Postpartum nurses and circumcisions? - page 2
I am a pre-nursing student, former doula student with some births under my belt. I would love to work postpartum when I get my degree. I would like to help the women heal and assist them in... Read More
Nov 12, '06Occupation: FNP Specialty: 12 year(s) of experience in Family Practice ; Joined: Sep '05; Posts: 63; Likes: 10Our hospital does em all the time. I havent had to assist with one yet. BUt when our baby had a circ i asked for tylenol afterwards and they told me they couldnt give him any. SO I told my husband to go to the store and bring me some infant tylenol so I could give him some. It sure did help and he didnt stop crying til then. I intend to do the same if this baby is a boy. I just dont tell the Girls working until after I go home
Nov 12, '06Joined: Dec '02; Posts: 41,761; Likes: 48,081Quote from BSNtobe2009He does not give shots of lidocaine because he says there was a case of the shot doing irreparable damage to a baby's penis.AMEN! That's what I say! I think it is unethical for a Doctor to not use pain relief during a circ, if it is safe and medically appropriate. I'm suprised the hospital let's him get away with that.
I helped with a circ today - the baby was numbed up fine and this doc and I don't tie the baby's arms down, just the legs, and that seems to not bother them so bad. This baby took a pacifier (we don't use sugar) and didn't make a peep.
stephLast edit by Spidey's mom on Nov 12, '06
Nov 13, '06Joined: Nov '06; Posts: 20,715; Likes: 23,951[quote=stevielynn;1921635]He does not give shots of lidocaine because he says there was a case of the shot doing irreparable damage to a baby's penis.
And a circ runs the risk of....??
In our NBN it is the nursery CNA who sets them up and assists. The nurses do the circ checks afterward. I am thankful for this, as I decided that I hated circs since the first one I saw. I wish they would be outlawed.
I have a friend who is a pediatrician in Finland where circs are not the norm (as in most of the rest of the world) and she says that if there is a problem down the road such as phimosis, they do preputiotomies first to try and save the foreskin. Circ is a last resort. I like that idea.
Nov 13, '06Joined: Feb '03; Posts: 388; Likes: 153We do an awful lot of circs at our hospital. The peds don't do them because as a group they decided that they would not perform an unnecessary surgery on a newborn!!!! Good for them. Our OBs and some of the FPs do them. They all now use lidocaine (took one a while to come on board with the lido, but started having alot of patients ask for it and finally started doing it). We also give them a lemon glycerin swab during the procecdure - their first little lollypop. A few of our docs have us swaddle the arms, but most of them want those kids strapped down tight.
I hate them and do my best to make myself scarce when there is one to do. I think parents should have to watch a video, with audio, of an actual circumcision from start to finish before they sign the consent.
Nov 13, '06Joined: Dec '02; Posts: 41,761; Likes: 48,081And a circ runs the risk of....??
I know, I know . . . .
One thing that the nurses and CNA's hate is that all the docs put on gauze with petroleum jelly or neosporin . . .that gauze is very hard to remove . . . as soon as the doc is gone, we remove the gauze and just slather with petroleum/neosporin sans gauze . . . .
The CNA's can assist.
The doc from yesterday usually does everything himself, including the clean up. However I wanted some time off the floor yesterday so I set him up with instruments and then changed the baby's diaper and placed the pacifier.
Nov 13, '06Occupation: Lactation consultant, L&D RN, some postpartum Specialty: OB, lactation ; Joined: Oct '03; Posts: 1,951; Likes: 96I have managed to stay away from them so far (I've been doing mostly labor although we are an LDRP). I hope to keep it that way. If it comes up I will probably try to be gone or switch the duty with someone else. We have about 4 OB's and 1 or 2 pedis who will do them and I think only one uses pain meds (but I've also heard he does the worst circs... so what are ya gonna do?). I believe they all use Gomco's. We do use paci's but I don't think we even have sweet-ease; I don't know if anyone uses sugar water or not but I don't think so.
Our medicaid doesn't pay for them. If people are going to pay cash for it themselves we send them to do it after discharge because it is really expensive with the added hospital charges if done in house. If they have private insurance that pays it then it is done while still at the hospital.
