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!
New to the allnurses boards and I have a question:
I am a new RN; OB LDR nurse (2 mos) and wondering if anyone has any advice for being able to confidently "check the patient for dilation and effacement?" I am training right now but do not always feel sure of this and just wonder how to be more comfortable with my assessment. Thanks !
New to the allnurses boards and I have a question:
I am a new RN; OB LDR nurse (2 mos) and wondering if anyone has any advice for being able to confidently "check the patient for dilation and effacement?" I am training right now but do not always feel sure of this and just wonder how to be more comfortable with my assessment. Thanks !
Hi Detra -
First, let me tell that it definitely gets easier to do SVE's (sterile lady partsl exams) for dilation/effacement/station. My first suggestion is to take a tape measure and measure out common household things ... glasses, measuring cups, shampoo bottles, etc. Then once you know how many centimeters they each measure, get practice measuring them with your fingers. Then find new things to measure :). This won't help with effacement and station though. That is something you just have to "get the feel" of during actual SVEs. You will totally know when something is 100% effaced .. the cervix will feel like a sheet of paper. The extreme opposite (0% effaced) is pretty easy ... really thick. In time, you will be able to call it 0% - 50% - 100% with some certainty :) And this will work for the most part :)
Another suggestion, if at all possible, try to check women who have an epidural so you can really take your time and not worry about her being uncomfortable. Always make sure to let the mom know what you are going to do and try to be specific ... instead of saying "I am going to check you" you could try and say "I need to check how far dilated you are, okay?" or "let's see how far dilated your cervix is now"
I am a new grad and just got a job on L&D floor...The internship starts March 2nd and is 14weeks...I was wondering if anyone could tell me anything that I should be doing before I start....I have been reviewing and reading books from nursing school but I am super nervous and REALLY want to be as prepared as possible!!!
- have a small notebook and pen to take notes - there will be LOTS to keep track of
- once you get the idea of how your day is supposed to go, make a check list for yourself to make sure you get things done in an organized way including admitting a patient and paperwork for after a delivery(I made up a checklist for lady partsl deliveries and then one for c-section deliveries and used them until I had it down
Can you tell me a little more about the checklist for lady partsl deliveries and c-sections? I know all hospitals are different in what is required; just trying to get a better idea on how to become more organized and make sure I am thorough in my duties.... Our unit is undergoing expansion and things are pretty hectic right now and a little overwhelming at times; the more prepared that I am will be a huge help. Thanks for all of your advice and insight; it's nice to know where I can get help!
So, I am on of those people who list to check things off as I complete them. And when I was in residency, I made out a check list ... broke it all down. You might not need this much detail or "reminders" but it worked for me until things became more fluid :) This is for an admission through a lady partsl delivery. Obviously, there will always be things that don't fit with these checklists ... epidurals that don't "work" the first time, BPs that plummet after an epidural, abruptions, postpartum hemorrhages, etc. I have it saved in Excel, but I can't seem to just attach the file here ... so I apologize for the formatting below. Hope this helps you in the beginning though :)
Aisha
-----------------------------------------------
Gather paperwork and ID bands
Look over charts - maternal risk factors?
EDC G P
Allergies Blood
GBS?
