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 OBSTERTICS-POSTPARTUM,L/D AND HIGH-RISK.
Dear mamababynurse, I am so sorry that you have had such a bad experience in OB nursing. It is really a wonderful place to work in the right situation. We all do have busy, busy days.I have had every type of OB patient. I've never had a GYN patient. I now work on the antepartum unit that you don't like. We take antepartum patients at any stage of their pregnancy. This becomes an issue when the beds are nearly full and one of our MDs wants to send in , lets say, 10 gestational age for a non-pregnancy dx. We try to get them moved to a medical floor so that we will have a bed for a fetus that needs monitoring. But sometimes that's difficult to get the MD to understand. Like HappyNurse said if it can happen to women, it can happen to pregnant women. So we see the whole spectrum of dx's. I wish for you to be able to get into a hospital where you could do mother-baby nursing. But remember that these pregnant women that we are taking care of will someday deliver and then their issues will become yours.
I also wanted to know how you were able to put a mom on the monitor without training. Everyone in our antepartum and L/D has to take basic fetal monitoring, then advance fetal monitoring and then do 4 hr of CEU,s of fetal monitoring every year.
Maybe you should think of going somewhere that you would enjoy nursing. :heartbeat
I too hope to find the right place for me. I know it is out there somewhere. Opportunities are very limited where I live. I have thought of travel nursing, but I have two young children I don't want to leave. I can go back to nights, but really dislike that idea. It's just unfortunate for me that I was sold a bad bill of goods. I was told I would be orienting to the nursery, I was told "the secretary is on maternity leave" (there is NO secretary), I was told I "might" have a "few" gyn patients, but, "don't worry, they're all straightforward, stable cases. Nothing complicated." I'd only had maybe two gyn patients before coming to this hospital, and with the hope of landing in the nursery sometime in the future, I took the bait. I thought "sure, I can deal with this". I've been there over a year now and have NEVER set foot in the OR (for Csections), NEVER been oriented to the nursery, and the only gyn patients I seem to get are the ones with MULTIPLE issues.
I realize that today's antepartum with problems is tomorrow's mama who may continue to have problems. I am perfectly comfortable with that, that is what I have been trained to do, that's all I've ever wanted to do. That and transition nursing. That, above all, is my favorite. I was never happier than when I was the one catching the babies, good or bad. There's nothing like it. But again, the opportunity to do that in my area is nonexistent, unless I go back to nights. So, this is the dilemma I struggle with on a daily basis.
If anyone has any suggestions or ideas, please let me know. Right now I seem to be stuck between a rock and a hard place.
I watched a labor nurse and learned how to hook the patient up to the monitor. I am in the process of doing just the basic fetal monitoring course, since it seems I will continue to get antepartum patients.
In looking over the duties I see C-Section scrub & circulate. I would love to hear some conversation about where this training comes from and how that works in your institution. Thanks. I am a perioperative RN and have been precepting the OB nurses in our hospital.
We don't circulate or scrub though. We are the baby nurse however.
steph
we circulate, scrub and do newborn care. as well as do all the ward clerk duties, do our own peri care and transfer our patients (cuz it's easier than hearing the techs tut and whine because you ask) and stock the rooms on the rare night that it's not crazy busy.
not to mention how we have to baby the husbands/fathers/over bearing mommy of the expectant mothers.
and have to keep a straight face when we see a male who is either the laboring woman's father/brother/inlaw/cousin and sometimes teenage son staring into the lady parts during birth. it's definitely strange.
In looking over the duties I see C-Section scrub & circulate. I would love to hear some conversation about where this training comes from and how that works in your institution. Thanks. I am a perioperative RN and have been precepting the OB nurses in our hospital.
we get scrub and circulate orientation when sign on. did two weeks just scrubbing. the nurse educator who worked for many years on l & d did mine. talk about hell.
my facility has 3 ors on labor and delivery and we better well damn know how to scrub in an emergency and the tech is off or on vacation or even on break.
Specializes in L&D, NICU, PICU, School, Home care.
I work in a small (5 LDRP) unit in rural NY. We have an OR on the unit but at this point do not scrub or circulate officially. We also do NOT have 24/7 anesthesia or OR crew in house. At night we may need to circulate until the OR nurse arrives in the case of a STAT C-Section. The new thing is they think we should learn to do both OR jobs so we can do all of the C/S. A little hard when we only have 3 nurses per shift. One scrub + one circulator + baby nurse = nobody left ont the floor for the other patients. We don't know how they plan to do this so it should be interesting!!!
You can also add housekeeper to the list of duties. After the regular housekeepers go home we have to strip and clean any discharge rooms or clean them when we are playing muscial beds to open a labor bed for a patient. (2 of our rooms can be doubled for post partum patients).
DEB52
98 Posts
Dear mamababynurse, I am so sorry that you have had such a bad experience in OB nursing. It is really a wonderful place to work in the right situation. We all do have busy, busy days.I have had every type of OB patient. I've never had a GYN patient. I now work on the antepartum unit that you don't like. We take antepartum patients at any stage of their pregnancy. This becomes an issue when the beds are nearly full and one of our MDs wants to send in , lets say, 10 gestational age for a non-pregnancy dx. We try to get them moved to a medical floor so that we will have a bed for a fetus that needs monitoring. But sometimes that's difficult to get the MD to understand. Like HappyNurse said if it can happen to women, it can happen to pregnant women. So we see the whole spectrum of dx's. I wish for you to be able to get into a hospital where you could do mother-baby nursing. But remember that these pregnant women that we are taking care of will someday deliver and then their issues will become yours.
I also wanted to know how you were able to put a mom on the monitor without training. Everyone in our antepartum and L/D has to take basic fetal monitoring, then advance fetal monitoring and then do 4 hr of CEU,s of fetal monitoring every year.
Maybe you should think of going somewhere that you would enjoy nursing. :heartbeat