kennedyj

Hey if you find an area you like persue it. I am on OB/gyn nurse and am currently working on my Midwifery degree and possibly a perinatal nurse practitioner so I can do more high risk and ultrasounds. At our labor and delivery unit there is also another guy. best of luck, Jared

I agree with Fergus, but feel it would depend on the situation and diagnosis. To see someone very sick may impact your ability to properly care for that patient. Your instructor should have complied with your wishes to not take that patient. I do congratulate you on a job well done and your courage to take on the situation under those conditions. It shows you a strong nurse. Once when I sold computers a made a system for a couple that asked me if I could buy them Pot. They poured me a large glass of Jack and coke when I was putting together their computer. They were also very strange. A few weeks lated I saw her as a patient during my Psych rotations. When picking assignments I did not pick her. Jared

hi, I graduated from Beth-El in colorado. I took one of the classes as an elective. it was great. most are if I remember well are 4 days long each and all day long. You have to turn in a paper after the course. The main Instructor Virginia Lynch is amazing. She lectures all over the country and has established a great program. If you already have a masters you can take the 15 sem hrs and get a masters certificate or also a BSN certificate (the classes are the same) if you dont want to take all the grad junk courses. good luck, Jared

reflexes give an idea but are somewhat subjective. Some people will write a 3 and some a 2+. But dont worry the purpose of DTR's is not to get a # but to assess the patients status. This can be done in several ways. The overall goal is to evaluate the level of Mg effect. Mg levels are desired to be kept around 4 -8 (during labor and 24hrs postpartum and until labor stops and is stable in PTL). Patellar reflexes are almost absent around 8 and this is where respiratory depression begins. Most patients will also feel drowsy. Mg is excecreted by the kidney - if urine output is low Mg levels will increase faster especially in small women. I had a patient on Mg once who just didn't have reflexes (strange). We had to rely on other assessments. You can also draw a serum Mg level if reflexes seem low and the pt seem more drowsy than normal. sorry to be long winded. Im procrastinating putting off some case studies I have due tomorrow. Jared

I just tape or chevron the hub above the insertion site. I'd try not to touch the tape at the insertion. Then cover with tagaderm.

I like micros advice. Who ever sais you had to finish your degree in a set amount of time. Most schools will give you an extra semester or 2 to finish. I am in the military full time. It took me about 6 years to get my first 2 years of nursing prerequisites out of the way. take your time. Now doing an NP degree online and i work nights ...hehe..... Best of luck, everything will fall into place. nursing school is a nightmare to ...well everyone. Jared

Thx. We on an admit exam we usually do all 3 (nitrozine, pooling, ferning and an SVE). Jared

oh. forgot something on the KY discussion. What about speculum exams. I hate doing them without any lube but they say it can give a false + for srom. Sometimes i'll have them insert it themselves. I think here they would freak if they knew you were putting warm water on a sterile speculum although there would probably be no real harm.

I have heard of many different ways of inducing a demise w/ cytotec. some places have them take a large oral dose then start lady partsl doses. First time hearing about crushing it. I have seen usually .25-.5mcg q 4hrs, sometimes it takes a while.

Yep. I've never known a woman to turn down a good warm blanket. Problem is that when they've got their warm blanket you can never get 'em out of bed and to work. sorry girls. Had to bat one for the guys

I love it! Thanks for sharing it. Now I now what to name my next pet.

Brandy- sounds like you got the brachial artery...lol. if not just picking on ya'! One thing that I was never taught in school was that after you are ready to pull the needle out don't push down with the gauze before. It only helps the needle scrape the vein. Instead pull the needle out then quickly press down on the gauze. If drawing 10ccs/2 tubes or less I like the 23g butterflies. Jared

I drop by there sometimes and sometimes I open a window and keep it open for a while in case someone else drops in. If we all stop by once in a while & more frequently we are bound to see others sooner or other. But if we only stop in and see its empty and leave we will keep missing each other. I keep trying to chat with spicyserver but she always ignors me :) lol..

Actually I enjoy giving shots and IV starts. Escecially the hard ones where others have failed. Although I am no superhero. some tricks Ive learned: Many people after they draw blood they put the gauze over the site, press down, and then pull the needle out this only bruises and damages the vein. - if you cover the site don't push down on the gauze until the needle is out. Don't worry if a drop of blood comes out. If giving am IM shot (this works well for kids or those who don't like shots) wipe the site and say Im going to tap 3 times. tap 3 times about 2 inches lateral to the sciatic nerve. It runs the reflex arc between the gluteus and the CNS and back. The body says its only a tap. after the 3rd tap the needle goes in. It will feel just like a tap. Try it!

