nograd

Dianah, I just wanted to get back to you and thank you for responding with such thorough information so fast!!! Like I said in the first post the nurses I met with were very nice and tried to provide me with some info, however, it was too basic, not exactly what I needed...So you have helped me enormously!!! I had a basic understanding, now I realize what a huge responsibiltiy that RAD RNs have and how it can be difficult to be in 20 different places all at the same time...So KUDOS to you and your profession. Anyways, I have to finish that paper, and I just wanted to get back to you and say: Thanks, I really couldn't have done it without you!!! Nicole

Hi all, I have been assigned to spend a day with a Radiology nurse as part of my senior year of nursing management module. I was there today and was sent to watch a few stress tests and saw a lower GI, however, due to a mis-communication was not really able to see the scope of the nurse. They did give me a sheet that was able to describe some of the scope of practice, which according to the sheet was mainly to start IV, respond to allergic responces and f/u with post procedural patients...needless to say I really don't have that great of an idea of the whole scope of practice. I have an essay to write and would like to know what your scopes of practice are so that I have a better understanding of your position. If anyone is online and could get back to me by the weekend I would be very appreciative of your help. You could PM my if you prefer. Thanks Nicole PS As a side note I was able to speak with the Director of Radiology nursing and clear up the miscommunication between the institution and my program so that future seniors could benefit from the experience, but my time had run out for this experience...never did get to see the radiology nurses in action...

I aboslutely LOVE ER! I am cable-less right now so I miss all the TLC show, watched or taped them all. Direct TV will be set up soon and I can't wait to get a peak at the Discovery Health Channel. :biggringi By the way does any one remember another show called ER from the eighties? It was a comedy with Elliot Gould and I believe George Clooney (YUM!:wink2: )? OR am I just dreaming????? Gotta Plow, Srubs is on!!!!

Hey, Thanks guys for the responces. It just didn't make any sense to me. It's nice to have somebody explain it and point out the obvious. I am "just a tech" so sometimes the girls are reluctant to validate my educated guesses. I like learning about OB and hope to be a L&D RN next year! It's nice to have some support. Renee, are there as many Angels visiting around your L&D as mine? Lately we have been doing 5+ deliveries on nights!! Nicole

Shay, Thanks for the reply. I know it's hard to make a judgment on something that you did not see personally. I agree it is a bit of a controversy up on L&D, but I really think that most the time, with good technique and fast analysis, it probably is accurate, just not this one (bad technique and the cord was basically 'clamped' right when we got into the uterus). However, some of the girls I work with, when asked about this say that they are absolutely accurate, but don't really explain why. Neo said the kid has a good outlook and most likely will not have any long term effects, since kids are so resilient! So basically good outcome. I just like to figure these things out, the human body facinates me. Thanks again, Nicole

Ok, I have a question for all you experienced L&D RNs... We did a c/s for a patient with fetal distress, late and variable decels into the 60s and FTP. We get into the uterus and the cord is an occult cord, coming down with the head of the baby who was asynclitic (sp?)...So out comes the cord first. VERY difficult delivery of the head, the way the baby was lying the face was coming out of the incision first, didn't fit, tried to push the baby back up into the uterus, rotate the head so that they could get the vertex out first, still no luck, something like 5+ minutes trying to get this kid out, all the time the cord is out and compressed, flasid and pale, the baby's face was blue+, we heard a cry when we first got into the uterus, but than, nothing no movement, nothing. SO doc finnaly takes the bandage scissors from me and extends the uterine and cutaneous incisions, finnaly making enough room to get this kid out. This is some 8-10 minutes after the first incision into the uterus and the baby's first breath. The baby is dark blue on delivery, and basically looks dead Apgar of 1 at 1 minute...Neo for delivery and codes the baby Apgar of 9 at 5 minutes. We send gases which come back good venous was something like 7.4 and normal base excess (-1.5) PO2 and CO2 were both in normal range as well. Arterial gases were good as well. My question is are these gases really accurate? This cord was compressed and flacid for more than 5 minutes, most likely there was little to no perfussion, the baby did take it's first breath when we got into the uterus (5+ minutes before delivery), and the gases were obtained from a section of the cord below where the cord was compressed and out of the uterus, and the OB had to squeez blood from the placental end into the section that was sent for gases. Can anyone explain this to me? Some of the nurses said that this was accurate, but can't really explain why? I don't think that they are, d/t the above facts, but would really like to understand this better. I am in nursing school and have a pretty good understanding of the physiology. This was the scarriest delivery I ever attended, I really thought we were watching this baby die in front of us! I got teary eyed when I saw that this baby was doing good in NICU. The little guy did well and went home with mom on schedule. Thanks to any of you all that could explain this one! Nicole, OBT

