You have a charge, baby and circulator? Wow! We have 2 nurses during delivery. The rest of the time...there may only be 1 RN. The nurse that was assigned to mom is the one responsible for mom and baby and room. Sorry to get off topic.
We do foley before in many cases and after in a few. It depends in what is going on.
Not for the whole case---just to get things started. I just pointed it out to show we usually don't have a problem quickly getting in the foley after the spinal, which is maybe why no one minds waiting until the anesthesia for us to place it.
In this job, I only am in the OR to do the baby..I am More than happy and willing to place the foley myself since I'm just standing there waiting for the baby to arrive..
Where I work the circulator (nurse who was assigned the pt) puts the foley in (which we do after anesthesia...unless of course the patient has one alreadyh in or it's an emergency) and she will recover the patient. We have one nurse who comes in to be baby nurse. Day shift has a scrub tech and evenings and nights does not (so of course in that case there will be either 3 RNs in there or if there isn't a 3rd to do baby then nursery would come). There have been at times where we're short and have to call the OR for a scrub tech for an evening or night section. It would be nice and in my opinion safer if we could have a scrub tech on all shifts that way it frees up an RN in case the floor has an emergency or a sudden influx of patients coming in (especially if they're active and definitely being admitted).
We put the foley in, prior to delivery if it will be general anesthesia, and leave it for OR for spinals. It has less to do with mother's comfort and more to do with spending the least amount of time, while under general anesthesia, so the baby will not receive as much of the anesthesia medications through the mother. They want the baby out "quick". A spinal has much less effect on the baby, therefore time can be taken to place the foley in the OR. Well, that's what they've preached to us all these years. Made sense to me. ; )
Agree, Jody. Also, I would hope that it's pretty rare for women to be getting GA.
Not terribly rare. I got general for my c-section. If a patient's platelets are too low, the baby is in distress, or the mother has some sort of issue that precludes a spinal, then general it is.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
I ended up with an emergent c-section due to fetal distress. The anesthetist and CRNA tried a total of three times to get the spinal in me, and at that point the OB just said, "Enough! Put her out!" because they wanted the baby out ASAP.
Because they had placed an internal monitor earlier, I already had a Foley cath in place, so as soon as I was "under" they started slicing. Even with as quickly as they were able to get the baby out, he still didn't breath independently for the first four minutes on the outside. I can definitely see how even a couple extra minutes of general anesthesia could have an impact on the newborn.
Idk, but I'd say our spinals well outweigh our generals. But both are used. And yes, I do believe that every little bit of time is valued. As is having good IV access before transporting to OR. From the incision to the baby's birth is also very quick, in most circumstances. I had to deal with this issue when I ruptured, with twins, at 26 wks. I'd had an aversion to having a spinal, but went with it because I knew it was really much better for preemie births. Didn't like it though...lol. My stupid arms shook violently against the restraints the whole time. They couldn't give me anything to relax that until the babies were out.
dariah
84 Posts
Not for the whole case---just to get things started. I just pointed it out to show we usually don't have a problem quickly getting in the foley after the spinal, which is maybe why no one minds waiting until the anesthesia for us to place it.