bignursenancy

Have any of you ever worked in Bakersfield, CA? If so what part of the city would you suggest living in? Is there a community close to Bakersfield that is safer? Have any of you ever worked at the hospital in Bakersfield, and if so did you have a good or bad experience? THanks!

I've been a l/d nurse 25+ years. My advice on sterile spec exam is get a bedpan and flip it upside down. Lay the patient supine with HOB flat. Slide the bedpan upside down with larger part under her buttocks. Smaller end should be just under the perineal area. This allows the cervix to be brought up toward the front of the lady partsl vault. Get you a good flash light and get someone to hold it. Warm the speculum in your blanket warmer for a few minutes and your k-y jelly too. This makes it easier for the patient and less traumatizing. Good luck. Like the above post, practice is what makes you feel comfortable. Ivs; I like to use jelcos if I have the choice. The pop makes you know you are in. I also like to put the fluids when I get blood return and 'float' it in, especially if it is a rolly vein. Just go very slow and the vein seems to open up. good luck and after 25 years there are days when I couldn't hit a 10' rope and then you call the newbie and bam they get it on the first try. So stay calm and you will learn tricks you will be telling us! Nancy

The Edinburg is one of the best Pp depression scales out there. "We just finished a 3 month survey on every pp patient. It is truly amazing at how many have just the baby blues and are able to pull out of it. Others can become quite ill. I would suggest going to the site above and look at the test. It is a simple test made on a 6th grade level (it says anyway) Nancy

That is why you are the nurse teaching the residents what the correct method is. Without you they know much less!! Our policy has always been if you have >240MVU in a 10min period then you best cut the pit off and let that uterus rest or the FHR seems to go south.

I had a patient admitted with this diagnosis and was scheduled for a c/section at 12 since she was repeat anyway. At 11 that morning the baby went crazy with movement. WE lost the fhr, rushed her back and the baby had nuchal x7.... That is the only time I have ever had that many. The cord was more than 3 foot long. The doctor told us anytime we had something supicious like increased fetal movement that we should always have continous fetal monitoring. He takes it very seriously.

It is absolutely the worst thing that can happen to you as a l/d nurse. I had one that had a previous c/section and came into l/d with 2nd preg, full term, in labor and 6cm. Doc came in to get epidural placed. Sat her up, laid her down, and I couldn't find FHR. I immediately called out to the doctor at the desk and told him I thought we had a ruptured uterus. He came in and we rolled stat to c/section room. Almost lost mom and baby at that time. Mom lived and baby did not make it (died a few weeks later). Again, that will live in my mind forever. Our docs rarely do VBACS around here anymore. They tell most of the patients, I will be proud to reccomend a doctor that does them, but I don't perform VBACS anymore. Liability is just too high. Good luck with your research.