GREAT THREAD! I work OB and the worst thing I have ever experienced was a pt who was post dates and when the MD ruptured the bag, there was a copious amount of meconium filled fluid but THE SMELL WAS AWFUL!!!!! There is no term to describe the stentch:o We immediately sectioned the pt, and one of the MDs said the fluid was filled with puss and meconium! That was the FUNKIEST looking/smelling fluid I have ever seen!!!! One of the RNs who has been doing L&D for 20 years had to leave the OR because of the smell, NEO was dry heaving, Anesthesia had an emesis basin near for his own personal use! Masks and all, it was something awful!!!! I must have done a 10 minute surgical scrub AFTER the section. Someone mentioned pseudomonas (sp?), we cultered the uterus, placenta and of course baby, went to NICU and was cultered as well. Baby was clear, no infection but had prophylactic antibiotics. Mom had spiked a temp, but after a course of IV antibiotics was discharged with baby 5 days later. Still don't know what was growing in that sac, but the smell will never, ever leave me!!!! The LDR reaked, and had to be sanitized. The smell was soo bad that you could smell it all over the unit. I worked the next night and swore I could still smell it and had housekeeping come up and resanitize the room. YUCK!!!! The other thing that gets to me is the tub after we do a water birth! Especially when the midwife delivers the placenta!! What I can't understand is that the few water births I have done, the mom actually did NOT get into the shower immediately after delivery!!!! THis water is up to their necks and is filled with amniotic fluid, poop from pushing, blood and God knows what else!!! The smell is not horrible, but not pleasent either, and I don't leave the room dry heaving...it just GROSSES ME OUT! I would want to sanitize my whole body the autoclave after bathing in something like that! I guess I am not the "natural delivery" type...delivering in a nice clean bed is fine by me!

Hey Jess... I am currently working as an OBT and LOVE IT:D I had actually never heard of an OBT until I worked as a secretary on post-partum...It seems kinda like the unknown position in the hospital. Around here they are not in great demand because those who become an OBT usually stay. It is different from a PCT position in our hospital. You have to be a CNA or finish one year of nursing school before you can train. We were trained on sterile technique, scrubbing and some assisting, we do first assist in emergent cases. If you read the post on responsibilities, you will see that in our facility it goes far beyond basic care. The salary is higher for a OBT than a PCT due to the advanced skills and responsibilities that go along with our job. Most of us are not CST (Certified Scrub Techs) but have been trained specifically to OB-GYN cases, in other words I wouldn't have a clue what to do if presented with a cardio-thorasic case. The OBTs at my facility are pretty well rounded and have also been instructed on fetal monitoring, labor patterns, IUFDs, and can start an admission if the unit is hopping. We can't do assesments or push meds, but we have been specifically trained on some interventions under the guidance of an RN like shave & scrub preps, positioning and what to do in a decel. We are pretty much the RN's second set of hands and eyes and work as a team, each one knowing their part. Look into it if this sounds like something you want to do, I can't gaurentee all good days but there is something about a crash c/s at change of shift and fast deliveries that keeps me coming back to work every day. It's fun, if you are an adrenaline junkie like me;) BTW, I too am a first year nursing student...and hope to stay just where I am...in L&D:cool: Nicole, OBT

Thanks for the info I have worked in L&D for a while now and have never heard of a suture recall and all we use are Ethicon Vicryl, Chromic and PDS... I was kinda shocked when I saw all of these recalls and I never heard a thing about them...Maby they were caught before and pulled by the suture rep and I never heard a word about it (I work nights) A friend of mine had some complications following a surgery back in the mid nineties and the surgeon used Vicryl sutures...she asked be about it knowing that I scrub and I had no recollition of any recalls. Thankfully everthing has turned out ok. Thanks again, Nicole OBT

Does anyone remember a recall of Ethicon Vicryl sutures in the mid 1990's? I found some info on the FDA home page, but would like to know if any of you remember this and what was the recall regarding. Thanks Nicole, OBT

I am glad to help. But I have to ask how many LDRs do you have? My facility has 9 LDRs, 1 Early Labor, 2 ORs...soon to expand. We do about 250 deliveries a month. We do not carry pagers/phones. We are expected to know what is going on with the patients we have and can read the strip so we know when and where we will be needed. We also always check in with the nurses and if we leave the floor we are on pagers. Have you thought of replacing those phones with pagers? It might help eliminate the phone calls, cost less and you can use a code system for emergencies and needs. Like crash sections are 911 for us we go directly to the OR open and scrub no questions asked...Just a thought. Ayanna... It is fun, I work nights and we have a blast:p It can be stressful at times, but I like the adrenaline rush. I too am in nursing school and have been doing this about a year. It has helped enormously...Go for it, if you like keeping on your toes, don't mind hard work and fluids;) Nicole

Maby I could help. I am currently working as an OBT. We are not CSTs, but have been trained at our facility. We have a LONG list of duties. Since we don't currently have a night secretary, we have covered that role as well as our OBT responsibilities which include: Set up for vag deliveries Set up and scrub for c/s Set up and scrub for tubals Set up and scrub for pp d&cs Set up and scrub for emergency pp hyst/ c-hysts Assist for extensive vag lac repairs Admit pt to room- EFM, vs, basic info If another OBT is scrubbing, help RN circulate Stock rooms Answer phones, call light, door Enter orders in comp as needed POC testing Controls on glucose monitor Finger stick/heal sticks for glucose Clean ob equipment Wash down ORs (except mop) Wash up recovery pts Assist RN as needed Assist MD as needed Assist other OBT as needed Help Secretary as needed (when we have one) Care for pt as needed Basic pt care (we are CNAs as well) Transport pts Open rooms for expected pts Clean (not sterilize) instruments Bring instruments to processing Stock epid carts Stock blanket warmer Assist RN after delivery with mom and baby Vital, weight, footprint, clean up baby after delivery Break down beds for vag del Assist with pushing as needed Put mom on tele Open/set up rooms for scheduled NST, IND, C/S Set up epid equip/bring cart Set up tub (we do water births and have portable tub) Clean up room as needed The list goes on.... It is too bad that you are having problems with your techs, I hope this helps. Nicole, OBT:)