New OB Nurses, Grads and Students, Please Feel Free to post your questions here:

[SmilingBluEyes]

Mugwump had a great idea offering services to new grads as a mentor (thank you for that!)

So, I thought having a "sticky" for new grads, OB nurses, students, and others with questions who want to post these can do so here. We also seem to see many of the same questions over and over, so perhaps this would help serve as an ongoing discussion of common issues/questions we all seem to have on our minds. This could serve not just for those asking directly, but others who may be "lurking" and looking for information or considering a career in OB, newborn, GYN nursing, or midwifery, doula services, childbirth education, lactation consulting, or other related work.

So if any mod thinks this is a good idea, mind stickying this?

Let's give this a go and see how it works out. We have many potential "mentors" here among us who, I am sure, would LOVE to help a new nurse/midwife/doula or student on his or her way to a rewarding career. I know I would love to help out!

[SmilingBluEyes]

I knew when I had my first baby,I wanted to be like the amazing nurses who took such wonderful care of me and my premature son. That is when I knew. And I went for it.

[mandana]

So I just finished my last day in L/D. It was pretty wonderful and I think I experienced a bunch in three short days. I saw a c-section (planned), three vag births and a blood patch. It's funny - I went into nursing largely because of the experience of having children, but I don't think L/D is the area I want to be in ultimately. The nurses were great and really let me do the skills that I was capable of but never burdened me with more than I could handle and it was a nice change having healthy patients with perky, juicy veins! It's also nice to be a part of such a happy occasion - I was fortunate in that all of my experiences ended with healthy mothers and babies.

Thanks for the advice, SmilingBlueEyes, it was a bunch of fun. Postpartum next week - I'm not nearly as nervous about that!

Amanda

[SmilingBluEyes]

WOW you saw a LOT....way to go. I am so glad your experience was to satisfying. If you have any questions about what you observed, please feel free to ask here.

[CEG]

Hello all,

I am a student doing a paper on evidence based practice. I've chosen EFM as my topic. Specifically, does evidence support the use of it. I have several books and am finding a lot of articles. I just wondered if anyone has any book or article suggestions for me. I have "Obstetric Myths vs Research Realities" and some articles from the ACOG journal and ACNM journal. Thanks so much!

Courtney

[SmilingBluEyes]

The literature I have read has indicated continuous EFM use has not decreased the occurence of bad outcomes, overall.Most of the literature I have read comes from AWHONN and other similar resources. You may want to focus your research in that direction. GOOD LUCK!!!!!

[SmilingBluEyes]

http://www.awhonn.org

[CEG]

Thanks for your help, I will definitely check those out.

Why do you think EFM is so widely used? Is it a fear of litigation? I have seen that mentioned in several places but I don't want to put that in my paper if it is totally off base. Most sources tend to agree that the only change in outcomes has been an increase in the c-section rate. What is your personal opinion on EFM if you don't mind? Thanks so much!

Courtney

[SmilingBluEyes]

EFM and other technology is used out of fear of litigation, sure. But there is a definate FALSE sense of security in its overuse. Also, to have continuous EFM strips available DOES prove extremely useful in a court of law, as well as a classroom. There is not a doubt; this is considered the baby's medical record prior to birth.

There has been purported theory (from many sources and professionals) that increased use of EFM leads to many interventions/actions that would not have been used or even necessary w/o its use.

Don't get me wrong; there is a definate appropriate time and place for this....but I think it's highly over-used.

[ebonynurse]

Hi SmilingBluEyes: i'm in my final semster taking OB/L&D/MotherBaby & NICU rotations split over several weeks this semster. I come from a background in computers (I"m very much a techie) ... I thought the postpartum unit might be a good place to start but then after taking L&D I feel like that's veen a much better unit. I enjoy the 'action' and see there's a lesser pt:nurse ratio on the unit. the big plus aslo is the technology. what would be ur advice for a new grad on these issues? i find myself wondering if i should go in to l&d/postpartum or NICU. at least i know i don't want to do med/surg for sure. don't i sound confused? i've gotten offers already in these different units in different hospitals but how do i choose?

Thanks,

EbonyNurse

[SmilingBluEyes]

Hi SmilingBluEyes: i'm in my final semster taking OB/L&D/MotherBaby & NICU rotations split over several weeks this semster. I come from a background in computers (I"m very much a techie) ... I thought the postpartum unit might be a good place to start but then after taking L&D I feel like that's veen a much better unit. I enjoy the 'action' and see there's a lesser pt:nurse ratio on the unit. the big plus aslo is the technology. what would be ur advice for a new grad on these issues? i find myself wondering if i should go in to l&d/postpartum or NICU. at least i know i don't want to do med/surg for sure. don't i sound confused? i've gotten offers already in these different units in different hospitals but how do i choose?

Thanks,

EbonyNurse

I would start in mother-baby if possible. Then you can move to higher-acuity areas such as L/D or NICU. Or you can do like I did, and start in LDRP (which combines Labor/delivery, post-partum and recovery) and learn a lot in short time. You are never bored doing this, and your continuity of care-giving is great, esp if you follow a patient during a course of labor/delivery and into her post-partum phase of hospital stay. I love it---LDRP is the way to go for me. But you will find most LDRP's are in smaller hospitals----not the really big ones. Most of the bigger hospitals have separate L/D and Mother-Baby units.

As far as NICU work goes, you would do well to start out taking care of well newborns, or "feeder-growers" first----before you move on to NICU nursing. Learn the basics first, then move on. Some may disagree. There are people who start NICU right out of school-----and do very well. It would be your choice.

Before considering exactly what area you choose, do try to find a hospital that offers new graduate "residencies" in specialty areas like OB and NICU. That is a great way to learn the specialty "from the ground up" and combines classroom with on-the-job work/training to ensure you learn the basics of each before being set out on your own to work that area.

More and more places are moving to computerized charting, so if you are a "techie" as you say, you will like this. It's becoming the standard of care across the board.

GOOD LUCK and let me know if there is anything else I can do to help you.

[ebonynurse]

Thanks for the advice. I really do apreciate it. I guess the idea of having 6/7 couplets to take care of in mother/baby just seems overwhelming. They all offer fellowships in the different specialty areas which is a good thing.

[SmilingBluEyes]

yes, 6/7 couplets IS overwhelming...and too many IMO. But L/D can be very overwhelming for a new grad, too. Especially in a place that would assign ONE nurse to 7 couplets----I bet L/D is just as tight staffing-wise. I have heard of places that assign as many as 3 labor patients to one nurse. I think that is horrible.

Really, I am really blown away by all the places routinely assigning 7 or more couplets to ONE nurse. This is a horrible disservice to the patients and their staff! How is anyone supposed to get more than bare minimal care this way? And what if you have two or more couplets having breastfeeding and/or infant and self-care issues? Seems to me, there is no real way to give good care to 14 or more patients....

Try to find a place where ratios are more reasonable, if you can.