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Thanks everyone for your input. I will talk to my nurse manager tomorrow (have already emailed her with my concerns but have not heard back) and as soon as possible visit with the medical head of nursery.

I didn't start this thread to debate mandatory drug testing. Yes, where I'm employed a drug screen is required for employment, and random drug screens on employees are done. If I were a patient, I would certainly want my nurse to pass a drug screen. BritEdRn I agree. We have no screening for withdrawal in babies, and little to no experience with it....only have the neonatal/infant pain scale. I want to know what resources are out there for these patients, if anyone knows of any successful program to help these mothers, and by helping them help their babies.

Ok, I'll get right to the point. Most of the nurses at the hospital I work at have always worked here, we deliver about 600/yr. I don't know who to ask or where to start. I really feel the need for some help for our drug abusing moms, and babies. We don't see much of it, but we are seeing more and more. We have no policy, no standards to guide us. If a woman comes in with no prenatal care, we ask the doc if we can get a UDS. That's pretty much it. I've recently had one who quit using 6 mo before her 1st ob appt....and no random or any drug screen during her pregnancy at all. When we do get a pos we call the child abuse hotline and I personally have gotten the response anywhere from they can't do anything unless the baby shows a pos screen, to being up in the dept within hrs (I'm assuming those probably were already in the system). We had our first full blown withdrawal baby over the weekend, and the nurses sat on it all evening/ night and into the day shift....stating, well his resps are over 100 because he's withdrawling...he's sweating and screaming etc because of that....when they finally did call, the doc ruled out infection with bc, cbc, cxr, ekg (which was next to impossible to get), THEN consulted someone at a bigger hospital and gave the little guy phenobarbitol. I'm frustrated. I would like to know what other facilities do, what resources are out there to help these moms during pregnancy and after, besides dhs taking the baby or whatever. Does anyone do drug screens on all their moms? We have only one nurse that has worked elsewhere who says where she worked on the east coast, everyone got screened. Your help would be appreciated.

wow. None of our docs would've ruptured her, we would have tried to give her as much time as possible, even if it just meant a day.

I have dreams about work fairly frequently. Most recently I had a good night at work ending badly with the OBGYN being furious at me for her missing a delivery (it took her 14 min to get there)...anyway, I dreamt that I got off work, went to the store and she was there pushing carts. I didn't even feel bad for her, just thought "hmm, must be losing patients and has to take a second job" then proceded with shopping. It was a good dream

The nurse who stepped in for only a few moments while I was in labor with my first child...she showed compassion that was inspiring. I had a strong curiousity toward the medical field...that and the program for nursing was 30 minutes from my home, and the college that I would have to go to become a teacher was 90 minutes away.

Aspirate. I've been a nurse for 16 years and 1 time only aspirated blood, and that was on a newborn.

I had a G2p1 spontaneous labor with an epidural. It was dayshift, she went complete, I had her give a push, and nothing. I called Dr.E (for evil lol) & told her exactly that, and the baby looked great. She stated she would see 2 more patients at clinic then head over to OB. Within a matter of minutes, the fetal heart rate dropped- 70's. Not just an early, they were staying down. I had her push and the head came down nicely, and had another nurse throw some O2 on her and call Dr.E. She told the office staff it was urgent, and got put on hold, so she hollered at the unit secretary to call her stat. She missed the delivery by 2 minutes, and was visibly angry. She never discussed any of it with me or the other nurse, she went directly to the nurse manager and "threw a fit" I'm told. Now, there is an inservice sheet everyone must sign saying basically we will not push Dr.E's patients, even if FHTs are low; instead do other interventions. I haven't read or signed anything yet, as I was working nights this weekend and didn't see our nurse manager. :banghead:Why not TALK to me, go over the strip with me, anything?

Chest pain unmedicated lady partsl birth or kidney stone?

In March our new uniform policy went into effect. Nurses wear white, navy, ceil or royal; aides wear dark brown. Our shoes and socks have to be all white with no color on them, and lab jackets must be white or the color of our scrubs. The uniforms can't have any print or trim of a different color. Hair cannot touch shoulders or be in the face. If it's pulled back the clips must match your hair or uniform. We have no uniform allowance. I suppose it does look more professional..but nothing has changed in other depts like lab- whom I've seen wear T shirts with logos on them, and pretty much anything.

I need some quick help here, I've never had a middle eastern pt. She is 25 weeks gestation, admitted with fetal demise. Any cultural needs you can advise me on would be appreciated. I want to give her the best care possible.

A few months ago I was called to the hospital because my grandmother was "sick". I met my grandfather sitting in the family room with 2 of my coworkers. I didn't know what was going on...I was under the impression she had died when I was called out of the room to "talk" to the doctor. I was actually, unknown to me, led to the room where they were coding her. I think if I had the choice and had been told what was going on, I would've went in...but I was sort of thrown into it. Then they asked if I wanted them to continue. I had no idea how long they'd been doing cpr or what drugs had been given. It was a very hard spot to be put in, and of course a burden I carry alone because my family would have a hard time understanding, no one else had made it to the hospital yet. Just a different perspective to think about.

We have a lactation consultant who is no longer an employee of our hospital. She works for the ob/gyn (we'll call him DrX)and sees his patients postpartum. All of our other doc's pts are seen by another lactation consultant from the health dept (who is an employee of the hospital). The problem is, we are not allowed to give breastpumps, shields, anything to those moms of DrX. We are to call his lc if they need anything...but not in the middle of the night, etc. I know there are a lot of differing opinions on shields, pumps, etc- but the bottom line is the bottom line. For instance an evening nurse called her wanting a pump for a mom whose baby was in the nicu and the lc said she'd just see her in the morning, let her rest tonite. She wants them to come to her office and buy the pumps from her, which they could get free from the health dept.

Just found out we are no longer to offer moms formula "a", instead, all babies are to get formula "x". UNLESS the mom requests formula "a". But we are not to offer or mention that brand. Most of our moms are on WIC and formula "a" is our WIC formula. We were told the formula company "x" made a deal with the hospital and the doctors agree with it so...give me some opinions people- does this happen everywhere?? Is this some type of corporate compliance issue violation?

Policy: "All regular fulltime and parttime employees must obtain approval form their immediate supervisors and from Human Resources before accepting any outside employment (including self-employment). Approval will be based on possible conflict of interest, any interference with the employee's ability to perform their duties and interference with their regular working hours. Activity related to outside employment may not take place during the employee's regular hours nor involve the use of hospital resources, including but not limited to :telephone, fax, copier, etc." Then it goes on to say if you are on any advisory board elsewhere it must have approval of NM, HR and CEO and says "approval will be granted based on the amount of time and the type of activity involved, any interference with the employees regular work schedule, and the benefit to the employee, and to the hospital." We agree, its none of their business, if they have a problem with my work or attendance they should address it then. They have forms for us to fill out and turn in which I haven't. The only thing we can think of that could be the cause of this is our CFO "left" several months ago and he is trying to build a new hospital which would be in direct competition with ours...also someone called in here to work somewhere else and got caught.