rnoflabor2000

Don' t forget, their are always subspecialties. Our hospital utilizes a perinatal flight team. Since most ER nurses and critical care nurses do not want to deal with a pregnant women. (note: I used the term MOST, not all, so please don't take offense if you are one of the special ones that will)

Someone tried to tell me that I had to take the "eyes" off of potatoes, or they would kill me. Nice huh?

If we want to delve deeper into other things beside just simple cervical dilation, we have to also think about such things as vag. bleeding...don't check the cervix until an U/S rules out a previa. You don't want to punch a hole right thru the placenta. About fetal position, this is true...especially if the cervix feels "weird" to you. Many "weird" cervixes can be malpresentation as well as cryo, etc...Our hospital policy is the presentation is noted along with dilitation/effacement/and station.

I am also a L&D RN training for an RNFA. I have run into several problems. I have only scrubbed C/S and Hysts. So when I take my practical, and they pick a AAA, I'm going to be lost. Should I go work in the main OR?

There are the walking epidurals that are supposed to let you actually walk...not a policy at our facility, but most of our epidurals cause inability to move the lower extremities. It also depends upon how you are placed after the epidural is placed. Usually a semifowlers with left tilt. If you are laid out flat, the level of the epidural can rise above the site. But I've never heard of an epidural that rises even that high. Does sound like a spinal. Epidurals and Spinals can both cause hypotension, however; spinals do it more often.

It has it's pluses and minuses. It is really hard to insert 25mcg into the post fornix of the cervix, since the patients getting it are usually closed or fingertip and very posterior (not always). It's not like pit, you can't really turn it off, although terb works OK. Can't use it on prev C/S, that's a good thing. Works wonders on multips. It seems to need very favorable conditions to work right off the back. Some primips can be on it for days.

redheads=PPH saying that it is quiet=very busy full moon or rain=SROM's calling in more than 1 induction=bus load of patients come in saying "my baby looks great"=stat C/S Dr or Nurse in labor=complications go to lunch=precip delivery birthplan=she gets everything she didn't want patient states she has to push=fingertip to baby falling out

2 non-union hospitals County hospital....shift diff (15%)7p-7a and (10%)3p-7p 2$hr/weekends 12hour shifts Current hospital....shift diff (15%) 7p-7a has 8 and 12hour shifts...I work 12's from 6a-6p so I get 1hr shift diff per day

First, early cervical dilitation may mean that the OS of the cervix is posterior, so without finding it, the cervix feels like "mush". Pull the cervix toward you with one finger, use the second finger to feel the back of the cervix. This may require an estimation of dilation. And of course, this is painful to your patient. Have the patient use labor breathing techniques for cervical exams. Second, use a dilitation chart and get used to how a three centimeter cervix feels to you. It is personally my two fingers side by side, using that as a basis helps me determine a 1cm (can't even get one finger in), 2cm (one finger in with a little extra room, or two in fingers atop each other, not side by side), and 4cm (two fingers spread apart easily). Always keep in mine things like cryo and biopsies of the cervix. It always helps to check a cervix during a contraction if you find it difficult to get to the os. But remember, women without an epidural AND having a contraction are the hardest to check. Hope it helps