Running into the room for every D-cel

Specialties Ob/Gyn

Published

I just started at a new hospital and I don't know if it is the lack of experience or what. D-cels happen, they don't ALWAYS need an intervention. So far, everyone I work with, seems to think, EVERY nurse on the unit needs to RUN into the room for every d-cel and immediately move the patient into 14 different positions and give terb.

I'm coming from a hospital where we almost NEVER used terb. we RARELY used 02 on mom's, we had a VERY low c-section rate, and we let our patients walk and use jacuzzi even when on pitocin.

We also let babies stay on mom's chest for 1 hour after birth without ANY interventions except drying and stimulating, and keeping baby warm.

When I mentioned this to the new people I work with, they looked at me like I had 4 heads.

I'm missing my old hopsital :(

This seems weird! When you mean deep variablity do you mean deep variables?

I am student so bear with me... I am thinking variability is irregular fluctuations between 5-25 bpm. As opposed to decels which would be a decrease of at least 15 bpm for at least 15 seconds. So maybe we had a decrease of 20 bpm but only for 5 seconds (or something like that, I don't remember exactly). So this happens several times but doesn't really fit the pattern of decels exactly. Maybe some of them were late in terms of timing, but they weren't long enough to be true decels.

Too me it seems like other factors contributing would make this a problem- unusual bleeding, heavy mec, etc. But in the absence of other problems it would just be something to keep an eye on. Maybe oxygen or increase IV fluids if mom is in bed anyway, but certainly no threats of c-section or actual c-section.

Anyway, I hope that is a passable explanation of what makes sense in my mind, it's scary in there ;)

No, this is not what I'm saying at all. Yes, I worry about decels and yes I intervene when necessary. But, having 3-4 nurses rush into a room for one little variable, when the primary nurse was already in the room, is NOT necessary.

My point to the post was, I came from a facility that was very low intervention and relaxed and we were a high-risk facility. My co-workers contributed to the experience of the staff, MOST of the L&D staff had been there for 20+ years.

I have been an L&D nurse for 9 years now and yes I go into the room for every decel. Well, almost every decel, I don't worry about short V and W shaped variables but, is it really going to hurt anything to change mom's position? NO!! I don't freak the patients out with it though. I let my patients know right from the start that for a variety of reasons I will be frequently helping them to change position.

Are you saying that you just watch decels and don't worry about them?????? I guess I just don't ever want to explain to anyone that I didn't respond to decels because I didn't want to worry the patient!

Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

sounds like you came from a great place to work, waterfall. I would miss it, too.

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