamaze classes and they actually knew how to breathe with their contractions when they got to the hospital and just needed us to remind them. They got Saline locks and IV demerol when they were 5-6 and beginning to "lose it". Then they went to sleep and relaxed, woke up 2 hours later ready to push. Then, they actually COULD push because no epidural in place to keep them from doing so.
Very few forceps or vacuum deliveries and low C/Section rates.
Yes, I remember those days.
Things have certainly changed.
The hospital I work at induces most everyone by 39 weeks. If they have the nerve to not delivery by 5-6pm they get C/Sections for "failure to progress"
We do "Cesarean Sections by maternal request"
These young girls today actually think a Cesarean Section is "easier".
Most patients get AROM and Pitocin.
Most patients get Epidurals at 2CM.
And the worst part...when the babies are crying and fussy we can't lay them on their tummies....sigh....
We have to go along or find another area to work in.
I've tried other areas and I always come back to L&D.
The grass is NOT greener in other nursing specialties.
I agree with you for the most part, except for the epidural part-I take it you are not all for them...? Frankly, I think epidurals are comparable to sliced bread in OB. A comfortable, enjoyable birth experience-why not? What I DON'T agree with is, the patient getting her epidural and the nurse sitting at the central monitor, doing her charting or whatever else because now she isn't "bothered" by the patient anymore! I believe in actively turning your pt. every 20 minutes, side to side and letting her "labor down" so the pushing is not started too early resulting in loss of maternal push power at the end. I support whatever method my pt. wants to use for delivery, but I'm also the first to question their decision to rule out an epidural from the git go. I do get into conflicts with our docs over letting them labor down (I don't think they've even HEARD the words used before at our hospital) due to impatience and the belief that pushing has to start right away at 10 cms. If the woman is having a fast labor, that's one thing, but it tears at my heart to have my pt. progressing slowly when the pain is so great.
crystal013
26 Posts
My First L&D job was in 1985. Ahh, the good old days. Most women took Lamaze classes and they actually knew how to breathe with their contractions when they got to the hospital and just needed us to remind them. They got Saline locks and IV demerol when they were 5-6 and beginning to "lose it". Then they went to sleep and relaxed, woke up 2 hours later ready to push. Then, they actually COULD push because no epidural in place to keep them from doing so.
Very few forceps or vacuum deliveries and low C/Section rates.
Yes, I remember those days.
Things have certainly changed.
The hospital I work at induces most everyone by 39 weeks. If they have the nerve to not delivery by 5-6pm they get C/Sections for "failure to progress"
We do "Cesarean Sections by maternal request"
These young girls today actually think a Cesarean Section is "easier".
Most patients get AROM and Pitocin.
Most patients get Epidurals at 2CM.
And the worst part...when the babies are crying and fussy we can't lay them on their tummies....sigh....
We have to go along or find another area to work in.
I've tried other areas and I always come back to L&D.
The grass is NOT greener in other nursing specialties.
Ahhh...the good old days....;-)