beachmom

I need suggestions please! Our hospital has encouraged skin to skin after birth for many years, and after lady partsl births this is happening. After C/S births, IT'S NOT. Our manager is all for us doing skin to skin in the OR, breastfeeding and keeping baby with mom all though the OR, PACU and back to her room. (If baby is stable and staffing allows.) The OB's, OR staff and PACU staff are all OK with this. The problem is, most nurses are still bringing baby to mom for a few minutes after the C/S then taking baby to the nursery to do the weight, meds etc. Some will then get the baby to mom in PACU. Others will keep the baby in the nursery while they do their paperwork and not get baby to mom until she is back to her room. Grrr. It is much easier on the nurse to bring the baby to the nursery. And it's an ingrained habit. We've had many forced changes by management lately, I think encouraging a change in practice would come better from a coworker (me) than from management. I'm on practice council, and this is one of our goals. I put a flyer on the bulletin board, but I need something more effective. I'm thinking a slideshow or video at the unit meeting, maybe? Do you know a good video? Any suggestions for me would be greatly appreciated. :)

Here's a whole list of names, with pictures. :) 19 Nonsensical Names That Nobody Should Have To Live With | RealClear

No, we don't have a 24/7 OB. Luckily all our OB's live 5-10 minutes away, and they can park right next to LDRP. The clinics are across the street - 2 minutes away. Our peds live farther away, 10-20 minutes. All of us are expected to be skilled with NRP. The next nearest LDRP is 2 hours away, so we do our best. Some of are CRNAs (anesthesia) live 15 minutes away, and that's scary. We have a "stat C/S box" in case the Dr. needs to get a baby out with a local. We all hope and pray we don't have to use it. It was used once in the past, and it was quite traumatic for the pt and the nurses. We have about 600 births/year. Not enough to pay for a 24/7 Dr. or CRNA. Although there is a 24 hour hospitalist if we have a medical problem. Doctors don't have to be in house for epidurals or inductions. Never heard of that. They have to see the pt. at teh start of an induction, and they all answer their phones quickly. Doctors and anesthesia both have to be in house or at the office (2 min away) if we do a VBAC. We have sleep rooms if they need it.

Lots of green in the Portland area and lots of rain to keep it green. Snow and skiing on Mt. Hood. Nice clean water from Mt. Hood melt-off. About two hours from the beach. Lots of culture, arts and diversity. Lots of environmentalists, and health conscious people. I heard it's one of the most livable large city. It has some excellent schools, others not so much. Excellent variety of restaurants and shopping. More parks than most big cities. You need to look into which part of Portland or metro area you live. Some areas aren't very safe. Other parts are much better. LOTS of traffic. Good bus system. I lived there 35 years and then escaped to a small coastal town. I hated the crowds and traffic and love my sleepy little town. If you were a hospital nurse, I would recommend St. Vincent for employment. I have relatives who work there. For a mental health NP, I would have no idea what to recommend.

I know they are different. I'm just saying you can cure strep. Why can't you cure MRSA? If the antibiotics kill the MRSA enough for the wound to heal, why is the person still colonized and infectious?

If someone has a MRSA infection and is on Vanco and Zosyn, and the wound heals, do they still have MRSA? If someone has strep, and they are treated with antibiotics, after 24 hours, they are not infectious anymore. Is MRSA different?

If someone has a MRSA infection and is treated with IV Vanco, when he gets out of the hospital, is he still able to spread MRSA to others? If a person has strep, after 24 hours of antibiotics they are considered not contagious anymore. But with MRSA, I have heard it said people may be carriers forever. I had a relative treated for MRSA, and the doctors just told us to "wash our hands a lot and we will be fine." I thought, no way. If he still has MRSA on him, if he touches ANYTHING in my house, and then I touch the same thing, I can now become colonized with MRSA. But if he is treated with Vanco, and the wound heals completely, is he still colonized? Can he still spread it to everyone he touches? So what's your opinion? If you invite someone in your home who was treated for MRSA, would you disinfect everything he touches?

