OB Nurses...

shay · Apr 21, 2002

You know, I think this question hasn't been answered yet for the reason that well, it would take a million years to answer it.

What do we DO? We triage pregnant pt's and determine if indeed they are in labor/water is really broken/ etc. and call the docs to tell them about our findings. We monitor the mother and baby for well-being, general health, call the docs if we see something icky/ominous and take action. We monitor the patient's progress thorough labor, the baby's health through labor, the mother's health. We do antepartum testing to determine if the baby and/or mother are well or if an induction/c-section may be medically indicated. We do ALL of the pushing with the patient, the doc just comes in to catch, sew, and leave. We start the IV's, draw the blood, push the drugs, coach, breathe, relax, run interference between insane family members and tired labor patients, fight with idiot doctors who want to induce ms. smith because she's tired of being pregnant, fight with idiot doctors who won't listen to you when you tell them your pre-eclamptic patient is getting ready to seize, fight with the grumpy anesthesiologist who doesn't want to get out of bed at 3 am to put in an epidural for a screaming patient, code sick babies, code mothers, sometimes code family members or at least take them to the ER after they pass out from seeing the delivery or the size of the epidural needle, we deliver live and dead babies when the docs can't or won't make the delivery, we train the residents how NOT to check a cervix, we calm down the pediatricians when they come for a delivery of a woman who has chosen to labor naked....standing up...and moaning...with thick meconium...., we fight with the ER when they want to send us a woman who is 8 weeks pregnant with a splinter in her toe.........................

I could go on and on and on and on................... we do it all....we just have two patients instead of one, and one of those patients is cloaked by a uterus and has a very sick sense of humor and timing sometimes.

anitame · Apr 22, 2002

Shay,

I couldn't have said it better myself. The only thing I have to add is that 90+% of the time it's the BEST job in the world!!

Anita

2ndCareerRN · Apr 22, 2002

Shay,

you wouldn't need to fight with me or my ER with an 8 weeker, if it is from the boobs up or the upper thighs down, we keep it, no matter how far, if over 20 weeks it may get down there b4 the night is over. And, if it is less than 20 weeks, we keep it.

But, you did leave out being called to the ER to try and find fetal heart tones on the early ones, when no one in the ER can find them.....my method is to start LOW...very LOW.

bob

bbnurse · Apr 25, 2002

OB also includes teaching mother and baby care in those units and post op care of OB/CS or GYN's. Supporting mothers with breastfeeding or just mothering techniques. Dealing with moms with great support and those without. Offering information and being appreciated and thanked profusely. Handling pp hemorrhage....my gosh, can one person lose all that blood and LIVE??? It's a combination of all the labor, the PP and the Nursery for many of us. It means feast or famine. And it IS the greatest job in the world....

rdhdnrs · Apr 25, 2002

Hey Shay!!

I would also add that after we deliver the dead babies, we bathe them, dress them, take their pictures, and bring them to the family. Then we cry with them a little and go do our next admission, maybe a pretermer, maybe a preeclamptic, maybe-nah, probably not somebody normal!! We also have to try to communicate with patients whose language we do not speak, explain conditions to people with elementary educations, all while doing QA activities and serving on improvement committees, etc.

Anything else?

Lisa

shay · Apr 25, 2002

Hey Lisa, don't you just love it when you have an IUFD in one room and a bubbly primip in the next....talk about split personality shift from hell..................

mother/babyRN, RN · May 14, 2002

We do everything PLUS....

Sable's mom · May 14, 2002

It is the best job in the world...until some moron comes up and says"boy, I wish all I had to do was rock babies" and the baby you're rocking is dying and you promised mom (a 17 year old rape victim now in OR) that you wouldn't let her 21 week baby die alone!!

rdhdnrs · May 18, 2002

Shay right on target. Also after yesterday, here's another thing we do: hold heart tones on a patient who's seizing while suctioning for anesthesia while he's bagging her while your buddy starts an new IV because the freshly started one just got pulled out during the grand mal, make an armboard out of Yankauers because the only available site was antecubital.

Document all of it. Go to your patient's room who is a quadraplegic (pregnancy already established when her husband beat her into paralysis), see that she's having autonomic dysreflexia due to clogged urinary catheter, replace catheter, do glycerine suppository, try to convince pt of desirability of central line, hear her say, I have white spots in front of my eyes, SHE starts seizing, have hysterical family escorted out, hold heart tones, suction for anesthesia while he's bagging etc.

All in the same day. It began to take on a nightmarish quality after a couple of hours. You know your L&D floor is going to hell when you start thinking where you can get a third crash cart just in case.

Oh yeah while the quad was seizing, surgery was starting a femoral line.

This is labor and delivery where all we do is rock babies.

Lisa:eek:

shay · May 19, 2002

Um, Lisa...have you ever considered leaving HROB for a nice birthing center or something? You sound like me 3 years ago....

rdhdnrs · May 20, 2002

Not yet. I think I'm addicted to the adrenaline. It is nursing in the trenches, and I love it. When I'm really tired, I'll go to private practice.

It's good to hear your voice here again.

Lisa