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posterior ?
He means the cervix is posterior, or way back by her tailbone. Hard to reach if you have short fingers like me!
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What nursing shoes do your recommend?
I can't fit my feet into Dansko's, and Crocs just don't cut it. Brooks tennis shoes with my custum orthotics for me!
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"glorified birth junkies"
It depends. To be a doula, you can take a few certification courses. To obtain my RN, I went through 4 years of college. To be a doula, you support the family and woman and help her clarify her choices but do not make/impose medical decisions upon her. As an RN, you do this and more, by giving pain relieving or lifesaving medication if necessary, documenting the process, keeping the woman and baby SAFE. To be a doula, you are there for the whole birth, 2 hours or 48 hours. As an RN, I show up for my assigned 8 hour shift, do my work, and go home. (For my family with kids, this works better as it is predictable. Do you need a steady income with benefits? Can you leave your family at a moments notice for 2 days to support a birth. It is very rewarding but not a great income or predictable life. Good luck.
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Does your hospital offer on-site childcare?
Ours offers 6:30-6:15. Since most of our units are 12 hour shifts, this doesn't help the nurses, aides, or housekeepers. It sure helps the administration, though, since they work conveniently within those time frames. Grr. Just one more reason to have a rift between Them and Us.
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Losing money being a nurse
Which were put in place by the Reagan administration.....
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How do you cope with the death of a patient?
I work L&D, and so deal with the rare maternal death and the more frequent but always emotional fetal demise. Go ahead and pm me if this is the experience you want to hear about.
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Is doula training useful?
So far as "making your money back", I would just consider it an extension of your education. Doula training is infinitely valuable to a labor nurse or CNM. It also shows your hiring manager that you are willing to invest in education toward your chosen field, outside of the BSN.
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taking students, precepting
You have to realize that often we only see students for one day. There is not much time to develop a relationship with them, nor assess and build upon their skills. We trained as nurses, not nursing instructors. Also, when you are working under us, our license and the license of your instructor is covering everything you do. That means I have total responsibility for any mistakes you make when you are caring for my patient. For new employees at our hospital, only nurses who are trained as preceptors will orient newbies, and with that comes a small pay increase ($1/hr). However, we are given neither choice nor compensation when nursing students are following our patients. Don't be so judgemental about a nurse's attitude.
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taking students, precepting
I generally find that having a student adds one "patient" to my load, since I have to spend more time explaining or precepting them to practice skills. It would be nice if I was given a lighter patient load when I have a student, but that is not the case. In L&D, I tell the students to put on their running shoes and keep up! I do enjoy the fact that having to explain my thought processes to a student makes me "review" for myself why I do what I do, but some days it is mentally exhausting. The students who learn the most while with me are very proactive in their learning and express eagerness and willingness to seek out learning opportunities.
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Caring for Jehovah's witnesses
Our hospital has included a question in our admission assessment to find out if the patient objects to blood transfusions. I work in L&D so this is a very real possibility for every admission, although rarely given in reality. If the patient objects, we have specific paperwork we go to in order to flag the chart and education the patient. There is a form to sign agreeing to some blood part, or none at all. They get to check what is acceptable. It is very clear to the patient that we are acknowledging their beliefs, and very clear to the staff what is accepted by the patient. The patient even gets a wristband to flag the fact that the patient has a specific request in regards to blood products.
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External Version??
If they are going to immediately induce you after the version, request the epidural first. You will can use it for a c/s if you have to. Plus, your abdominal muscles will be more relaxed if you are not in excrutiating pain. Sounds like your OB's have a plan for you - do you trust your OB's?
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Can I handle OB?
I work on a unit that does about 200 deliveries a month. I usually only care for a demise twice year. In my 8 hour shift, I have managed not to actually be at the delivery for about 4 years now. I usually manage to get through the shift okay, but end up crying on the way home. Sometimes after a delivery I even have nightmares. However, I'm still able to care for my patients. There is grief support to offer the woman, and I find the nurses who have had a demise or miscarriage themselves give extremely compassionate care. You can always offer to take the hardest assignment or most complicated patient instead of the demise. I, however, do not do terminations. I have signed a form every place I work stating that I will not be involved in the care of a woman having a termination. Thankfully, I now work at a Catholic hospital, and terminations are not performed. There are so many wonderful moments in OB. Don't give it up without trying it if you are interested. Good luck.
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Obtaining License In More Than One State
Usually, after you are licensed in one state, it is just a matter of paperwork and money to get licensed in another state. Some states will require a few special courses, ie in WA you need an 8 hour HIV course. Find out the requirements for each state by calling their Board of Nursing or looking at their web sites. Start soon, sometimes the process can take a few months. Usually there are verification letters from your school of nursing, your original state of licensure, etc.
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How to get a job OTHER than reading Classifieds
I always dressed up professionally and went to visit the nurse manager I wanted to work for on the unit. It always netted me a job! Anytime you go to HR, dress professionally, of course, but have a clear goal in mind and talk with the managers. They will always say to put in an application, but they have at least seen your face. Sometimes I would just walk up to check out the unit and ask if I could schedule time with the NM. Othertimes I would call and request 5 minutes of her time and set up my own interview. Remember, you are interviewing them as much as they are interviewing you. I would always come with a current resume and letters of reference/ reference list in case they asked. I also had all my credentials to show them in case they asked. Then, even if it was only a 5 minute chat, I would sent a thank-you note for the courtesy of her time.
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Future CNMs
It sounds like you have found the PERFECT place to get your experience - very well-rounded in care. I've worked the gambit from birth center to Level III, and everywhere in between. I'm grateful for all the experience as it brings a different perspective to my care. I'm still not in a life situation to do midwifery, as my kids still need my care for about 14 more years, but I would like to do a seminar at The Farm with Ms. Gaskin and re-energize for my labor support. Someday....