I know that this battle has been going on for years without a clear resolution. I am familiar with the AWHONN position statement on this topic that was last reviewed & reaffirmed in 2007. I believe that AWHONN made this statement because there ...
We are going to the ACOG recommended 1:1 pitocin concentration soon at two local hospitals. This should be easier & safer for the nurses since there are no calculations involved for either induction or augmentation of labor. My two questions ho...
Our hospital is growing & we now need to order new IV pumps We want a "smart pump" that meets the needs of all of the hospital, including L&D & PP. I am just asking for your pros/cons, vote on the 3 IV pumps we are considering: SIGMA, ...
I am trying to be sure we provide the best perinatal care to all pregnant women who are patients on units other than L&D at our hospital. This especially applies to those 20-24 weeks gestation & further who have a potentaily viable fetus. C...
OK, I have two questions on EFM to throw out to the OB commuity for consideration. This is one way I check to see if this hospital is practicing in a similar manner to other hospitals of like size & level of care. This is a Level III facility w...
I know that this is a hodge podge of questions, but that's just how my day has gone. #1 -Just checking with the other L&D units to see how you handle keeping a patient on CEFM when moving the patient from room to room. Had a demise between room...
We do 4800+ births per year We have one anesthesiologist 24/7, but they do C/S on the floor as well as epidural anesthesia One practice has an OB & occassionally a CNM in house 24/7, but they cover two hsopitals & occassionally the OB gets ca...
Doesn't anyone use Leopold's maneuvers to find the fetal heart & assist in placing the fetal monitor? I love the clicking sound of a direct placement over the fetal heart! Plus it is evidence based practice. Fluffy women & wigglers are a c...
Thanks to RAIZIE and NRSKarenRN for reminding us of evidence based practice. As a CNM I placed many foley catheters as a prefered choice for women who wanted to avoid oxytocin if at all possible. The level of discomfort with placement was nil to mil...
I read an interesting editorial in the Nov. 23, 2006, edition of the NEJM by Dr. Michael F. Greene. It's entitiled "Obstetricians Still Await a Deus ex Machina" & it is about the research into EFM over the past 30 years. The last sentence reads ...
I am so frustrated this week with how possible legal issues are changing the face of childbirth. Even with evidence-based research we are required more & more to intervene or limit women from just having babies because of the fear of lawsuits. ...
We are doing 450 births/month, 5,400/year. We have 24/7 anesthesiology coverage & one group has an OB in-house 24/7 who ends up covering all the emergencies when the physician of record is not in house. We do all our own scheduled & emergen...
Last comment for the day. I was using the recommendations from AWHONN & the IOM report on magnesium sulfate to teach safest care of the mother on high risk medications in Professional Development Day (annual,reqired competency+ class) recently. ...