Do you count? - page 4
I am a pre-nursing student and l&d is a particular interest of mine. Maybe because I have had 3 little ones. Anyway, I watch these shows on the discovery channel and I hear the nurses counting. To... Read More
Jun 27, '04Joined: Mar '04; Posts: 5,926; Likes: 15Quote from L&D_RN_OHI understood what you were saying. I just wish all nurses were like that and would really listen to their patients. Some of mine did and some didn't. That's all I was bringing up.....everyone is different.I understand that people use their own experiences to make generalizations about situations. I'm sorry that the nurses at your delivery made assumptions about your ability to push. I was merely pointing out that I don't assume anything and I am sure many other L&D nurses do not either, but rather, listen to their pts and their needs. You said "I hear everybody saying...." I just think that was a misinterpretation.
For instance, my pt last night, told me, "I feel like a have to take a crap". I did not assume because she had an epidural that she was unable to feel that or when she needed to push.
I should have said "I hear some people saying......"
Now I will stop sharing my personal experiences and let you guys discuss your experiences at work with the pushing issues.
Jun 27, '04Occupation: LPN in LTC Joined: Nov '03; Posts: 345; Likes: 1Do you think it's alright to ask the woman? Sometimes I didn't know what I wanted in the middle of labor. Other times, like when I was laboring quietly with my 8th at home, my two midwives chatted in whispered tones about a display booth they were going to do for some event or other. They weren't being loud or trying to be rude, but I didn't have the heart to tell them I really wished they would be quiet. It was my own fault for being so passive.
But that was in transition. Maybe it's different in the pushing stage.
Jun 27, '04Joined: Apr '02; Posts: 38,756; Likes: 16,281You should OBSERVE the woman, watch how she is coping and then offer your help if it appears she is having difficulty staying "with it" , or concentrated or can't make progress. Or if she ASKS for your help . It's ok to ask, but first observe to see how she is doing. Good luck!
Jun 28, '04Occupation: L & D RN Joined: Apr '03; Posts: 28Quote from ayndimAloha,I am a pre-nursing student and l&d is a particular interest of mine. Maybe because I have had 3 little ones. Anyway, I watch these shows on the discovery channel and I hear the nurses counting. To me it is just plain annoying. And when I was delivering I think I would have told off anyone who did. Well with #1 my hubby did try to count but the CNM told him I knew when to push and for how long before I got the chance. So do you count when your moms are pushing? If so do any of your moms ask you not to? If you don't do any drs/cnm's want you to?
Patients will let you know what they need. They sometimes need hearing the count to focus on, knowing that there is an end in sight as they expend
that much energy and trying to get three good pushes from each contraction usually. But I usually ask as my moms get into transition before they ready themselves to push what their preferences are. There are even times where the whole family or whoever's present all count together which changes the dynamics of the room. But the bottom line is what the patient wants, she usually gets. That's what we're there for anyway.
Jun 29, '04Joined: Oct '00; Posts: 8,729; Likes: 8,412I let the woman do what she wants to, and put my finger gently on the head and tell her when I feel the baby moving downward. Most women get the idea of what is going to work for them and what it feels like to push effectively. I had an unuasual labor recently where the baby came out with short little "squirt" pushes...never would have thought they would be effective, except I felt that head coming down, so figured we'd go with what mom wanted, and it worked.
Jul 6, '04Occupation: USAF Joined: Jul '04; Posts: 18; Likes: 1I pretty much go with the flow. If the patient is not pushing well, I might suggest counting, but I rarely count myself. I have the dad or the labor coach do it. Gives them something to do, and they are usually more receptive to it. Plus, if the mom doesn't like it, she may not want to tell me, but usually has NO PROBLEM telling her partner to shut up! And, I think that for the most part, open-glottis pushing works great. I just think it is very hard to explain to someone in labor how to do this. If they are doing it on there own, great. Like I said, I just go with the flow
Jul 6, '04Joined: Apr '02; Posts: 38,756; Likes: 16,281Friday, what worked for me with a new mom unable to push effectively at first was a mirror. I showed her the head peeking out when she pushed well....it was all she needed to give her the "oomph" to finish the job, and effectively. She, being a primip with a strong epidural, pushed her baby out in 40 minutes this way, without me counting once. It depends on the mom. The visual was all this lady needed to get the job done.