JenniferNRN

aaaah, good ol' hands and knees. i love to put them in that position when they are "stuck". sometimes only takes a couple of contractions to bring that baby down. i had an unattended last weekend. typical g2p1 with a fast labor. came in complete, explosive srom after about 10 minutes there, and then there's the head. it was the first nuchal cord that i couldn't reduce so that was new for me, but ended up with a healthy baby and mama. that's all i could want. i also only had one glove on though, and my fellow nurse put another one on my left hand as i guided the head out w/my right! learned my lesson too! :smackingf jennifer

Thanks for all of the responses. I appreciate the input. I have learned that it is a little more common than I thought to take those under 20 weeks, and of course, our units are all so different as far as having a triage area or ante unit. I love how much we can learn from each other here.

I am very curious as to what other hospital policies are on this subject and what your opinions as ob nurses are. our hospital is a rural one, doing about 150-200 births per month. I work nights on the weekend and we don't have an ob in house. many of our pt's don't see a doctor until morning, or at all if they are d/c'd by phone order. The hospital is also very short on money so most units are understaffed and overworked, including the ed. In order to help the ed out, we are now required to take pt's with gestational age of 12-20 weeks, with an ob complaint (ie: vag bleeding, fluid leaking, abd. pain), after they have been seen by an ed physician. the old policy was 20 weeks or above. One problem we have with this are that we are sometimes so understaffed as well that we are overwhelmed with these new pt's. we also have ed calling to say pt is "3 months", and if the person taking report doesn't have the foresight to question, the pt comes up, we wheel her out, and she is 11 weeks. at this time, we have accepted her and everything turns into a battle of wills between us and the ed. Another problem is that we don't have any protocols/policies for pt's under 20 weeks. I know how the docs in our ed are and even though they have "evaluated" these pt's, I know they want to get them up to us asap to avoid dealing with them, and I'm worried that we are going to end up with an ectopic or some kind of emergency that we haven't seen before. Most of our ob's are at least 20 minutes away, if not more. My question is: at what gest. age does your unit accept pt's, and what kind of policies/protocols do you have in place? I'm also curious as to what you have experienced if you take pt's of a lower gest. age, and to what your thoughts are on it. Thanks for your input and for allowing me to vent a bit!

Which is exactly why I HATE Jello! Bleh!!! I have to agree with the majority here...mucous, spit, snot....all the worst. I have gagged repeatedly reading this thread! I work in labor and delivery and you can bring on all the blood, poop, placenta, meconium stained amniotic fluid, and vomit and I'm fine. But give me someone hacking up juicy stuff and I'm done for. We once had a pt who had an uncommon ailment in pregnancy of overproducing mucous. Previous shift told us that she drooled so much that she kept a towel by her face and it was soaked. Needless to say, we pretty much had to draw straws to figure out who would take care of her. Thank goodness I didn't because I don't know if I could have kept my gagging under control. God bless those who can work in areas we can't.

We mix 5 Units in 500 D5LR and start at 1 mu/min. We double every 15 minutes for an hour, then go up 2mU per hour until max of 20 mU without further order, until ctx's are adequate and every 2-3. BP every 15 min until stable on a particular dose, then every 30. Continuous monitoring on Pit. We can place our own IFSE but MD's must place IUPC.

My first was 9#15oz (C-section for FTP after 3 day IOL) and second was 11#13oz (repeat C-section). I thought I was having twins and they missed it! Was very uncomfortable and couldn't sleep from about the 7th month on. Blood sugars were fine.

Hello. It has been almost 8 years since I had my son at Camp Pendleton Naval Hospital in California, but I will try to tell you what I can. Pros: I know they had advanced technology at the time and I have heard from several people that military hospitals tend to have newer techniques/drugs before other hospitals (I had Cervidil used on me there and 2 years later in Wisconsin, they said that they just started using it, although that could be just be CA vs. WI) I remember the epidural placement going quickly. I had an intrathecal before the epidural, which allowed mobility. Before I was on Pitocin I didn't have an IV and was able to walk the unit as well. I did have continuous monitoring when I was in bed. I was an induction and all about pain relief, so I couldn't really tell you about refusing interventions. I was able to shower early on also. Where I was there were a couple of Certified Nurse Midwives that I saw regularly and I really liked that care and attention they gave. I felt there was a multitude of education and resources available to me. They set me up immediately with WIC and childbirth ed classes. There were many different free classes offered. I felt since it was a teaching hospital that I usually had a lot of attention and caring people at my side. I also felt that being a military spouse, rather than an actual member, I received a lot of respect from everyone, no matter what their rank. There was a home visit during the first week from a nurse to check on my recovery (I was ultimately a C-section) and answer any questions. Cons: It was a teaching hospital so I had many different people checking my cervix and failing to start my IV on multiple tries. I had many different caregivers come and go throughout my long labor and postpartum stay. They were strict about the baby rooming in and I practically had to beg them to take him for an hour or two so I could sleep a little that first night. They were very big on getting you to care for yourself and your baby immediately, which was hard after a primary C-section. I don't think there was any private rooms although I was lucky enough to be without a roommate. They didn't have anywhere for my spouse to stay. Those are the highlights that I remember. Many things may have changed over the last 8 years and I am sure that others have had different experiences. Now that I am an L&D nurse and have seen the good and the bad that can exist, I think overall I had a very good experience there and I retell it fondly. Best of luck to your sister no matter what she chooses.

Yes, we too have many pt's that show up to have the baby because, "Today is my due date" or because, "There was pink mucus on the tissue when I wiped". Countless pt's of this type. Now if we can only get the docs to educate them in the office....

Congratulations! :balloons: I too started in L&D right after graduation almost 3 years ago, and I would never want to be anywhere else. I would have to reiterate that you ask a lot of questions of many different nurses. Each nurse has something unique to add and you can take away a little bit from each to find your own style. Always listen and take interest because I see the quickest to fail are the ones who have the attitude that they "already know" everything, so other RN's lose interest in teaching them. Also, jump in and do things over and over when you can. Do a lot of cervical exams to practice finding different cervices and assessing dilatation. It takes a while to know what you're feeling in there, and even after many years, we still question ourselves and ask other nurses to check behind us. The more you do procedures, the more comfortable you will be. I could go on and on, but my final piece of advice that was given to me early on is, never get complacent. When you get complacent and think you can relax because you've got it all down, that is when it will turn around and show you that you don't have a clue. Always good to stay aware and ask, ask, ask if you are unsure. Hope that helps and doesn't scare you. L&D is a wonderful place to work. There is a lot to learn, and it may feel overwhelming at first, but it is worth it to hang in there. There is nothing like feeling a baby's head before it has made an appearance, or placing a bundled up newborn in a proud parent's arms. It is truly rewarding. Good luck on the NCLEX!

If you really have your heart set on babies only, is there a children's hospital in your area? Just a thought. :)

Add me to the "those who received nothing" list. We didn't even get an acknowledgement of the week. The following week we celebrated "hospital workers week" and all of the activities (one free meal, ice cream social) were planned during the 9-5 shifts during the week. How about us weekend night shift people?? I would have appreciated even a simple thank you flyer in my mailbox but I think the best gifts would have been some kind of gift card or day off. I am surprised to see so many places that skimp on nurses week.

I'm glad that we are LDR only because I am one of those who enjoys L&D but not postpartum. I am cross trained to PP and Nsy, but I will choose L&D most days with a trip to Nsy once in a while. I like having a choice in the matter. Just my opinion though....

2 more things I've found recently to add to the others... ---snowstorm=SROM's ---make plans for a day at work (I planned to clean the lounge refrigerator)=too busy to even breathe much less do something else!