Old School

Jolie, BSN · Jan 4, 2004

Good gracious, I thought you practiced in IL, not in Outer Mongolia! I thought most of those old stand-bys had gone the way of the dinosaur!

I once floated to a well-baby nursery in a large and well-respected teaching hospital that had some of the most archaic policies imaginable. There was absolutely no scientific or research basis to the care provided there. When questioned, the nurses could only say that "It's always been done that way." Well, I believe it, since Moses himself must have been cared for by the person who set the policies in that Nursery. I guess they could get away with it, since they only dealt with well babies who thrived in spite of the care.

But it was eye-opening, since the P&P manual in the NICU of that very same hospital had references for every entry.

L&D_RN_OH · Jan 4, 2004

Originally posted by acuteobrn
Starting all IVs in the hand w/ and 18g angio

This is the only one you mentioned that we do. No enemas here. And we wouldn't necessarily do continous fht on a 26 wker even in PTL. Just cont. toco. I like to think we are pretty liberal here. Our pts get up and move (well, the ones you can kick out of the bed, :chuckle ) Even on Pit, we just use the telemetry unit. Of course, we have Jacuzzis too. So it's hard to say, you have to stay in bed when there is a big tub across the room from you.

I wouldn't say our policies are old school, but there are a couple docs....... The same female doc who cuts every perineum she sees, ordered cont efm for an obs pt she was planning to dc in the am. Huh? If you don't think she is in labor, then why cont efm? We normally send the false labors/early labors home. Even at 4 cm, if they aren't changng their cervix. Of course, it has bit us in the butt a couple times, when they come back later that day or the next darn near complete:chuckle

acuteobrn · Jan 5, 2004

Maby the IV in the hand is my personal issue. Have had em', hurts like hell and they are very positional, specially when the mom is pushing or breast feeding.

But you brought up a good point bout the epis. we do em on alot of pt...but even worse alot of the older docs LOVE those nice big LML's OUCH!!!! I'd rather have a section then get stuck sitting on a donut for a month. Just me though.

Good gracious, I thought you practiced in IL, not in Outer Mongolia! I thought most of those old stand-bys had gone the way of the dinosaur!

:chuckle Dang you found me out... I am indead practicing in Mongolia, aka Generic Inner Chicago City Hospital!!!!!:chuckle

Dragonnurse1, ASN, RN · Jan 5, 2004

Originally posted by L&D_RN_OH
Even at 4 cm, if they aren't changng their cervix. Of course, it has bit us in the butt a couple times, when they come back later that day or the next darn near complete:chuckle

Before I went to nursing school and it was time for baby #3 went to L&D in labor. Spent several hours nursing staff kept trying to send me home. I refused until I saw the MD - just felt something wrong. Nurse called to the desk from my door - Someone else is going to have to work with this b****. Md arrives does exam and calls staff to foot of my bed. Says I want anesthia and OR NOW. Just how long have you been feeling the baby? Answer oh about 4 hours. And just what part of the baby have you been feeling? The head. "Well I suggest you all go back to school. You have been feeling the butt and he is breech and wedged in canal up to his knees!!:imbar Emergency C-section was fun.

Never forgot that when patients came to ER in "labor".

at your cervix · Jan 5, 2004

I recently left a hospital where about half of the doctors, believe it or not, were still giving IV push pitocin after delivery!!!!!

allnurses Guide · Jan 5, 2004

Originally posted by at your cervix
I recently left a hospital where about half of the doctors, believe it or not, were still giving IV push pitocin after delivery!!!!!

Ok, I know I just had a seizure 3 days ago and my mind might be a little fuzzy but . . . what is wrong with giving pitocin IVP after delivery, meaning, I hope, delivery of the placenta? If we have an IV in place, we give pitocin IVP. If not, we give it IM. 10 units.

We do not do enemas or the "big shave". However, I did have both those done with my first child and it was hell growing the hair back in. Also had a episiotomy. Ouch.

We use sanitary belts and the big old fashioned pads. I remember in my childbirth classes 20 years ago being told to BYOP . . bring your own pads . . . much more comfy. Also, those little "Tucks" are nice.

steph

SmilingBluEyes · Jan 5, 2004

Lord we don't do ANY of these things.

some of them are REALLY outdated.

Glad I work where i do.

dawngloves, BSN, RN · Jan 5, 2004

Gee acuteob. You mean you don't shave any of your pts?!:chuckle

fourbirds4me · Jan 5, 2004

EVERYONE gets a 18ga IV. Continuous fetal monitoring if admitted. Not out of bed if on pit. Foley after epidural.

SmilingBluEyes · Jan 5, 2004

Originally posted by fourbirds4me
EVERYONE gets a 18ga IV. Continuous fetal monitoring if admitted. Not out of bed if on pit. Foley after epidural.

WE do these things....at discretion.

NOT everyone gets an 18g, some 20 and i avoid hand veins like plague for comfort and ease for patient. Those wanting low-intervention, we just do saline locks.

FOLEYS are placed for duration of epidural drips.

Pit ---they can be in chair-- on ball,---whatever ifwe can capture US and FHT, its ok.

acuteobrn · Jan 6, 2004

Hey Dawn,

There have been times where they insist on me shaving. However, that is something I just won't do a head of time as it is not plesent!!!!

As for the foley thing, I personally like it, I have a better idea of output and don't have to worry about the ever-expanding bladder.

I really wish I could move my pts around more. I have done various positions in bed. Some nurses walk in and look at me like I am from outer-space (hands-knee position...should have seen the look on the face:chuckle )

I would love to try and help chang things, but change is a hard thing to impliment w/o a director and w/ most RNs over 20 yrs experience each.