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!

Couldn't agree with you more. I've been NRP certified for about 10 years. Every delivery I attend, I have that thought in the back of my mind, what would I do? Not that I want to have to go through class more often than q2years, but I sort of wish it was more often, especially since I don't use it often. You know it's one of those skills that you have to have, but hope to never use! I do look in the book monthly, just to remember things. It's a good reminder.

Stand up for yourself. Been doing OB for about 20 years. Talk to your manager TODAY! Try to get one preceptor, follow her schedule. Talk to her. IF she's a good teacher (which every preceptor should be) make her explain, explain, explain. Talk to the MDs, if you're attending their deliveries, find out their preferences for things, stools, different vaccuums... (it's great to have the MD on your side). Step outside your "comfort" zone. Push yourself farther, make your preceptor let you do the care, the paperwork (ugh!). Obviously, she may need to step in if you're making a mistake, but sometimes you learn better from mistakes. Keep in touch with your manager on a weekly basis, include your preceptor. Find out what the expectations of each are, and your own too! Maybe they expect too much, too soon. But please hang in there. The joy of doing your job well, to see the smiles/tears of new parents faces is all worth it.

We do about 200 births a month. We have a "holding" nursery, open from 11pm - 7am. Usually used by bottle feeding moms. Some breastfeeding moms use it, we bring junior out when he's hungry (his schedule, not ours). Kid eats, returns to nursery... Then mom can sleep without fear of baby being in room. It's also convenient for mom's who you know were in labor the night before, which means they are sooooo tired, probably haven't had any rest for 24 hours. (which increases their pain, irritability...) Of course, we do make sure that all parents know how to take care of, feed, change diapers before going home. It works out well for us staff too. We can keep a better eye on babies without disturbing parents. We do make rounds on babies q2hours if they're in moms room. But there have been instances (choking, gagging) that if baby had been with mom (sleeping) the consequences could have been different. In the nursery, the baby was seen immediately, and taken care of. Personally, I like having the night nursery. I know it makes my job easier.

Be prepared! This unfortunately is part of the deal of working OB. At least once a month we have mock drills on different situations, post partum hemorrhage, infant abduction, seizures, prolapsed cords.... Hopefully, you work in a unit where everyone pitches in. Do you have an OR in your unit? If so, go into it every once in awhile, get familiar with instruments.. Have your scrub tech go back with you, they are a fountain of information, tap in to it. Talk to the doctors, anesthesia, RNs with more experience. A dirty instrument is better than no instrument, that's what antibiotics are for. Needless to say, document, document, document. Not that it will bring back a mother, but it will keep you out of court.

I know we all didn't go into nursing for thank you cards, I think it started when patients became clients and hospitals became "hotels". I go home knowing I did the best job I could do, kept my patients safe... But it is nice to be recognized for it once in awhile.

Been there, done that. Had a male student (whose father was an MD) with a learning disability. He couldn't read well, so all books were put on tape, his tests were oral exams (he couldn't write very well either). Didn't seem very fair, considering part of nursing is reading/writing orders, clearly... Did make it through all clinicals, never knew if he passed boards. I sincerely hope not, for his own sake as well as his coworkers and patients. I never knew if he was held to the same standards as the rest of the class. You know, those 20 page care plans, the top 20 side effects of every drug you're giving. I did feel sorry for him because I don't think the instructors were being honest with him during clinicals/class. He just kept getting passed along from class to class, when it was apparent he wasn't up to the difficult task of nursing. So being a doctor's son didn't help him at all.

OLD OB RN: remember when: 1. C/S, in bed for 2weeks and then sent home 2. Vag deliveries in bed for 7 days. 3. Babies were only brought out to mom for feedings, then whisked back to the nursery to be cared for. 4. Absolutely, no children allowed on the unit. 5. Dad's did not attend deliveries/surgeries 6. Epidurals? How about twilight sleep, pudendal blocks... 7. We were actually considered a hospital, not a hotel with "clients".

Been an OB nurse for almost 20years. You are in the right as far as I'm concerned. There really is no reason for that infant to be in the morgue, it's really hard on the parents to imagine that their child is cold/alone.... We keep our fetal demises either in the room with the parents or in our utility room until parents/family are done holding/baptism/pix. Then the baby goes to the morgue. But can be brought back to our unit if requested. I also precept new staff for fetal demises. It's very uncomfortable for RN's to deal with these situation, unfortunately they do occur. No one knows what to say (don't have to say anything, just be there) We're trained to bring life into this world, and darn it, babies aren't suppose to die! Sometimes, being emotionally involved with patients can be very draining, you can't take your work home with you, maybe that's why that RN was so rude, she just didn't want to get emotionally involved.

Nothing for thanksgiving. But after we attend a mandatory 1hour forum (where the big whigs all pat themselves on the back for the great job they've done this past year) we get a $15.00 certificate to a local grocery store. Unfortunately, my spouse also works for same corporation/different hospital, they get $50.00 American Express gift cards. I work midnites: for Thanksgiving & Christmas Eve, we get FREE sandwiches and pop (1 each please). I guess our bosses don't really have to do anything for us, but I wish they were consistant from hospital to hospital, shift to shift

I have to believe that we leave because you can't "turn off" being a nurse. It's a 24/7 job, whether you're being paid or not. YOu mentally take your work home with you, and sometimes physically (On you uniform). It's also what you make of it. If you let other workers degrade you and do nothing, than who's at fault. If a doctor expects you to fetch his coffee and hand him papers, and you do, who's to blame? I learned a long time ago to stand up for myself (but not in an obnoxious way). Not only does it make others treat you better, but you feel better about yourself. Why would you let co-workers and complete strangers treat you worse than your own family? I also believe that the work level that most, not all, nurses are expected to function is incredible. Management knows that we WILL go without lunch, breaks, bathroom time, stay late, because of the PATIENTS, no because of MANAGEMENT. It's just something we as nurses do, other people can't comprehend why. Our jobs don't stop just cause the clock says it's quitting time. We can't close the doors at 5pm on Friday and reopen on Monday. We don't slow down on holidays, or off shifts. It takes someone very special and dedicated to become a nurse. I applaud each and everyone of us, and those in school, who have accepted this challange. And boy what a challenge it is. Maybe some of the "posters" who are in school will be the ones to figure out how to make our jobs easier and less stressful