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.

We are 500-600 deliveries and if your pt goes to c section you become the circulator. Nicu comes for the baby though. We recover. Try to get baby back with mom in recovery. Most of us also can be the scrub nurse.

I prefer the Symposia Medicus courses myself. They are more expensive but I learned alot each time. Thinking about their Fetal Monitoring one in Las Vegas next year.

Hey there! Wait just a darn minute. Now you are talking about me! During the last 2 strike votes at my facility I was asked by my union rep to do the counting. I am just a regular RN. I happened to be in the lunch room a couple of days later and randomly heard the same thing..."Well I heard there was a secret count and they didn't release the numbers..." I turned around and said I am they, and you are harming my reputation, I did that count. I am sure that is why my rep asked me to do it, because these rumors always go around. And anyone could be present at the count. Quite frankly no one wanted to hang around until 930PM to see the count.

I too, work in California. These salary postings don't say whether they are 1.0 and/or if they include a differential. I have 25 years seniority so should be at the top of the scale and I don't make that much. Could they be including the cost of benefits as part of salary also?

We do 2 1/2 hour recoveries. We are a level 3 facility doing 500+ deliveries. We have 18 labor rooms and 6 antepartum rooms. Our Csections recover until they can lift their hips. But we do baby vs, assesment, meds, skin to skin breastfeeding and bath. We don't shower the mom though, most of them cannot walk well enough. MB has 4 couplets, and about 52 beds on 2 floors.

We do not dilute, although I sometimes pour it over ice, I think it is more palatable cold. I tell people to be prepared for the taste, like liquid sweet tarts...

Sometimes you actually have to push pretty hard to break the suction if she has been pushing a long while and the head is really wedged in.

American Acadaemy of Pediatrics guidelines actually are for eyes and thighs in first 6 hours following birth. I think erythromycin is a state law in California. Studies are showing that exclusively breastfed babies are getting adequate Vit K through breast milk. Oh course we don't know who will be exclusive. CDC actual guidelines are for Hep B within 48 hours of birth. As a lactation consultant I object to any thing that interfers with skin to skin and breastfeeding, especially initially. You can never get back the first hour of life. Since most of our patients get epidurals I find that an excellent time for teaching, the quiet time before the birth.

We always have an in house OB and if we have a question about presentation, or can't find a heart rate we just call the OB to run an ultrasound.

I graduated from San Francisco State University in 1978. It was the year of the assignation of Mayor Moscone and supervisor Harvey Milk, the massacre of Jim Jones and his followers in Guyana, and quite frankly I barely remember it. Too busy to watch TV and when I started working full time nights obsessed with sleeping, paid little attention to the real world. My class was about 75 people, 5% men, 15% asian, the rest caucasian women. It was before much technology, we used typewriters to write papers.Computers were just coming into style, we had maternity quizzes on a computer, and one student had a tech savy father who tried to help us analyze our data for a research project on his computer but the program crashed and we ended up doing it last minute by hand .