CMCRN

I would never ever cross a picket line. And especially for $46 per hour that would be a huge pay cut for me. Thanks to my union here in California I make a fair wage.

You've probably allready done your presentation but I'll chime in anyway. I live and work in California and am a member of a union, The California Nurses Association. I have been a nurse and a member for over 30 years. I think it is definately important, you can define working conditions to insure safe staffing and safe patients, cared for by nurses who have been oriented to the area not floated at the last minute. Here in California we have ratios to insure safe staffing. If I was a new grad looking for a job I would definately want to work somewhere that had a union. Usually salary and benifits are better. Chico David is much more articulate than I am on the subject.

L&D and ED attract similar personalities, type A, that like the drama. I think it might be easier to go from the ED with the skill set learned there, to OB, than the other way around. If you knew for sure that you wanted to only work L&D then I would say just go there, but if you like both and hoping they are really busy units where you get to see and learn alot, I might start for at least a few years in the ED

Oh and we have 24 hour in house anesthesia backup.

Our conscious sedation protocol does not call for EKG monitoring. We do q 5 min vs, bp,pulse and O2 sat. Usually it is just fentanyl which we also give to our labor patients. Primarily it is for D&Cs that would have been done in the office except that it is afterhours, nights and weekends.

Conscious sedation, usually fentanyl and maybe versed. I think all of us would prefer they be done in the OR also. It requires one of the triage nurses be one to one with that pt and is quite often is not as straight forward as it is billed by the OB. So I just wanted to get a sense from around the country what others were doing.

I work in a level III hospital, about 6,000 births a year. We have a separate OB triage unit 2 floors away from L&D. We are trying to develop a protocol for doing D&C s in the triage unit. Does anyone do this? If so, up until how many weeks? And do you also do D&C if a PP pt comes back in bleeding after discharge?

Better RN salaries on the west coast are a direct effect of Union representation.

My employer, too, offers a financial incentive of $100 per month. I think they do this if they are going for magnet status, which means they are giving a ton of money to ANA

IV? that must be a typo We do have a protocol for po Vitamin K. Double the IM dose orally but it does require 2 follow up doses and is somewhat hard to find outside the hospital setting apparently. Compounding pharmacies can make it up for you though.

I think you did fine. I agree with the other posters, I do not necessarily turn the Pitocin off first, the goal is to get delivered, I acess the whole situation and try the interventions you did. I have been an L&D nurse for a long time, but not so much postpartum, last week we had to keep a c section, twins, mom in L&d for 24 hours because of bleeding. I had only that patient and she kept me completely busy for 8 hours! And she wasn't on Mag! I had to give blood, teach pumping, manual expression, try to get 2 near term babies on, try to get her up, after she got the blood and could sit up without fainting, etc, etc, etc. I agree that newbies should take the difficult pts, that's how you learn, but your assignment was too much and you should have gotten more help from your co workers. JMHO

I think you sound prepared. I took it 6 years ago and realized afterwards I had overprepared. If you have a number of years experience then you allready know this stuff. Many people I work with have taken it since then and most of them passed, some took the review class. I think you are right in your statement about test taking skills. Reviewing a practice test helped relieve my anxiety by letting me see basically how questions were worded. Good luck!

feisty is exactly right

I think this is an impossible assignment. In California it is definately out of ratios! What position is the ruptured 28 weeker? If baby is any position but vertex, in my facility, she requires continuous fetal monitoring. As does the preeclamptic, and to add a fresh post op on top of that... I'de be on the phone to my charge nurse, while doing everything that everyone else suggested above.

Yes, constipation can cause uterine contractions and exacerbate preterm labor.