OBnurse3

Hi all! I'm currently enrolled in an RN-BSN program, and have recently been given the assignment to read the NPA for Missouri and describe what it says about delegation by the RN to the unlicensed assistive personnel, use of the term "nursing diagnosis", patient abandonment (refusal of an assignment), or requirements for continued licensure (practice, continuing education, or others). The problem is......I'm not finding any of this information!! Am I having a "senior moment" or does Missouri really not govern anything other than IV medications and acceptable nursing programs (because there's ALOT about that!!)????? Any help would be greatly appreciated!! Thanks!

One word: EMTALA

I appreciate all your responses. I agree that it is an administration problem, and they are working to recruit more femal OBs. However, what am I supposed to do when a pt presents in active labor and refuses a male physician and that is all I have to offer? I can't transfer an actively laboring woman, I can't send the doc in the room and I can NOT legally deliver this baby on purpose!!! (We all know precips happen) So is it possibe to hand them an AMA form and tell to get on down the road???? As for PNC, our docs are covering this THOUROUGHLY in the pre-natal visits, to the point of having the pt and husband sign a paper that states thy understand that a male might be the doc on-call and they will allow him to deliver, if they don't sign it, they must transfer care to an all female practice elswhere. The problem is they are siging these, but when the time comes, they refuse our male docs!!! Let's face it, while it is an administration problem, if she refuses our male docs, and I can't transfer her, what are my options?? The only things I can think of are: make her sign the AMA form, or let her deliver into the bed unattended. But then what liabilities are open for there (failure to rescue) as it pertains to baby??? I know there is no "right" answer, but I just wanted to bounce this off other nurses and see if there is a possibility I am NOT thinking of

In our facility L&D is separate from PP/Nursery. However, we staff 2 CSTs at all times (ESPICIALLY night shift) in the case of a C/S. They are our first assist and scrub. When we do not have a C/S they are responsible for "tech type" duties including cord gas transportation, cleaning rooms, VS (on PP as well), "babysitting" etc. We do NOT have a secretary on the night shift, so they also function in that capacity as needed. They are a blesing and a God send! I am fortunate to work with an awesome bunch of ladies!

Which was my initial (and HONEST) feeling, but unfortunately, the boss-lady wants me to do "some looking" and get "some ideas of how other facilities handle this". yadda-yadda:banghead:

How does your facility handle those patients that refuse male physicians and there is no female physician on-call??? We are having a problem with this at our small-ish hospital, as we have only 2 female OB/GYNs on staff, one of which is on maternity leave. Looking for input to take to the managers' meeting, becuae we are DEFFINATELY not going to "just let the nurse deliver"as our patients' are suggesting!!!!! And HOW do you handle it when the request due to religious practice rather than personal preference??? Thank you in advance!!!

I became an OB nurse because where else can you get paid so see miracles all day long?? It has really increased my self-respect just for being a woman...and obviously for all other women as well...our bodies are truely amazing.

I am 13 weeks post c/s #3 and I have found that once your nurses get you up...KEEP MOVING! Do as much for yourself as you can..but don't over do it..listen to your body. ...and whatever you do.....stay away from recliners!!!-they're great to sit in, but you need 911 to get back out!:chuckle

Congratulations and welcome to the big world Miss Kassidy Anne!!:balloons::balloons: Best wishes for a long and happy life!!!

I Am a smoker and there are plenty of days I go without..however, on those days I do get in a smoke or two I make it my duty to take a non-smoker with me. I don't feel that it's right to go just because I'm a smoker. Smokers make sure we get a break (providing all h*ll isn't breaking loose), so I make it my personal obligation to make sure non-smokers they get theirs.

The big thing to keep in mind with pp is that you are there to support and TEACH...If this is what you enjoy doing there's no better place. I love having my couplets..not only do you get to interact with the family, but you really get to do patient CARE... something there is so little time for in other areas. Even with mom's that have other children..there is still so much to teach. If your ideal vision of nursing is spending QUALITY time with your patients and really getting to know their dynamics to better advocate and care for your patient...the pp is it!

I "did my time" in med/surg and what it taught me was priceless. However, I have also found that (at least where I've worked) there's not a lot of turnover in L&D (Because it's soooo awesome) so if you have the chance..go for it! Med/surg does give you a solid basis on which to work...it helps to hone those skills you learned in school, and teaches you quite a lot along the way. A major bonus of going striaght into a specialty field is that you're a "clean slate" and can go into the field without any "Bad Habits", as my boss would say. The nurses I worked with on med/surg that loved it were some of the best nurses I've known...but then again, they were doing what they loved...I was not. Just food for thought.

I agree with everyone else...get what you can off, but why torture? Vernix is heavier on preemies espicially, and isn't their skin more fragile?? It's a simple fact "It ain't easy bein' cheesy" (but your skin sure is smooth)

I have had, on more than one occasion, parents express concern over handling the baby during burping..I always have to remind them that 1.It's not THAT easy to "break a baby" and 2. no one wants a baby with a belly ache. Here's a funny thing...I just had my 3rd baby (8weeks ago) and this is grandchild #5 for my mom...I guess having worked L&D for a year now I too have gotten used to handling babies more casually...and it drives her nuts!!! My new saying to my mom "Gee, it's amazing my other 2 survived isn't it??" Actually, her constant jumping at the baby when I handle her has almost made me drop her...but thanks to my cat-like-reflexes:cool:, she is thus far, uninjured!!