shortstuff31117

We absolutely offer an epidural to anyone with a demise. It's still labor!!! We actually encourage it so that they don't have the physical pain on top of everything else. I can't believe these doctors...what evidence do they need for pain control?? It's despicable what they're doing...

It applies more pressure to the Toco. I've done it and it works okay. I think it works better with some brands of fetal monitors more than others. There something that can be bought and put on the stock that is supposed to work well. Look up The Addition, I found her on Facebook. You can get free samples.

Looks like a contaminated surgical field to me. I'm all for making the experience better but wow. Curious to see infection rates.

Anymore updates?? I was just looking at the Capella Program...wondering if anyone had any more info on it??

No, this nurse is good. There are a lot of things going on in our unit right now that I wouldn't even think of getting into on here. And you say we should have brought up concerns before...well how would we do that when it was just suggested that she train for charge? There haven't been issues with her nursing care, so there was nothing to bring up before. Again, I was only trying to get an idea of what other facilities are doing, I shouldn't have put in the part about her experience I guess. I think it's a little ridiculous of you to call us immature.

Well there is more to it, but I was only asking about facility requirements. No need for some of you to be rude!

Hi all just wondering - in your facility, what are the requirements for charge nurse? I work in a small LDRP unit, we have 4 main charge nurses on each shift. My manager wants to train another nurse to do charge sometimes, however this nurse only has 3 years of experience. The rest of us don't feel like it's a good idea. So I'm curious about what other facilities are doing? Thanks?

Yes where I work is like this. Small community hospital, doing around 50-60 births a month. Mainly 1 group of OBs. It varies as to when they come in, or when they might actually stay in house. They don't come in for epidurals. This hasn't been an issue in the time I've worked there (8years). Not to say there haven't been emergencies, but somehow they seem to happen when the OB is there, or at change of shift when there is extra staff around. Maybe it's "backwards" but it is what it is. I don't see it changing, at least not around here. I'm in WA by the way...

As of now, there has been no legal action taken, and it sounds like the family isn't planning on it. Obviously that can change. I think it's being done via phone because we're on opposite coasts...

Oh yeah we were all advised not to discuss it. 4 weeks after the fact but whatever...I don't discuss it. I'm feeling very frustrated and am thinking of looking for other employment...

Ahh sort of like a debriefing? My hospital is known for not doing that. Everyone involved met with the quality control person individually up to this point. I can't imagine the accounts differing very much from person to person, but obviously I have no idea what the doctor said.

What do you mean by an RCA? I don't plan on saying much at this meeting. My charting can speak for itself as far as I'm concerned. I put in a call to my union to see what they have to say...

Thank you for responding. I am of course thinking the worst. I'll try not to. Just waiting for a call back from the risk management person. I'm just trying to figure out what kinds of questions she could want to ask me, when she has my charting.

She works for the hospital lawyers. Probably says it all doesn't it!

A couple months ago, I was involved in a case with a bad outcome. I'm now supposed to go in to the quality control directors office and have a phone conversation with the RN investigator hired by the hospital (to review the case). Does this sound typical? I'm of course worried that they're investigating me, and I should be worried about my job...

No I don't have my own malpractice insurance.

I was involved in a case (bad outcome) that is being reviewed and I am now supposed to have a phone conversation with the nurse expert who reviewed the chart. Has anyone had to do something like this before? I'm wondering what the motivations for this are...I know we can't give legal advice on here so I'm not really asking for that, just looking for experiences. Feel free to PM... Thanks!

My boss asked me to run mock codes for the night shift. I'm very excited about this, I think it'll really help keep up our skills. I'm looking forward to springing these on my coworkers as they have no idea I've been asked to do this. I could uses some help coming up with a big list of scenarios, ranging from not so horrible to your worst nightmare. Especially your worst nightmare! Thanks!

That's truly disgusting. Those poor moms...I can't even imagine! We don't have 24/7 in house anesthesia, but in the 5yrs I've done OB, we've had only one c-section under a local. She did have an epidural, but the baby crumped, and needed to be delivered NOW. Luckily 2 OBs were in house but yeah..scary. My coworkers said the look on the anesthesiologist's face when he walked into the OR and saw the baby already delivered was priceless. He did give Mom some Versed so she didn't really remember anything, thank goodness.

Wow you guys are busy! 18 labor bed doesn't even seem like enough LOL. I work at a small community hospital. Last year we did just under 700 deliveries, which was a slight decrease for us. We have 9 LDRPs, as well as 7 "surgical" rooms, which we use if we need to move people after delivery, for readmitted babies, and GYN surgeries. We have 1 OR that is dedicated for OB, and another that is used for GYN surgeries (we can use it the rest of the time). I work nights and our core staffing is 3 RNs and an OR tech, who also acts as our unit secretary. Day shift staffs 4 RNs (except Sat and Sun) and an OR tech. We limit our scheduled events to 2 per weekday. We have a group of 5 OBs who do the majority of our deliveries, and 1 other OB, who does 2-3 deliveries a month with us. We use our LDRP rooms as triage rooms, and take turns doing triages. We just rearrange assignments if we get an admit. We are 1:1 for labor. We circulate our own c-sections. We have a level 1 nursery as well, but that is staffed among us, no special dedicated nursery staff. Anyone who is not at least 35 + 4 gets shipped to a higher level facility if they're determined to be in labor, pprom, etc.

Just curious what you guys are doing. It used to be that we would leave the foley in for 24 hours if the patient had duramorph. About 2 years ago we got a new group of anesthesiologists, and they said it was unecessary, and once the patient was up moving around well, we could pull it out. I now generally pull mine as soon as they are up, it seems to keep them from laying in bed forever. I haven't had any issues, but I have a few coworkers who are still scared to pull them before 24 hours, for fear that they won't be able to pee and will have to be re-cathed.

What the other posters said...I generally do not hold legs. I use the foot pedals if they have good control, and the stirrups if they do not. I definately involve family members, that way I can sit on the end of the bed to help coach mom. I also have mom pull back on her legs, this helps a lot. Of course, I work nights, so all my patients labor down. It's a lot easier when there's no doctor doing the exams

What makes you think we have an infection control nurse?? Haha just teasing, making fun of my hospital really

At my facility, we place both IUPCs and FSEs. Our policy also states that we may rupture membranes in order to place an FSE - in an emergent situation. We usually make the decision as to whether we would like to place an IUPC or FSE as well. We don't have any kind of competency for either.

Our epidurals run continuously. Anesthesia only comes to bolus if they need some breakthru pain control. Our pts. usually aren't up for at least 2-4 hours after delivery, sometimes longer if they get a bolus right close to delivery