Our babies all generally scream and cry and it makes me sick to my stomach, I can't even stand to hear it so I usually try to go away if I'm in the area.Last edit by mitchsmom on Nov 13, '06
Nov 13, '06Joined: Dec '02; Posts: 41,761; Likes: 48,081The babies w/o medication usually scream and cry and I hate that too.
I will say that the ones with lidocaine do not usually scream and cry. This one doc I've mentioned who is so good usually does not have a crying baby. I'm very grateful for that.
All my boys are circ'd although I personally did not want it done. The two oldest are glad - they have told me they would be very angry with me if I had won the argument with their Dad.
This won't go away - people will circ. I'm just grateful that some docs do NOT USE those horrible Gomco's and do use pain meds.
And I reserve the right to not work with the doc from hell.
Nov 13, '06Occupation: Postpartum staff RN Specialty: 5 year(s) of experience in Postpartum, Lactation ; Joined: Mar '04; Posts: 129; Likes: 21At my old job, the peds did the circs and I worked a lot of day shifts, so I assited with lots and lots of circs. Everyone had their own way of doing it. Some used Gomcos, some used Mogens and some used plastibels. All but one used Lidocaine or EMLA. Even though I am as anti-circ as can be, I really didn't have a problem with assisting. I felt that I was a great advocate for the babies comfort while I assisted. I made sure they got in their full 2 minutes of suckling on Sweatease before the procudure was started and tried to be a calming presence.
Now, I work nights and the OBs do the circs on the day shift and the NBN RN is responsible for assisting. I can't say that I have missed that part of my job.
Part of being a good nurse is understanding why people choose to undergo procedures you would never choose for yourself or your family and to assist them through that procudure with as much compassion as possible. Our job is not to judge. You will make yourself crazy judging all of the abismal parenting choices you will come across in postpartum.
Nov 14, '06Joined: Mar '06; Posts: 88; Likes: 9Just to clarify one thing I read on this thread, my OB Instructor stated that the reason why Peds don't do circs is because they are not trained surgeons. OB's are trained which is why they do the circs.
As a current nursing student who just finished her OB rotation, I was able to watch a number of circumcisions, using both of the surgical techniques. I didn't think it was that bad, some of the babies screamed, others weren't bothered at all. I think strapping them to the board made them scream the most. The OB's did four shots of novocaine on the base of the skin where the penis enters the body. And the babies all got the sugar water during the procedure.
Nov 14, '06Occupation: Nurse Educator Specialty: 13 year(s) of experience in NICU ; From: TX, US ; Joined: Nov '05; Posts: 8,750; Likes: 1,692Quote from ClariseIn general, she's right. I've worked with both pediatricians and neonatologists who were trained in circs though.Just to clarify one thing I read on this thread, my OB Instructor stated that the reason why Peds don't do circs is because they are not trained surgeons. OB's are trained which is why they do the circs.
Nov 14, '06Occupation: Nurse Educator, psych forensic hosp Specialty: 45 year(s) of experience in pure and simple psych ; Joined: Mar '05; Posts: 804; Likes: 120Some day circs will be in the same class as female genital mutilation.
Nov 14, '06Occupation: full-time student Specialty: Looking for a career in NICU ; Joined: Oct '06; Posts: 1,020; Likes: 82Quote from q12RNI probaby wouldn't be giving birth at a hospital that wouldn't even give Tylenol to a baby that had just had a circ. It would make me wonder what other silly practices that they are doing. That's just me.Our hospital does em all the time. I havent had to assist with one yet. BUt when our baby had a circ i asked for tylenol afterwards and they told me they couldnt give him any. SO I told my husband to go to the store and bring me some infant tylenol so I could give him some. It sure did help and he didnt stop crying til then. I intend to do the same if this baby is a boy. I just dont tell the Girls working until after I go home
Nov 14, '06Occupation: Registered Nurse Specialty: ICU ; Joined: Dec '03; Posts: 612; Likes: 24I don't know if it's mentioned, but when I asked about my son's circ, the doc told me he was numbing him, and the numbing procedure took longer than the actual circ. So, that may be why some docs would rather just do it and get it out the way. There's no excuse though, because no matter how long the procedure takes, I would want my child medicated first. Overall, I am extremely happy with the circumcision because it way better for hygeine. My cousin has an uncirc baby and he screams at the top of his lungs everytime she has to clean it. She regrets it now.