cassioo

I got sent home with my 1st one because I was closed after my mom took me in because I complained of a back ache all day (doc had told me 2 days prior oh at least 2 more weeks and I was right at 38 wks then) the husband got off work and drove me home walking up the steps I thought great now I'm peeing (no gush) tossed and turned a while and decided it was worse went back about an hour later and was 3 then after 30 minutes I thought this is going to be back if I have that average 12 hours to go so asked for med oops too late I was complete from getting back to the hosp to having a baby was not quite 2 hours so that back ache was doing something...and my doc had gone out of town. I was told any day now with #2 & #3 on the 1st of the month (due the 27 & 20th) had each of them on the 30th of those months the 3rd one being induced but it only took 20 minutes once that pit hit....just sinful to drop a baby so fast...4th one was a c/s for breech...give me a vag delivery anyday.

I don't know there are "rules" it's a just do it thing maybe faster if you have to get the baby to the bed for resusitation but otherwise there is time to reach for clamps and scissors.

It depends on who is doing it and what the initial does is but most everybody goes on a ropivicaine drip at 8-14 usually it's 12 ml/hr which gets turned of at delivery. We used to use a bolus injection but don't often do that anymore. The hospitals I've worked perdiem at do the same thing.

Ours couldn't get up if they tried or they'd be sitting on the floor their epidurals are so heavy...some can't get up for a couple of hours after delivery when you check a fundus after delivery you can just push out urine and they can't even tell or start to control it.

I like the smokers, drug users, alcoholics who come in and don't want mag or terb because they don't like how it makes them feel or better yet "will it hurt the baby" um not as much as the stuff you've been doing.

I had a patient tell me she smoked before coming for NSTs she did it because it was a stimulant...told her no wonder the baby is nonreactive for an hour stop it (she was also a long time drug user) I had one 37 weeker I was going through the admission questions... do you drink alcohol while pregnant? she yes me when her last week he told me to go drink some beer....me DON"T listen to him!!! Him being the OB he says that to everyone thinking he's being funny "go home and drink beers" I told him some people believe him. I live in the tobacco belt with cheap smokes we have a very high rate of smokers.

We have either the doc or the assist (sometimes another doc sometimes ARNP sometimes CST take baby to warmer which is set up with sterile drape and sterile blanket on warmer. The equipment is under the drape. As far as slipping anybody could slip whether they were bringing baby from table or picking up at table.

Sometimes 30 minutes isn't close enough. Do you have a protocol for when to call in the 2nd nurse? Is the house supervisor or somebody able to come and help if needed? If you have 1 in labor and another shows up do you call as soon as you determine they are in labor or do you wait for a 3rd to show up or call when the 2nd is there and say look out or do you do mother/baby and is there a postpartum nurse that is able to come and place a pt on a monitor and get that initial assessment done? If I was swamped I'd turn off any pit going tell docs too bad or tell them to get up there and monitor their patient and write up anytime you felt there were unsafe condidtions...also keeping track of how many patients you had, when you called for backup and what happened...you hate to see it but it might take something really bad before they change their ways.

We're kind of in the same boat. We do have central monitoring from the desk but not from each patients room which is also bad for labor if you have 2 patients and you're in a room. My question is do you often have a long wait for those 4 rooms you have and anticipate the 8 being fulll if they are you need more help.

We don't have any policy on admission it's a case by case thing. If they come in thinking they are SROM and we deicde they are we admit, if they think they are in labor we watch a little while if they are due and dialated and the doc feels like it he might admit them but not if it's close to his time to go home unless they are changing if they are advance dialated they are admitted....no policy just the mood of the day

Where I work we put in a foley after the epidural and take it out when ready to push. where I was per diem it was I&O sometimes multiple times. Have a travel job starting next week 600 miles away so we'll see what they do there

I only saw that box once at an AWHONN monitoring class that we used to place FSE's there was a little baby model inside and you opened the box to see where you placed the lead...no fair if they put the baby in there breech :) Checking just takes practice. After years every now and then I still ask for a 2nd opinion Make sure you pt has voided prior to checking so that cervix isn't higher up in the air. It's easier to check if your doc uses and IUPC just follow it up.

yes it only works for a very short time.

We're lucky to get ours to write anything at all because they are busy and we aren't as busy as they are we play lots of babysit the doctors that's why our really do let us do about anything but as long as you've documented all along what was going on that shouldn't be a problem....and if a doctor said to take off the O2 because it made them look funny I'd also be explaining to the patient why they should leave it on. Everything you say and do some doctor or patient can always say they didn't tell me that so the documentation along the way matters.