Typhoid is the worst for me. Worst than tetnus. IF military deploy you get an IGG shot. It is the one that turns babies into men!!!! Its like a 5cc shot of cold honey in the cheek. the cold shot rips the muscle and it burns too. Supposed to be 2.5cc in each cheek but who has time when you have over 1000 to do.

Have you thought about physician assistant school. I know many people who start out going for pre-med and change to PA school. You have a broad scope and they usually like you to have a pre med background. J

From the articles on Misoprostil I think that Searle and the manufactures do not want to entangle themselves in the debate so they are following the cover your butt rule. I think it boils down to the question of whether she really doe's need an induction and if her Bishop score is not adequate to use pitocin. So many times when you start a pit induction on an unripe cervix you end up turning it off and trying again the next day. Prostiglandins gel (or Pig semen to be more politically correct) just doesn't work as well as cytotec and including repeated doese may cost up to $1000 in meds. Cytotec costs pennies. But not to put a price on safety. Cytotec works better for ripening the cervix. I haven't seen research but have heard of practitioners using it in lower doses and having lower risks of tetanic contractions and c/s. for example 25 MCG every 6-8 hrs. It takes longer but spreads peak medication times. Most places use 25-50mcg every 4 hrs religiously. This may make a good research topic. J

lol. i'll have to remember that one next time a patient says 10. sweeeeet!!! Jared

yikes!! That sounds like madness! I can only imagine how you felt at the end of a shift. # tube feedings can take you up to a good 45 minutes and they will need it every 3-4 hrs. When you get a fresh c/s patient you are moreless in there the first hour and frequently the first day assisting feeding and dealing with pain. We use a care hour system that says how many nurses are needed. Today we have 8 patients ( 1 c/s , 3 antepartums, and 4 svd's). We have 2 RN's and a technician who does almost all the baby stuff except assessments. If we got another c/s and 3-4 deliveries we would call in a nurse. Sounds cush but is needed for patient safety and to do appropriate teaching and nursing care. do should definately get the BYB (bust you butt) award for working there or the BTDT (been there done that). Jared

We do couplet care and It would probably depend on what roles are done by nursing staff. We do complete rooming in where the infants stay with the moms the whole time 1-2 days and only bring the babies to the nursery when they shower or go to the bathroom. It is great for staffing and helps observe care since the moms will be on their own in a day or so anyway. Some say it is cruel because the moms get little rest after a tiresome delivery. I agree with this also. Most moms are ok with provinding total care but I know of some places that staff the nurseries for about 5 hours at night and offer a sleep time for the moms. We usually do a generic discharge class each night in the conference for all patients going home then each nurse tailors specific concerns with their patients. We have SVD and C/S patients only no gyn surgeries. Usually 6-10 couplets at a time. Nurses shouldn't probably care for more than 4 couplets. We also do NRP and initial baby assessments also which can tie up time.\ best of luck Jared This I have heard to work extremely well. Especially in private centers or hospitals. The average cost to deliver a baby at our military hospital is $22-33 total ($11 per day for food). Medical services are equal to others I ve seen in the US. The maternity ward is a little older and has shared bathrooms. The L&D unit is excellent.

Most schools seem to have a program that is about 45 college semester hours. It depends on how busy you want to be in terms of how long it takes to finish. I am going to Univ health sciences center- Colorado (online w/ preceptorship clinicals in Germany). It will take 3 years for me. I have seen people do it in 2 years full time. The classes are fun and you learn a lot. No careplans or junk like in the BSN courses. Best of luck, Jared

The verbal assessment 1-10 scale is moreless standard however an assessment of pain should always be done rather than just getting a number to chart. However when in active labor with out an epidural on the pain scale you can almost cross out numbers 1-7. Jared

If you want to get your foot in the door take an independant nursing elective in labor and delivery if you can spare the extra course. I did this as a senior nursing student first in a trauma center then Labor and delivery. It was an incredible experience. Do it at the labor and delivery unit you wish to work in. best of luck, Jared

As major metioned it greatly depends on your support. We have a high risk setting that delivers about 100 births /month. Most nurses attend a full time 4 month course prior to working labor and delivery. The nurses do the SROM checks, Labor checks, cervical exams, and work with the moms in every way. The Obstetrician only needs to check in on the patients from time to time and usually gowns and comes in when the patient is about 5-10 minutes from delivery. This allows one provider to have many patients. But once again you need a very well trained nursing staff. We are also trained in deliveries so if there is a c/s or another delivery going on the nurses can do the delivery. Especially if the on call doc has not arrived yet. Best of luck with your facility, J

I like that one! Labor is labor is labor!!!! The patients needs should come first. Hard to believe anyone would actually send someone away. Especially with todays greedy hospital settings :) odd Jared