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For anyone who went straight into Mother-Baby/L&D as a new grad, do you have any regrets?
Nope! Started in Mother Baby, then within a few months cross trained to L & D. Almost 14 years later and no regrets! If L & D is your goal, full speed ahead!!
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Too old for OB?
I am 56 and have been a L&D nurse for almost 14 years. I am considering a change as well but I'm still hanging in there. I work part time in a busy L&D and have at least 9 years until retirement!!
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Orientation time to L &D
Just collecting info. How much time did you have to orient to L & D? Does it vary if you are a new RN or experienced but new to L & D? Did you have classroom time and floor orientation? Thanks for any input!!
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Longing and Wanting
When I sat on an interview panel for new candidates for our department, I really wanted to hear that someone was passionate about Labor and Delivery. It is a tough job, it can be like an ER sometimes, you can get yelled at, pinched and scratched. You have got to LOVE what you do to be a Labor and Delivery nurse. If you can convey that to the manager, that it is your passion and that you are committed, you will definitely stand out!! Good luck!
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Plausible situation or not? Have you ever seen this
If she was having serial ultrasounds for multiple gestation, and the provider was aware of such a big discrepancy in size, they should have induced her before the discrepancy became that dramatic. Sounds a little fishy to me too!
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Checking your patient's dilation.
If you can find the head (or presenting part) slide your fingers around until you find a circular ridge. If you can't get your finger inside at all, she is closed. If you can't find it, slide it behind the baby's head where you will find a posterior cervix. Some preceptors teach you to use the monitor paper as a guide. I believe that once section is 3 cm. 2 sections is 6 cm. and 3 sections is 9 cm. Practice makes perfect! You'll get it! TAKE YOUR TIME!!!
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Checking your patient's dilation.
If you can find the head (or presenting part) slide your fingers around until you find a circular ridge. If you can't get your finger inside at all, she is closed. If you can't find it, slide it behind the baby's head where you will find a posterior cervix. Some preceptors teach you to use the monitor paper as a guide. I believe that once section is 3 cm. 2 sections is 6 cm. and 3 sections is 9 cm. Practice makes perfect! You'll get it! TAKE YOUR TIME!!!
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Trick and tips
I agree 100% with the side lying, head flat, top leg up for turning an OP/OT baby. As far as laboring down, FANTASTIC! The only thing I see occasionally is, if in high fowlers sometimes the cervix can become edematous. I like side-lying for laboring down as well! Keep them moving!!
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What..work with NO residents??
I work for a small hospital and we do not have docs or anesthesia in-house. Yes, it can be challenging, but all of our docs live close by and in an emergency, we can have a doc and CRNA there within a few minutes. Conversely, we have had nurses who came from teaching hospitals and they did not know how to to a cervical exam correctly. It really makes you hone those assessment skills!!
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How much do you make as an RN in Labor and Delivery where you work?
I have 6 years experience and started at $40.00/hr night shift. I now make $52.00/hr base plus night shift diff. of $6.00/hr. I work in a small town one hour north of San Francisco. The cost of living is very high. Median home prices are around $500,000.00 and gas is $4/gallon.
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pain med...
Fentanyl IV push, 100 mcg. q 1 hour up to a max. of 6 doses in 24 hours. We push is very slowly, like over 3-5 min. Some RN push it over 3 contractions but I think that could take too long. I agree that it doesn't work all that well if they are really active. I have noticed it causes alot of patients to vomit (oh, joy!!)....but it works well if they are in early active phase.
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L&D ladies who work nights...
Alianeco, I completely agree with you! The atmosphere at night is wonderful! No managers, no doctors hanging around, no meal trays! Heaven! I had a really tough time adjusting to nights at first. I could not sleep during the day! I finally have it worked out.....I come straight home from dropping my kids at home, turn on my white noise machine, pull the blinds and turn off the phone. The kids have my husband's cell in case of emergencies! I usually sleep from about 8:30 am until about 2:30 or 3:00 pm. Pick up the kids, come home start dinner, help with homework, do a few loads of laundry, shower and get ready to go back to work at 6:45. I work 3 nights one week and 2 the next. Somehow, after 2.5 years my family is getting in the groove of me sleeping during the day when I work. Don't feel discouraged if it takes you several months to get used to it....you will and then you will LOVE your job! GOOD LUCK!
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Healthy women schedule C-sections to prevent vaginal stretching
I have also experienced lady partsl birth (twins born lady partslly) and a c-section. I would take that lady partsl birth over and over rather than try to recover from major abdominal surgery while caring for a newborn! OUCH! Having your belly cut is never more comfortable than some stitches down below! With that said, I would fully support my patient who had previously delivered a 10pounder over a 4th degree and wanted to opt for a c-section the second time around!
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Managing Pitocin Augmentation, again...
Hi everyone, I just got back from a 2 day Conference on EFM by Lisa Miller, CNM, JD. She had lot's of info. on Pitocin management. She said everyone who is administering Pitocin should thoroughly read the ACOG Practice Bulletin called "Dystocia and Augmentation of Labor" from December 2003. Bulletin #49.
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twin delivery...vaginal or c-section???
I delivered my twins lady partslly 18 years ago, Twin A Vertex and Twin B frank breech. It was successful and my beautiful girls are now beautiful young women.