nursedude1

:angryfire Please don't disrespect other members of your profession like that. There are different levels of experience and initiative all across the board. Some are just a little more timid about patient care than others. I could just as easily say that RNs understand WHY we do what we do, and are trained to think critically, whereas LPNs don't necessarily always understand. But to say that would be an gross generalization and a disrespect to many of the fine LPNs that I work with. It would also be wrong. Just understand that we all have the potential to be great nurses. Some of us just need a little more encouragement than others. It is this disrespectful attitude that causes us to "eat our young" and drives many fine folks away from the profession. We are all part of a team, and that means complimenting each others' strengths, not highlighting each others' weaknesses.

On my old unit, they used to care for terminal oncology patients. There is a story about an elderly, retired nurse who came to the unit years ago, named "Audrey". She stayed on the unit for some months before her death. She was reputed to be quite the matronly caregiver, always going the extra mile to comfort and console her patients. Now, facing her own demise, it was her devoted husband who would come and sit with her for hours on end. He would sit on the edge of her bed with one hand on her shoulder. Not long after her passing, a surgical patient came to this particular room. From the very first night the nursing staff noted the patiet to be very restless. When making rounds the nurses would note that the light would always be on, despite having turned the lights out the last time through. When finally asked what the problem was, the patient seemed almost embarrassed. She said "I don't want you to think I'm crazy, but every time you turn the lights out, I get this feeling that someone else is in the room with me. Then I distinctly feel someone sit down on the bed next to me and place their hand on my shoulder...":eek: Needless to say, the patient was moved to another room that very night.

Don't beat yourself up. This is not an easy profession and by no means do our patients or our employers make it any easier. Do the best you can to provide safe, competent care to your patients and when the day (or night, as in my case) is done, go home and find something you enjoy to immerse yourself in. For me it is my family. Occasionally I find myself verbally revisiting the night and its goings-on, but my wife usually shuts me up pretty quickly! Anyhow, the point is that you DO make a difference in your patients' lives each and every day. All you have to do is stop beating yourself up for not being able to solve all of their problems, and you will see this. The truly great thing about our profession, is that if you feel you are getting burned out, there is always something new to try... Don't throw in the towel!

Both cammy and jolie are correct. Although you do assess your OB patients and provide their care much in the same way as with M/S patients, you often enough do not deal regularly with the more complicated medical issues found elsewhere. This is not to say that OB is a cake-walk by any stretch. Some of the OB-specific conditions can be just as complicated as the general medical ones. I have worked in both OB and now in med/surg. Many of the OB nurses I used to work with were incredulous that I would want to leave that specialty for something they considered less glamorous or important. In reality, though, I feel that it HAS made me a better all-around nurse. That doesn't mean it's the right thing necessarily for you to do. Only you can judge the pitfalls and benefits for yourself. Good luck though...

I agree with smiling. I started my nursing career on a high-risk antepartum / GYN combined unit. The GYN stuff really has nothing to do with L&D - they're at opposite ends of the reproductive spectrum. You might look at the high-risk OB unit as well if they are hiring. It would likely be a less intimidating introduction into the world of OB for you without the steep learning curve of L&D.

Who ever said that any of us hate poor people? Disillusionment and frustration with a few that abuse the system does NOT equate hate. That, too, is a generalizing and judgemental statement, made simply because you feel strongly against her point of view. I'm pretty sure that no one here has denied that there are plenty of exceptions to these vocal and memorable few that truly irk us...

I suppose you will have to count me in with the minority of posters here who are being flamed for their points of view. I, too think that a disproportionate number of people expecting entitlement in such situations are ones who are having their lifestyle supported by our tax dollars. Yes, the phenomenon of entitlement does cross socioeconomic lines, and at no point would I suggest that the poor have no right to quality care, but you can't deny resentment at the fact that certain individuals obviously don't appreciate the good thing they have. I agree that the system is far from ideal, but there are many places in the world where the poor are left to rot in the streets. Be thankful for the good care that you get and don't insult me as a professional... As a side note, I would never let my personal or political points of view affect the quality of care that I give my patients. That is just plain wrong. But don't mistake my neutrality in the care I give my patients with an all-out tolerance of stupidity and opportunism. You have to EARN my respect.

Wow. What an utterly thoughtless and completely inappropriate comment your friend made. I hope this wasn't within earshot of the patient. Like others here, I have personal experience (as a father) in this sort of matter. My wife still emotionally suffers from the loss of our daughter (full term, no rational cause) even 2+ years later (and probably will for a very long time). The uninitiated often think that the mother's reaction should be to "get that dead baby out of my belly". It is almost invariably the exact opposite. That mother has spent long months (sometimes years, if you count pre-conception) waiting for that tiny new life to become a real part of their day-to-day life, and in a few cruel moments, that hope is torn from her very soul. She needs time to process the loss and work her way through the inevitable disbelief before having her child taken from her. The physiological risks in most cases are negligible. She will suffer the loss over and over in her mind for years to come. Your friend needs to realize that although the child has died, he/she is no less a person. On a similar note, I have run into similar attitudes when it comes to parents wanting to keep the child with them for a time. In trying to remember that most nurses don't know what it's like to lose a child before you've gotten an opportunity to know them, I remind them that if it were their child, they'd probably have trouble letting go too. I do whatever I can to facilitate the parents' grieving process. Oh, and for all of you nurses that do have the privilege of caring for these folks, a special request - PLEASE DON'T FORGET ABOUT THE DADS!

