flytern

How do you give shift to shift report? How many patients will you have? I too work until 0730 in labor/delivery. Most days, we leave by 0730, but, if someone comes in active labor at 0650, it's our responsiblity to admit them. We use computer charting (but it takes forever when you're patient can't answer your questions!). So everyday is different, just don't short change your pt care/charting because you need to rush off.

I remember the show. It was a food show (go figure) on PBS. The placenta was fried up and eaten on crackers. In England. Mine: I had a bald father rub the placenta on his head for 1/2hr, supposedly to grow back hair. All it did was make him look extremely gross!:nuke:

:nuke: Have to agree that I don't see much difference in being Magnet or not. Except for the public relations end of it. Most of the preparation for obtaining magnet status seems to be paperwork, committees.... not in actually improving bedside care of the patient. But it is a competition thing. We have 4 hospitals in a 30 mile radius, one being magnet. Boy the day that was announced, we had committees coming out of our ears (this was about 2 years ago) Now we hear nothing about it.

450 bed hospital, 30 bed LDRP, we do our own C/S and recovery which is why we have to have ACLS certification. (They say we legally have to have same skills as our main OR staff!) :nuke:

We do the full blown ACLS course every 2 years here. It's really scary to imagine having to use that stuff. We're lumped into the program with RNs from ICU/OR/ telemetry. It's like a foreign language. Except for some of the drugs (mag, epinephrine) :nuke:

Unfortunately, when patients here the words "you're complete" they think they have to start pushing, urge or not. If they have an effective epidural, no urge, and are -3/-2, sometimes I tell a little white lie ans say they're an anterior lip. And explain that it's not time to push yet. 15 years ago I worked with a wonderful OB who truly believed in laboring down. Heck, mom is exhausted whether she pushes for 15minutes or 2 hours. And usually after about 1 hour, they aren't the best pushers. :nuke:

Started out as an office nurse: got Christmas bonus(usually about $500.00) nice dinner at a restaurant for staff/family. Then went to hospital nursing (3rd shift) We see the empty tins of popcorn/cookies, the leftover Olive Garden lunches from the docs, the crumbs from the sales reps... From the department director it's usually a tree ornament (looks like about a dollar was spent) and a dinner that was ordered at 5 pm for the 11 pm shift, and heaven forbid someone thing about putting it in the fridge!

Get out there and interview! Gone are the days that the only way to get into OB is if nurses retired or died! Depending on the hospital, and nursing shortage, there should be positions open. In my hospital we currently have new grads and transfers from other units. Your background is definitely a plus. Again, gone are the days that only "healthy" young pregnant women existed. Now we're dealing with many co-existing problems (diabetes, cardiac...) Good Luck :smilecoffeecup:

If you plan on diving straight into L&D, just remember, it's not only about giving birth. In today's society the "healthy" pregnant woman is a rarity. Most moms have other conditions that have to be attended to, hypertension, diabetes, cardiac, drug use.... So being a well rounded nurse is a a big plus. However, that's not to say that you can't learn that stuff on the floor.

Unless you're 80 years old, you can do this. I would encourage you while taking these pre-courses, to maybe get some sort of job in a hospital/nursing home. It might give you an idea of what it's all about. Remember, nursing is a 24hr/7day job, no holidays off, weekends a must. The rewards are numerous!

I'm partial to OB. But I have a Bachelors in Psych too. It truly comes in handy. Especially these days. Not a day goes by that we don't have either a unwed teen mother, or someone who has psychiatric problems (usually mild). For some reason, Rns that I work with are uncomfortable with these patients, so I usually volunteer to these assignments. Now it's not hard core psych, but you still use those skills. Especially listening skills. And vice-versa, we have OB patients on our psych unit. Don't pigeon hole yourself. You can have more than 1 passion.

I'm with you SmilingEyes. I'm glad to see someone else out there believes in "laboring down". This is what I learned a long time ago (when dinosaurs roamed the earth). But where I work now, it's complete - push NOW, can't feel the "spot" 0 too bad- push for 2 hours- then a C/S. I can't call it pushing, if mom really isn't participating. I too fudge dilation, mostly to the patients, because they learn (from everyone and their sister) that once you're complete, you have to start pushing. Even if I have to wake them up to do it! I believe in mother nature doing most of the work. Pushing is exhausting, whether for 15 minutes or 3 hours. Most of our MD's are coming around to the "laboring down" theory. They don't like to sit around for 2 hours while their patient is pushing, they get too antsy to get in there and do something, like vaccuum or c/s.

Congrats! What a feeling (both scary as all get out and exhilarating) But, forget the docs. Sometimes you just have to say, stop the panting and push! Why prolong moms pain? Before we had our "doc in the box" (the MD who spends the night with us), we routinely did a nurse only delivery about once a week. And considering some of our MD's, it was probably better for mom and baby. (no epis and usually no tears). We're much more patient with out patients! Last month, I had a multip come in, complete, barely made the bed, delivered the baby. MD got called after the fact, came in, started blustering about not being called in time. The patient and the family said to the doc, I knew we were in good hands, this RN had delivered her last baby! So I'm 2 for 2 with this group, maybe I should go into private practice.

We have 1 LC on staff, she is not an RN. She doesn't have the best relationship with the staff RNs. Not sure if this is because she isn't a nurse or because all she sees is the "boob-mouth" connection, can't see the whole pix of mom's physical/mental picture. We do have a few RNs now looking into becoming LC. It will take them about 2 years to obtain. No increase in pay for them, just self satisfaction. Hours for our LC: 7-3:30 M-T-Th-F, 3p-11p Wed. She does teach a breastfeeding class once a month, does alot of outpatient teaching for discharged moms. Desperately needed, since they see her for only about 5 minutes as inpatients. Good luck with whatever route you choose.

I'm usually charge RN on a midnight shift w/lots of "newer" nurses. I try to attend most births (mainly for support/another pair of hands/gopher). I try to mimic what their primary nurse is doing. The only time I try to intervene, is if I see that the patient isn't pushing effectively, mostly by either not feeling the "spot" or some such thing. I try to suggest to mom to either change position, put hands under thighs, use towel for pulling... I give her/dad the explanation of why (so that the new RN learns too) she might need to change what she is doing, help with positioning.... but I make sure the primary RN knows that she (not me) is running the show. You can't learn everything there is to know during orientation, alot of it is "hands on". Lord knows, sometimes I still need someone else to double check a lost cervix, start an IV. Somedays you've got it, somedays you can't find the door on the barn! If verbal coaching is needed during pushing, usually we just tell mom to push the most comfortable way for her, dad does the coaching. We don't yell (maybe because it is the middle of the night), but sometimes you do need to get into your patients face, especially if she's losing it. I have no problem telling everyone in the room to shut up, get moms attention, and tell her to concentrate on me, listen only to me. There's nothing worse than 2 RNs, dad, nursery RN, mom, other support persons, all yelling something different! Stand up to this nurse. It's not her patient, or her delivery. Talk to her. Maybe this is the only way she knows how to do deliveries. TEACH HER!