cnmmsn

That was the point of trying to get a protocol started. It would be for all patients. I never cease to be amazed at the people who turn up positive. The RDS would be for everyone at least once during the pregnancy. I will have to see what research I can find.

Our facility has been talking about doing drug tests on all of the OB patients. Either one time in the office (if neg) and then follow up if it is positive. It is already in our new OB packets that we may do a random drug screen at any time during the pregnancy. Our referral center states they test all laboring women, but we can not get a written policy from them. There has been an explosion of meth and crack labs and use in our rural area . We don't want to miss something staring us in the face. There has been an increase in TTN and RDS babies lately and we have not been able to pin point a source. If anyone has a policy for drug screening their patients, could you please send a copy to me. I really need to get something going to either prove or disprove the theory. Any suggestions?? Thanks, Vicki

I am new to this list but it was reccommended that I ask for the collective opinion here. Is there anyone who is practicing as a CNM or in AP/IP care that routinely does a rapid drug screen either during an office visit or on admission to the unit in labor? I live in a very rural state and we have had a massive jump in meth and crack use here. I feel like we are missing a lot of the problems (and we have an increase in unexplained TTN and sick babies), but the OBs I work with are not quite sure how to approach the problem. Does anyone have a protocol that they use that they would be willing to share? I already have included in our new OB packet that the pateint may be tested at anytime during the pregnancy for drug use. So far no one has even mentioned it. We have had several poitive screens that were done for cause(pt's behavior, family member reporting use, or other reasons.) The ones that were positive for multiple drugs were not patients I would have expected. I think I am doing a disservice to the babies by not checking at least once during the pregnancy to see if there is even a problem. I am just not sure how to set up the protocol. If someone has one that works I would greatly appreciate it. Our referral center states they test all moms in labor,but I can't get a written policy from them. If there is not a policy available, would anyone like to help me research and wrote one? Vicki

We have just had 2 of our patients become certified as labor and postpartum doulsa. There are 2 major certifing bodies (as far as I understand) DONA and CAPPA. They both have pros and cons to which you might choose as a certifiyingbody, so read up on them and see which one fits your goals and time. It is a great way to gain experience if you ahve a good relationship with the hosp/doc/cnms that you work with. Vicki

I worked while I did my clinicals. I survivied it, but it is not something I would reccommend to anyone else. I had small children and needed the income. I worked part time/prn and between that and clinicals, not much time to even sleep. If there is any way to get around working, you will get a lot more info out of the clinicals. WHNP is women's health nurse practitioner and are not midwives (they do not deliver babies, but can do IP/AP/gyn care if they are in a practice that allows it. The master's that I had to get was in nursing (thru Case Western) and my certificate was in midwifery. Very different training and scope of practice. Frontier now has the CNM track and the FNP track. They grant their own master's now instead of having to go thru Case Western like we did in the old days. Vicki

I graduated from there about 10 years ago. A great school, but you have to be willing to work. You have to prove to them that you know your stuff thru papers and didatic work. In classrooms you can sllide a little bit more. The number of deliveries and AP/IP/PP visits were more than a resident school, but I got of there being able to hit the ground running and was not lost like a lot of the other CNMs I have talked to. You are lso need to be self motivated. There is no one to stand over your shoulder to make sure you get your work done. All in all, a great school, but not an easy one by any means. Vicki