luv l&d

After 30yrs in L and D, I decided to take the RNC. I re-read Williams Obstetrics and took a practice test from 2 or 3 yrs ago. I also attended a refresher class on Newborn care (I strictly do Ante's and Labors, no babies). The test was helpful as I had not taken a "professional" test since boards ,when they were a 2 day test. Took me most of the summer to review slowly, but I did get my RNC.

Ah, nisentil. what a great drug! taken off the market after a couple of older pts died after surgery. We would give it at 3 or 4 cm's and moms would sleep til almost complete. It was before epidurals were common place in the late 70's and ealy 80's. I miss it.

ACLS is required when you do PACU. PACU in labor and delivery would be for post c/s, cerclages, d and c's, anything that requires anethesia. Just re-did my ACLS and for the first time got to do my BCLS at the same time (something I have been complaning about for yrs,why both??) Somebody finally got smart. I am not sure what Ob-gyn nursing is but in our L and D, we do labor, delivery, antepartum, surgery, and some postpartum. Our postparum unit does mother-baby. We just keep the NICU mom's.

Oh my I remember, circs in the delivery rm. iv (anticubital, no iv access) pit with anterior shoulder. pudentals (wish more would still do them) trying to guess at when to move a mom to the delivery room so they would not deliver in the hall, or you would not be pushing in the delivery rm for hours doing recovery, and mopping the floors, and cleaning the instruments and re-set-up all at the same time. one hour time frame washing, wrapping and re-sterilizing all our equipments. smoking in the break rm. buccal pit, iv alcohol for ptl, ritodrine ggts for ptl, terb ggts for ptl, gosh what else?

In my facility, we would have magged, tapped and evaluate for a cerclage. 2-3 is nothing if she is not infected, and we could slow the contractions down. At least we could have tried a delayed interval delivery if not infected. but a 20 wks, they are not considered viable, and parents still have an option.

17 when I started and 20 when I took my boards. (a 2 day process in the "old days")

We have "caught "a few scrub techs doing this very thing (keeping the OR open "just in case") but they were on the night shift and told the RN's that it was ok. I am a scrub, and an RN and when we caught wind of what they were doing.... Needless to say it does not happen these days. We do alot of high risk and can do an "emergent" (used to be call a crash, a rose by any name...)in 6 minutes. not pretty but usually sterile. alway have to do an xray after, but all of us are pretty confident that our counts are ok, so that we have not had to go back in. I can't believe you are not held to the same standard as the OR and PACU, and yes all the RN's on L and D are ACLS and NRP certified.

Having used meditech, Watchchild and Qs and then going for a wk to Louisiana and doing paper, I really, really like Qs. I am not a young nurse, and have been doing L and D for aover 30 yrs, but oh, my... Computer charting does take some getting use to but it is sooooo easy to adapt to your style of charting. I was always a event person, and then fill in the blanks and this works great for me. We do not chart in meditech at all except order entry at this time. Now..ask me about E-mar... esp during a crash and burn!!! Yuck!!!

Oh,my, paraldehyde!! use to give it in emena form for DT's. The first one I gave, I was an aide at my sm regional hospital at home (between my 1st and 2nd yr of nursing school) and no one told me about the" Special" non-plastic enema kits for these tx. Needless to say the first enema I mixed, did not make it to the room. What a mess and the Smell!!! Never made that mistake again.

Sorry for the spelling error, and yes I did mean interval. We probably do 4 a yr and every time we have the G/P discussion. I voted for G1 P 1/2, but nobody else like that (HaHA)

Let me throw another fly in the ointment. What about inteval deliveries? G1P? LC1 but still pregnant. It is a constant source of discussion on our unit.

Our Qs only interfaces with meditech in the admission of the pt. We still do orders and labs on Meditech, all else on QS. having used Meditech to chart labors, I will take QS any and all times. We had "watchchild" prior to qs and it was a good segway into computer charting, as alot of our nurses were older and not very computer savy. Qs is a more "windows" based product. You can configure your QS system to fit your unit needs. Our "tabs" are alot different from the screen above. I love the "click and point" on the strip it self, and with labors use that almost exculsively. Ante's and Posty's are different. Don't use the baby portion, myself, so can't tell you how that works, tho I know some of mom's admission stuff, labs etc, does flow to the baby chart. Good luck in your transition, new stuff is always a challenge, but once you get used to it, you'll wonder what took so long.

After a "certain age" I think the productivity of the person doing 12's is compromised. 4/8's are my choice. still 3 days off in the wk, but home in the evening to interact with family and friends. full time benies at 32hr/wk. and if the day goes to s**t sometimes I will stay and help out. nice choice for me.

With the QS system we do not, and I repeat, do not do the admission in meditech. Only in QS. Our managers are great to back us up on this, esp. when the rest of the hospital is using meditech.(only l/d,level 1,ante and pp are using QS) Occasionally we have some one going from ante to the OR or our OR to ICU We then print up all our admission screens and let them figure out what to do with meditech. We only use meditech for orders at this point and allerigies,ht and wt for the pharm.

With the QS system we do not, and I repeat, do not do the admission in meditech. Only in QS. Our managers are great to back us up on this, esp. when the rest of the hospital is using meditech.(only l/d,level 1,ante and pp are using QS) Occasionally we have some one going from ante to the OR or our OR to ICU We then print up all our admission screens and let them figure out what to do with meditech. We only use meditech for orders at this point and allerigies,ht and wt for the pharm.