Go for it if it is really what you want to do. I plan to work in L&D myself someday (when I find the right facility), but made my start in antepartum / GYN nursing. The learning curve is not so steep there, but you get to have a similar focus and pick up some interesting observations along the way. While no one can openly block you from pursuing this specialty, I will honestly tell you that you may encounter a lot of resistance, depending on the open-mindedness of the other nursing staff. Not going straight into L&D, I didn't get too difficult of a time. There are a lot of factors that determine how you will be accepted, though. Best advice, just do what your heart tells you. You'll be happiest in your career that way! Best of luck! Nate

Wow - it's strange to hear people talking about indocin being an out-of-date treatment for PTL... on the antepartum unit I came from (not 6 mos ago) it was routinely used as well as terb and nifedipine. Never heard of ibuprofen use, although it makes sense I suppose...

You're probably right as far as the patients not able/comfortable speaking up for themselves. There are always three sides to every story, each one usually not without merit... I happily advocate for the comfort, safety, and privacy of each of my patients. I only worry about the message that this sends to our patients and to the public with regards to men working in nursing. We have a hard enough time recruiting men to this profession to begin with. Now we present with the perception that men in nursing are not trustworthy (while women are). It doesn't matter if that's not the true meaning behind all of this. The general public doesn't care about details, only perception. We male nurses, as a minority, should be trying to change the public's perception about us, not apologizing for being here. I know that this probably qualifies as a rant, so let me just summarize by saying that while there certainly many people out there who have different values than our own, I also think that the public perception of men in nursing is influenced by our own attitudes and behaviors. In my 2.5 years (a plethora of experience, to be sure) of OB/GYN nursing, I have found very few patients (even those from more modest cultures) that I have not been able to 'win over'. Even the most reluctant ones, in the end, would admit that my determination and sensitivity changed their minds about having a man "take care of them".

Our facility protocols were much the same for fresh C/S pts as described in the post above. And for any patient that complains or wants to refuse a fundal check, remind them as to WHY you are checking (prevent PP hemorrhage, ensure adequate involution, etc.) and most will usually come around and let you. If they still won't let you check, document it and watch their lochia like a hawk...

I went for OB/GYN right out of school and loved it. I am now working in med/surg because I wanted to diversify my nursing experience, but if you can seriously see yourself working OB/Postpartum for the rest of your nursing career, then go for it. There is honestly truth to either side of the argument. Usually the older, more experienced nurses are the ones to tell you that you need 2 years med-surg experience first. It is helpful experience for sure, but I think that it is easy to become bogged down and burned out if you are not careful. Some facilities require you to work a certain time period before you can transfer without your manager's approval. Then again, some managers, if desperate enough not to lose people, have been known to block transfers (meaning you would have to go to another facility to work Postpartum). Bottom line, go with your gut. If you decide years down the road that you are ready for a change you can always do so at that point.

As a man who has worked in OB/GYN, and may someday again work in OB/GYN, I find a lot of interesting commentary here... I have run into the issue of chaperoning before. My heart's desire coming out of nursing school was to work in L&D. I took a job on an antepartum/GYN unit and was glad that I did, due to many of the issues raised here. The thread most troubling to me here is the insinuation that any man performing an intimate procedure with a female patient must be a sexual predator. Yes, we do live in a litigous (sp?) society, and we must constantly be vigilant to protect our licenses. In two-plus years of OB/GYN nursing, though, I have only had ONE patient to make any kind of accusation against me, and it had nothing to do with any intimate procedure. The patient had a psych history - she claimed that I had 'accidentally-on-purpose' "caressed her breast" while reaching for the blood pressure cuff. Of course my unit manager and her manager took it no more seriously than they had to and the matter was soon over. I guess what I'm trying to say is that any reasonable person is capable of speaking up if they are uncomfortable with a situation (patient or staff member). If you notice that a patient seems to be uncomfortable with a certain aspect of their care, you should then graciously ask if there is any way you might be able to accomodate that patient's sensibilities. I have never performed an invasive exam on a female, but I have on innumerable occasions had to work 'down there' without incident. We might (and then again, we might not) be avoiding a few lawsuits, but what we are also doing, unwittingly, is to undermine the bonds of trust that we try to build with each of our patients. No one in their right mind would deny a chaperone to a patient that requested one, but to require one for each and every encounter only sends the message that we as professionals are not trustworthy. What's next? Video monitors at the bedside to record every move that we make?

What a laughable statement! I educated new mothers countless times on breastfeeding in my 2 1/2 years of OB nursing. I'd get the occasional side glance, but 99% of my patients accepted me because I was there to help them in their time of need. Matter of fact, when my son was born, the postpartum nurses (all ladies, of course) were horrible in the realm of breastfeeding education. They were overbearing and callous - all evidence of an "I've done this before so you'd better shut up and listen to me" attitude. I was never able to work L&D because of such attitudes, but the ladies on my floor readily accepted me. Often, as is evident in this thread, the problem is the other nurses, NOT THE PATIENT. Such nurses project their own feelings onto the patient because "I know what they are going through..." This prejudging and labeling of patients is wrong and only serves to put up barriers to effective, competent care. Every patient brings something different to the table. Don't assume that you understand their mindset just because you've seen the same clinical picture time and time again. Despite being a "uniquely feminine experience", we are all capable of understanding the reproductive and birthing process. As far as the psychologic aspects are concerned, our patients don't need a dissertation on what it means to be a woman. They only need to know that we care and are competent and will do everything within our power to help them through a potentially difficult experience.