For the benefit of new nurses and future/prospective OB/GYN nurses and doulas, midwives, others, thought I would try a sticky that discusses various duties/skills sets and other characteristics that make a "good", well-rounded OB nurse, doula, midwife or other professional dealing with Women's Health Issues. This question seems to come up now and again, so let's help em out.
I will start. Here are skills sets for OB nurses that I found apply in most areas. Again feel free to add to this; I want to learn as well!
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OBSTETRICAL ASSESSMENT SKILLS
Inbound facility tranfer unit
Outbound transfer to other facility
Identify fetal position (Leopold maneuvers)
Fetal heart tones
Severity of contractions
lady partsl exam, dilitation & effacement
lady partsl exam, station & presentation
lady partsl exam, culture collection
CLINICAL SKILLS
Set up tocotransducer
Intrauterine pressure catheter
Auscultate fetal heart tones
Intact/nonintact membranes
Nitrazine test
Internal fetal monitor
Interpreting normal/abnormal fetal heart patterns
Baseline interpretation
Early decelerations
Beat to beat variability
Late decelerations
Prolonged decelerations
Set up OB pack
Set up baby pack
Cord blood collection
Artificial rupture of membranes
COMPLICATIONS/FURTHER DUTIES
Pregnancy Induced Hypertension
Antihypertensives
Clonus
Diabetes
Abruptio placenta
Placenta previa
Prolapsed cord
Preeclampsia
Eclampsia
Malpresentation
Premature rupture of the membranes
Premature labor
Magnesium sulfate
Drug dependent
RH incompatibility
Herpes
HIV
HBV
Hemorrhage
Blood transfusion
Forceps delivery
Vacuum extraction
Precipitous delivery
Gestational Diabetes/Diabetes and its sequalae
Starting IV's
Cesarean section-circulate
Cesarean section-scrub
Central line placement, set up & assist
Epidural, set up & assist
Spinal, set up & assist
Local, set up & assist
Foley catheter placement
Pain control, narcotic
Intrathecal medication delivery
Episiotomy, set up & assist
Uterine massage
Lochia assessment
DVT
Induction of labor
Cytotec
Prostaglandin supp
Oxytocin infusion
PATIENT TEACHING
Relaxation/breathing techniques
Premature labor prevention
Phone triage
Also:
Labor coaching/support for birthing mother/family
Neonatal assessment/resuscitation as needed
Breastfeeding initiation/support/ongoing teaching
Self-care and baby care once you go home
Care of any surgical wounds/therapies
After-care telephone triage (answering questions once a new family has gone home)
Specializes in Practice Nursing, Postnatal Nursing.
Hi, yes, LMC is a Registered Midwife, usually an independant midwife or working with partners in a collective group. None here work for the hospital, in the bigger areas they do, they can be 'core' midwives who see from antenatal to six weeks post partum or ones who work rostered shifts in Delivery Suite for those 'just in case' mums who turn up with no care throughout pregnancy. Gas is entonox (nitrous oxide mixed with oxygen), Pethidine is an opioid, sorry, not sure what you know it as. Its different to morphine.
Specializes in Practice Nursing, Postnatal Nursing.
I should add, a midwife working shifts on Delivery Suite in our larger hospital (the one where our non-normal births go to) would also care for an referred inductions, and probably for the emergency caesars too. They can call in the obstetrician and peadiatrician as required also. We refer to them as a secondary facility. Their cut off date for deliveriers is 32 weeks, any younger go to a larger hospital again. The secondary facility has a SCBU (Special Care Baby Unit) for prem or sick neonates. If we need to send a babe out at birth, we call for the helimed and usually a nurse from SCBU and a paed will fly north to us to retrieve the babe. Same goes for a woman who may get transferred via helimed, they either send a midwife with the flight team, or the LMC will accompany the woman. If going by road in the back of an ambulance, then the LMC goes too (2 to 2 1/2 hour trip).
There is only one thing I can think of,which is practiced in the hospital, specifically in the ward i'm in.INDEPENDENCE on mother's part.We do not allow visitors inside the area to prevent the newborns to be exposed to viruses or any organisms that may cause infection. Many raised a brow, some voices on this policy. Well, I'm used to it. I'm just an employee.i know it's for the baby's sake.
Hi, I'm an RN, i work permanent 12 hr nights in a birthing unit at a small rural hospital. There is one of us on duty at a time :-). We can assist the LMC (lead maternity carer) in labour and delivery, as she directs. We are mainly here for postnatal care of well mums and bubs. Typically on this unit, in fact in a lot of hospitals in NZ, there are NO doctors at delivery. Most women choose to have an LMC during their pregnancy, and get all their A/N care from her, then they will meet up with said LMC at the hospital (or home) when birth is imminent. Anything other than a 'normal' pv delivery is transferred out. The occaisonal breech and twin birth has been delivered here. We (the LMC) can offer gas, pethidine or water for pain relief.
We have two delivery beds, a birthing pool and 4 postnatal beds, plus a day bed for use when A/N's come in for monitoring or assessment, and this bed can also be utilised if ward fills up.
I have a question? I hope it isn't a stupid one, but i am an ER nurse so I am not familiar. What is an LMC? Are they similar to a CNM? Also, here is the biggie....how does water provide pain relief? Sorry, I am sure the OB nurses think I am stupid now.
Specializes in Practice Nursing, Postnatal Nursing.
Alot of women use water for pain relief, either a spa bath, shower or the birthing pool. LMC is Lead Maternity Carer, the midwife who sees them thru pregnancy, labour, birth and to six weeks post partum.
Water for pain relief works the same during contractions as you would find it useful during menstrual cramps....some women like it, some don't...the buoyancy of the water is also a factor, if the woman is in a proper birthing pool the 'weight' of her pregnancy is lifted and this often feels beneficial.
I'm not an RN yet, but I thought I would add something. I do work for an adoption agency and one thing that happens often in our area is that nurses and hospital staff have no idea what to do in the case of a birthmother asking for information on placing the baby for adoption. Many women have no plans for adoption until they go into labor.
The problem in our area is that nurses take it upon themselves to find a friend or family member that "has been wanting to adopt". This is unethical and it shouldn't happen. My agency wrote a booklet to educate the hospitals on protocal and state regulations in the event a mother would like to initiate adoption plans.
I just figured it would be good to mention this as something that nurses can educate themselves on as it would not only include helping the mother find resources, but also dealing with adoptive parents and rooming-in, etc.
There are so many duties and responsibilities I feel it is one of the area where there is soo much nursing independance. Anyways aside from all the great responses here I might add RESPECT for the patients beliefs. I don't know how many times a patient has been "pushed" to breast feed when they where not interested. There is a line between teaching and bullying and though I am pro breast feeding I feel that the patients belifs and deires NEED to be respcted. (Just as the patient that wants to breast feed and a nurse throws a bottle in its mouth)
texas-rn-fnp
79 Posts
What is an LMC? Is that like a midwife? What type of gas? Pethidine? Please elaborate. This is different than here in the US.