I can't count the number of women that come in planning on a totally natural birth who decide, at 6 cm, to go with the epidural and are very happy they did. I always tell them I'll support whichever direction they go. I don't know the exact statistics, but I've done PPV on enough natural birth babies to know that just doing things natural does not guarantee a perfect baby. Personally, I've had a C/S and two VBAC's, two with epidurals one natural. There are pros and cons to all the different choices. There are risks to whatever a woman chooses. At home, the woman risks an unexpected postpartum hemorrhage. At the hospital, she risks a spinal headache from her epidural.

I knew a man with a first name of "Fuk." It was pronounced "Fuke". Too bad it wasn't spelled the way it was pronounced. He was an immigrant from one of those small, south Asian countries. I'm sure it was a fine name in his country, just an unfortunate English spelling.

This was a night shift nurse's note in a LTC facility. "No pulse, no BP. Will keep comfortable." She left the next morning, saying nothing about it to the day shift. Day shift CNA, of course, found pt. dead. The nurse was let go. I always wondered what the official time of death was, and if the facility told the family about this.

Considering his actions the last few days, I wouldn't take care of him without a policeman present and any other safeguards I might need to keep myself safe. That being said, he'd get the same care from me as anyone else.

We had a nurse give a pt. two regular Tylenol instead of Norco. Too bad for her that the pt. was a hospital pharmacy tech and recognized the pills and turned her in. Don't know how many patients she had shortchanged in the past. We had a young male patient with pain control issues who didn't agree with his prescribed meds. He broke into the sharps container and a nurse found him sucking on the vials.

Our patients are "alert and oriented." When I started working at the hospital, I was "orientated." I never liked the word "orientated," and now I learn I'm right, it's not American English.

There was a nurse on our unit, whom I will call "Kate," who was recently found "diverting" narcotics. Several months ago I was on the shift after hers and medicated a patient that Kate had. I brought two norco as the MAR said she had two several hours earlier. She said, no, she had only had one and she would just like one again. I know it's a very serious accusation, and to my knowledge at that time, she wasn't under suspicion. Sometimes patients are mistaken, after all, they are sick. Maybe the pt. wanted one, but the nurse gave two because most people want two, and the pt. didn't notice. Maybe she charted two, and then the pt. asked for one, and Kate put the other pill back. I didn't report it. My only proof was what the pt. said. Now I feel guilty. Maybe I should have reported it. How many patients have been undermedicated since then? Luckily she was found out, and the state board is involved, and she is no longer working there anymore. Would you have told the manager at that time?

One of the peds is out of town for a couple weeks, and a locum tenens took his place. We had a 34 weeker in labor and needed a ped at the delivery, so we called Dr. "LT." This is a small hospital that ships out early moms if we can, but it's 2-3 hours to the bigger facility, so this mom was going to deliver here. From Dr. LT's questions before the birth, I got the idea he didn't help with early deliveries. The big hospitals have specialists to attend early ones. Our main nursery nurse that night, whom I will call "Jo", has over 20 years experience with babies and teaches our NRP classes. You would think experience and knowledge would trump a degree. But no. At the birth, Dr. LT took over, did little according to NRP. Deep suctioned the mouth, then asked Jo for a smaller catheter to deep suction the nostrils. Jo respectfully told him that it was not indicated for a vigorous, screaming, baby at age 2 minutes. The baby might vagal down and lower his heart rate. The doctor insisted babies were obligate nose breathers, and he must be suctioned, and then he said "I'm not listening to you." He pointed out some other things we were doing "wrong" when we were following NRP. When he decided to ship the baby, we all thought, "Good, then we don't have to deal with you anymore." Baby was doing well, so I gave him some skin on skin time with mom while waiting for the team. I felt sad for the parents. The other peds would have kept the baby here. Moral to the story: I am SO thankful for the peds that we have here.