jaka1

Our OB policy says that under 20 weeks goes to the ER as well as non obstetrical problems over 20 wks. In this case it was the ER nurse who called 3 times saying "I don't care what you think you need to do, someone better come put her on the monitor", they just don't get it. Two days later it was the PA who insisted we monitor someone who was 17 weeks "so it looks like we tried to do something" even after the OB-GYN called us and said he was sending her to the ER and needs to stay in the ER and does not need to be monitored except to doppler heart tones.

I once had a pt come in for c/o PIH symptoms. She refused to have labs done and refused the IV on the advice of her friend who then convinced her to get "just the heplock" and no fluids.....why???? She eventually left AMA.

Thanks for your responses. I was summoned to the ER to monitor someone who was 14wks. I thought it was a bit absurd but haven't found any literature that actually says when it is appropriate to use EFM. I only find "late pregnancy" as a time line.

What is the earliest gestation that EFM would be appropriate to monitor for FHT's or contractions?

hello, I have been doing newborn nursery and ob for the past 12 years in rural AZ. In our facility I think the nursing shortage is due to the lack of effort in retention. The facility does a lot to recruit new grads from the local community college but once they have experience they tend to go to bigger facilities where the pay is much greater. Since we have so many new grads in our facility, the experienced nurses tend to get heavier patient assignments with higher acuities and yet we make only cents more than they do which only adds to our frustration level. I also think nurses are leaving due to stress related to the number and acuity of pts they are required to care for.