MamaMadge

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!!

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!!

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!!

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!

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!

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!!!

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!!!

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!!

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!!

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.

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.

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!

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!

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.

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.

I had a multip the other night that went from 6 to complete in about 15 minutes and pushed once. Thank goodness the CNM was in house!! It happens and you shouldn't feel bad about it....what a nice easy birth for the moms!! GOOD JOB!

Presla, great idea on the internals...sometimes the patient is having lot's of contractions with insufficient montevideo units.

I just had one....the MD had us keep the patient flat on her back with an ice pack on. It went back up inside by the time her recovery was finished (2 hours). When she got up to the bathroom it was completely resolved. Fundal checks were done carefully, supporting the lower uterine segment and bleeding was minimal. It was freaky to see it the first time though!

The very tricky thing about a seemingly "dysfunctional" pattern with u/cs every 1-3 minutes is that sometimes there is coupling or trebling and increasing the pitocin will break that pattern. Once you break that pattern you will see that the u/cs are truly 4 minutes apart but with coupling noted. I think following your policies and procedures is the only way to go ( and will support you in court!) but sometimes going up just by one milliunit and watching for a few minutes, you will see a change. It is tricky and I usually run it by my shift lead if I'm not sure....it's the only way you will learn! GOOD LUCK

TXMama, Thanks for sharing your stories! Your personal experiences will serve you well when you become an L & D nurse! I think once you have been doing this for a while, if you have to ask yourself "is this too much bleeding?" your instincts are telling you that it IS and you need to take action fast!

Starsgirl78, THank you so much for your story. I know it takes alot of courage to share such painful memories.

Definitely OB tech or OB intern is a great way to get your foot in the door. Also, do you speak any second languages? In No. California, we have a very diverse population, so being bilingual has always given me an advantage. I think enthusiasm and persistence will go along way as well! Good luck!

Clean gloves where I work too. During C-sec, surgeon places baby onto warmer on sterile crib blankets. We pass the wrapped baby to the nursery nurse.

rxbunnie, congrats on graduating and taking the NCLEX! Yes, I have heard people say that L & D isn't "real" nursing....they have obviously never been near a Maternal-Child unit! We deal with very sick women, trying to balance their well being with that of their baby, IV drips, hemorrhages, post-op wounds, infections etc. etc. I know I'm preaching to the choir here, but I feel very much like a "real" nurse! I wouldn't try to convince other people that you are a real nurse....just let em' laugh....we know who and what we are!!

I am so lucky where I work. Our docs and midwives are great about coming in. I wouldn't wait to call when a multip is 8cm. They just seem to go so fast at that point. Most of our providers like to be called when a multip is about 7 or sooner if she feels "pushy!" The primip is another story! They are so unpredictable. I've seen them push for 2 hours and I've seen them push the baby out in three pushes. I will usually have them "test" push and see how they do. I have been told by the providers that they like to be called when you can see about a silver dollar size of the head and it stays after the contraction/push is over. Like I said, our providers would rather sit there for a few minutes than to miss a delivery.