I work on a Mother/Baby Unit. We do take care of many Mag sulfate pts--usually PP with PIH. Very rarely AP's on Mag. The Mag is USUALLY started in L&D. But at least 2-3x in the last year I have heard co-workers who have bolused the pts on the floor. The other day an AP PIH was bolused on our unit then transferred to another hospital where they would probably deliver her d/t the PIH. To the best of my knowledge we have not been trained to bolus the Mag--it was not in MY orientation. We carry at least 4 couplets, even if one of the moms is on Mag. Sometimes we have 5 couplets, and some of us have even experienced carrying 6 couplets. Anyway the nurse caring for the patient had 3 other couplets, had to do the bolus and transfer. I think that is too much. They are setting the stage for a mag sulfate scare at our hospital.
Wondering if any of you bolus Mag on the M/B unit, what monitoring is done on mom and if AP what, if any fetal monitoring? After reading the sad story of the maternal demise from Mag, I have to wonder why there are not National Standards for Mag? Why do some hospitals provide 1:1 nursing and others carry Full assignments? Why is there no JACHO standards for Mag or AWHONN standards for Mag? When there is such a range of how to care for these pts shouldn't someone narrow the gap as to what is SAFEST, not what works best for the staffing of the unit? And, back to fetal monitoring, should that be done during a bolus? We aren't trained in fetal monitoring....ARGGGG Thanks for listening.