need hw help

SmilingBluEyes · Nov 24, 2002

I will try to help you but the questions you ask will have many answers that vary by case and hospital.....also did you consider asking nurses/CNM's who work out of BIRTH CENTERS? they are a burgeoning business in which many birthing families find great satisfaction in their childbirth experiences.

Anyhow:

I am Debbie, R.N. I have an Associate's Degree in Nursing

I have worked in labor/delivery nursing for 5 1/2 years now.

What do I do in the hospital setting to make a family more comfortable? Well, first I make them "at home", showing them around, explaining the equipment and birthing bed in the room. Most hospitals, nowadays, have birthing rooms that are more homey than in the past.....with the surroundings intended to be relaxing and pleasing to the eye. This includes wallpaper, window treatments, wooden beds/cribs...etc...more like what you would encounter at home. The lights are dim (we use special lamps for birthing). The family is made to feel as if they are welcome...we have a kitchen for Dad and Mom that includes snacks, soup, juices, soda, and frozen dinners for hungry moms if they deliver before our kitchen closes. One thing I do is give them all the education and then the leeway to make choices in their experience wherever possible. If their medical situation permits, they can walk about, bathe, shower, sit on birthing balls and rock. They can have intermittent monitoring. They can usually defer having an I.V. if their medical condition permits. They may sip clear juices, eat clear dinner trays, and have all the ice chips they want in early labor....later on, they may just prefer to stick to ice. I offer back massage, foot massage and application of heat and/or cold when desired. They are allowed to have whoever they want in the room with them for their comfort and support...even children, if properly supervised. They may play music and use aroma therapy (no candles however) if they choose. If they tell me they do not want medication, I will offer none unless they change their minds. I offer support and touch if they choose. They also may have hired a doula..if so, I work with that person in the best interest of the patient, respecting their choices along the way. I will say, I ask the mother and her family to be open-minded. What does this mean? There are times when the situation may necessitate a change in their birth plan...if this comes up, I explain very thoroughly what is going on and why we have to intervene in the way we are. I keep them informed of changes and what they mean. I respect the birth plan as much as possible, given the condition of mom and baby throughout the birth process.

SmilingBluEyes · Nov 24, 2002

I will try to help you but the questions you ask will have many answers that vary by case and hospital.....also did you consider asking nurses/CNM's who work out of BIRTH CENTERS? they are a burgeoning business in which many birthing families find great satisfaction in their childbirth experiences.

Anyhow:

I am Debbie, R.N. I have an Associate's Degree in Nursing

I have worked in labor/delivery nursing for 5 1/2 years now.

What do I do in the hospital setting to make a family more comfortable?

Well, first I make them "at home", showing them around, explaining the equipment and birthing bed in the room. Most hospitals, nowadays, have birthing rooms that are more homey than in the past.....with the surroundings intended to be relaxing and pleasing to the eye. This includes wallpaper, window treatments, wooden beds/cribs...etc...more like what you would encounter at home. The lights are dim (we use special lamps for birthing). The family is made to feel as if they are welcome...we have a kitchen for Dad and Mom that includes snacks, soup, juices, soda, and frozen dinners for hungry moms if they deliver before our kitchen opens (e.g. in the middle of the night).

One thing I do is give them all the education--- and then the leeway to make choices in their experience wherever possible. If their medical situation permits, they can walk about, bathe, shower, sit on birthing balls or rock. They can have intermittent monitoring. (if the pregnancy is healthy). They can usually defer having an I.V. if their medical condition permits. They may sip clear juices, eat clear dinner trays, and have all the ice chips they want in early labor....later on, they may just prefer to stick to ice. I offer back massage, foot massage, effleurage, and application of heat and/or cold when desired. They are allowed to have whoever they want in the room with them for their comfort and support...even children, if properly supervised. They may play music and use aroma therapy (no candles however) if they choose. I speak in very quiet tones and encourage all around the laboring mother to do the same. I keep the lights very low.

If they tell me they do not want medication, I will offer none unless they change their minds. They know the options available and I do not bring up the subject of medication again once the options have been covered. I offer support and touch if they choose. They also may have hired a doula..if so, I work with that person in the best interest of the patient, respecting their choices along the way. I will say, I ask the mother and her family to be open-minded. What does this mean? There are times when the situation may necessitate a change in their birth plan...if this comes up, I explain very thoroughly what is going on and why we have to intervene in the way we are. I keep them informed of changes and what they mean. I respect the birth plan as much as possible, given the condition of mom and baby throughout the birth process.

Meds: offered when asked for in ACTIVE labor. (usually contracting every 3-5 minutes with cervical change). We use a variety of IV narcotics such as Stadol or Fentanyl, if they choose. They may elect to have regional anesthesia in active labor (epidural/intrathecal) with the approval/order of the care provider.(obstetrician/midwife/family dr.)

Regarding Cesarian Section Deliveries: The decision to perform surgical delivery is NEVER made lightly and is NOT determined or decided by the nursing staff. Usually, it is considered when the condition of mom and/or baby makes it necessary. There are a variety of reasons why this may happen: baby/mom's medical condition deteriorates; failure to progress (many factors considered here), maternal feve (in some cases), and malpresentation of baby are a few. If it becomes an emergency, all the personnel needed to do it are in the hospital within minutes, to include nursing staff (for mom and baby), anesthesia provider, obsterician/surgeon and his/her assistant. It usually is only minutes if there is a true emergency.

Hope this helps. I could say much more, but I think this is too long already. Ask anything else you want.