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L&D,- Mother/Baby
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MemphisOBRNC has 23 years experience as a BSN, RN and specializes in L&D,- Mother/Baby.

I have worked in L&D for 23 years in Memphis, TN.

MemphisOBRNC's Latest Activity

  1. MemphisOBRNC

    On-Q Pain Ball after c/sections

    We tried this a couple of times at Bartlett and did not have much success. We haven't used it again since.
  2. MemphisOBRNC

    National Certification Corporation?

    I am certified by NCC, too. I also took the EFM test. It was more a personal goal for me, as my hospital does not recognize (pay more) for certification, which I think is a shame. From what I've read, most hospitals, at least around here, don't pay extra. Many will pay for the cost of the test, though. I HIGHLY recommend taking a prep course. The one I took was 2 days.
  3. MemphisOBRNC

    Fundal pressure

    Speaking of inductions working better after ROM, I just saw this article: http://www.medscape.com/viewarticle/564597?src=mp entitled Amniotomy Has Little Effect on Progression of Labor
  4. MemphisOBRNC

    Memphis hospitals - Please help

    I have been at St. Francis (both locations) for a total of 29+ years. I am now at the Bartlett location. Tenet is not a bad company at all. I have never worked doing 'floor nursing', though I know many of the nurses that do. You may want to try contacting Human Resources at various hospitals and ask about the turn-over rate of nurses and also ask about the patient satisfaction scores. St. Francis- Bartlett has been a 5 Star (the best) hospital and also received the J. D. Power and Associates Distinguished Hospital Award. I believe it was the first hospital in Tennessee to accomplish that and we are very proud of it! http://www.jdpower.com/corporate/news/releases/pressrelease.aspx?ID=2007053 :balloons: Good luck in your search.
  5. MemphisOBRNC

    Fundal pressure

    In my 22+ years of OB, I have done fundal pressure and continue to see one or two docs that do it now, mainly because they are inpatient. They are the same ones who want the patient to start pushing at about 8 cm, too. Suprapubic pressure can be helpful if you have a dystocia and need to get the shoulder down and under the symphysis pubis. Fundal pressure can actually wedge the shoulder against the symphysis. IF you ever do fundal pressure, do it from the patients right side to help prevent liver damage and make sure you can justify your reason if you end up giving a deposition!
  6. MemphisOBRNC

    Best Memphis hospitals for RN's

    The shift diff. for RN's at St. Francis (the big one and Bartlett) is $3.75, plus $1.00 for bedside, plus $1.00 for Charge nurse. Thanksgiving, Christmas and New Years are usually time + 1/2.
  7. MemphisOBRNC

    Best Memphis hospitals for RN's

    Prinzessdy, that information is backwards. The 'big St. Francis' is the one closing their OB unit. St. Francis- Bartlett is doing fine.
  8. MemphisOBRNC

    report sheets

    If you will PM me with an email address, I'll send you what I have. It's in Excel format and I can't upload it here.
  9. MemphisOBRNC

    Standards of Care

    Perinatal Guidelines is another good one.
  10. MemphisOBRNC

    anyone use prepidil?????

    We haven't used Prepidil in a LONG time. He should switch to Cervidil, then he wouldn't have to wait for hours for the Pit. to be started. It's much easier to insert in that it doesn't require the use of a speculum. It can be sort of tricky to get it in the posterior fornix without it coming out of place when you take your fingers out. We nurses put it in but couldn't do the Prepidil.
  11. MemphisOBRNC

    cervical checks, again

    http://www.birthinternational.com/product/model/ta027.html Using a chart very similar to this is how I learned. Also, there is a little trick where you can use your fetal monitor paper as a guide. (1 minute of paper = 3 cm)
  12. MemphisOBRNC

    charting vacuum assisted deliveries

    Ditto babykatchr. I don't document the pressure since I don't know what it was.
  13. MemphisOBRNC

    Is it better to pick one OB area or cross-train?

    You must maintain you level of expertise in you primary area but it never hurts to have a variable skill set to work in the other areas. I have worked the last 2 years doing LDRP. My expertise is L&D. I feel I am pretty strong in PP and Nursery but neither is my primary area. I do normal, routine care but will send the baby to the baby pros (NICU nurses) if there is any question about something going on.
  14. MemphisOBRNC

    Ever had to get a court order for treatment?

    We also had a patient that refused and emergency CS with not only her first pregnancy, but also her second. The charting of the Drs. and nurses was excellent. The chain of command was followed. Her husband and her sisters also refused. Hours later, her husband finally agreed. She ended up with a mentally damaged baby. Guess what: she has brought a law suit- go figure.
  15. MemphisOBRNC

    standing orders/JAHCO

    Several years ago, we, too, got away from using routine or standing orders per J.C. recommendation. Now they want Read Back on all orders not written by the MD. My question: do you now have a protocol for what to do with all those L&D patients that appear at your door? In other words, we always document: admit for observation, fetal monitor, vag. exam as indicated, urinalysis etc. We put phone order per Dr. X / our name and stamp it with the Read Back stamp. The problem I have is that it may be 1 or more hours before the Dr. is actually notified that the pt. is there. Isn't that false documentation? Our registration dept. will not put the pt. in the computer if we don't send down orders. Based on EMTALA, it's the law that we have to see these pts. and do a Medical Screening Exam so why not have a protocal. Makes too much sense, I guess. Any thoughts? This year, one of the biggest J.C. focuses was overriding medications. If the order sheet has not been sent down to the pharmacy and the meds. were not 'put into the OmniCell', we had to document on paper that the med. was urgently needed and the order had been reviewed by 2 nurses, both having to sign the form. It was then faxed to pharmacy. Since our babies are not born when our Vitamin K, Erythromycin ointment and Hep. B vaccine is pulled for delivery, the override is done on every baby. Since the order sheet had no name and MR # on it (the baby isn't born yet) pharmacy can not enter the meds. At what point do you pull your baby meds?
  16. MemphisOBRNC

    Any Legal Nurse Consultants who did not take any courses?

    I am curious about the fee charged for review of the record and the fee charged for appearing in court. When asked to review, do you go ahead and prepare summaries, timelines etc? If anyone posts their charges, please indicate what state you are in.

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