Hep B
Herpes
Pull IV start supplies
Go to room
Put on ID band
Mom on monitors (FHR, contrx, V/S)
Verify allergy status/safety check
Get mom to sign consents
Start IV - start meds if GBS +
SVE if intact (unless contraindicated) and before Pitocin
Chart
Do full admission charting
exam, assessment, note and problem
chart fluids, meds, and charges
Call for epidural when needed (ordered)
Insert foley after epidural
Set up delivery table
FHR/VS/Pain/Dermatome
Chart when complete and ready to push
Delivery
> Pull foley
> Position patient and annotate
> Document when Dr arrives and that pt is pushing, etc > Assist with pushing
> Document time of birth
> Document any complications
> Start pitocin when placenta is delivered
> Document placenta delivery time
Dr Leaves
> Remove sharps from delivery table
> Clean up mom, apply ice/pad, fix bed
> Clean up table and room
> Put bands on baby, mom, and dad
> VS/ Fundal checks/Pain/ Dermatomes
Mom Q 15 x 4 Baby Q30 X 4
Q 30 X 2
Q 1hr X 2
> Mom up to void at 1 1/2 to 2 hrs post delivery or when fundus displaced
>> or do in/out catheter
> Baby bath after 1 hr or 1 1/4 hr - retake temp > Footprints
> Chart - fluids, meds, and CHARGES
> Do ballard, delivery charting, birth certificate
This is so great ! I can see now how to set this up for my facility and it will be a GREAT help! I am so excited. I just passed NRP this week so hopefully things will begin to "click".... thank you so much for your help
I am a pre-nursing student at a private university in Michigan and I have been asked to create a survey and distribute it to individuals in the field of nursing related to OB and midwifery. I was wondering if it would be possible for anyone to complete it on here. If there are some questions individuals would prefer not to answer, that is fine with me. I am simply looking to get them filled out.
Position/Title
Years of Experience
Type of experience with obstetrics/midwifery:
How would you describe the culture in your working environment?
What factors contribute to this culture?
Have you ever been burned out? What caused the burnout? What did you do about it?
How do/did you handle emergencies?
How are men and women treated differently?
Why do you think these differences occur?
How would you describe the culture of your working environment?
Does the culture change dramatically between hospitals and/or clients?
What factors contribute to that?
What kinds of written communication are required as part of this job?
Who is the audience and what is the format for these documents?
What features are important in these documents-- for example, is it important to be objective? Is it important to be detailed and concise? Why?
What other kinds of interpersonal communication are an integral part of this job? Do/did you use e-mail? Instant messaging?
Do/did you give oral presentations?
What kinds of informal conversations or small group conversations are important?
What kinds of skills do people need to be successful in this kind of interpersonal communication?
What typical problems do new hires have with communication in this job?
How did you overcome these problems when you first started?
What type of language is used in your career? For example, what kinds of technical terminology or key concepts are essential for you to understand?
Why are these concepts and terms important?
Is there anything else you wish to contribute to this survey? Feel free to include any additional information.
Thank you for your time, even if you don't respond!!
Hi! I am a nursing student just beginning my OB theory. Could someone please explain to me how contractions are marked on the graph paper? I have searched through a stack of books and the only information I could come up with was useless to me as it made no sense. I do know that from dark line to dark line is equal to one minute with the boxes being ten seconds each. That's all I could come up with and I know that can't be all there is to it. Thanks in advance for your help! ~Jen~
I plan on taking a CNA course at my local community college and I recently found out about OB techs. Is there more required training to become an OB tech or do hospitals hire CNA's and train them? I work as a catering associate at a hospital now (i make/deliver patient food) and the nurses in L & D say they use scrub techs. I would ask more questions but our hospital in currently way under staffed and super busy. So are scrub techs CNA's that are trained at the hospital or is special schooling? Are scrub techs and OB techs the same position?
I hope I am posting correctly.... I will be graduating with my BSN soon, and am trying to decide between NICU or L&D, PP, etc (Women's Health). I only was able to observe for a day in NICU (level 3) but found it really interesting. (and I loved the babies..:) I really loved my rotation in the LDRP, which included L&D, AP,PP, and nursery. I have to decide on my last semester preceptorship soon, and am really torn about which to try for. I am middle-aged, and the job market is , well, you know....Would anyone out there be able to give me some advantages/disadvantages of NICU vs. LDRP? I feel like I can be happy either place, but I want to make a practical decision based on my age, and job prospects. I would be so excited to do either one! Any ideas? Thanks !:)
detra, BSN, RN
9 Posts
New to the allnurses boards and I have a question:
I am a new RN; OB LDR nurse (2 mos) and wondering if anyone has any advice for being able to confidently "check the patient for dilation and effacement?" I am training right now but do not always feel sure of this and just wonder how to be more comfortable with my assessment. Thanks !