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High-risk OB, Labor & Delivery
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AngelNurse2b has 5 years experience and specializes in High-risk OB, Labor & Delivery.

AngelNurse2b's Latest Activity

  1. AngelNurse2b

    Boyfriend wants me to stay away

    I work directly with suspected covid patients at my hospital and I live and work at the epicenter of the covid outbreak in the Bay Area. I have the opposite problem, and actually had to turn down my dates, because I know I am a risk and I do it to protect THEM from ME, as I understand that I may be an asymptomatic carrier, given my high risk for exposure. I would reassure your boyfriend that you aren't working directly with covid patients and that may help ease his fears. I know it hurts and I'm sorry, but try your best to not take it personally and understand that some people are more fearful because of the unknown than others. This is a time of mass hysteria. I asked the guy I'm dating if he was afraid of me. He told me today "you take care of yourself, so I'm honestly not too worried if you get the bug." That said, I won't see him for months until I know am I safe.
  2. Hi NerdyNurseMe, The outcome was very good for me. I followed some of the advice in this thread and it worked. I asked for help from my union and felt supported and guided by them. Here's what I did: I enhanced the management's vague PIP so that it was based on tangible outcomes and I showed substantial, documented effort to improve. I stayed on this unit, fought this PIP, and proved myself. A few years later when I had grown into a strong nurse and had a glowing annual review, I left this hospital. Even though things were excellent for me on the unit and I was happy, in the back of my mind I did not trust the management because of what they did to me and I wanted a change anyway, so I left. Fast-forward 3 years....I later learned that this manager was bullying other staff nurses too. This manager was fired from her position.
  3. Hi All, I was very excited to start L&D travel nursing at the beginning of the year. This has been my dream to do what I'm doing right now and I'm grateful for the experiences and opportunities I've had as a travel RN for the last 7 months. Now I'm having a tough time finding assignments because I don't have post-partum,PACU, and (most importantly) OR Circulation experience. At the hospital I was trained at, L&D nurses just did labor/delivery/recovery for vaginal deliveries and immediate care and resuscitation of the newborn, if necessary. I have found that this is NOT ENOUGH experience to maintain employment as an L&D travel RN. I've gotten lucky with the last few assignments because the hospital either worked with me by switching assignments if the patient turned into a c-section patient (and had the perm staff circulate OR and I would get the labor patient) or the hospital already had designated OR nurses/team. I'm learning that most hospitals don't operate this way. Lessons learned. I'm disappointed that I have to quit travel now. Plan is to find a permanent job that will train me how to circulate OR so I can travel again in the future. I've had two hospitals offer to train me to OR while on assignment, only to later change their minds because they don't want to train a traveler to a new skill, which is understandable. If you'reconsidering travel nursing as an L&D nurse, I would recommend training at a facility that let's the RN do everything (i.e.triage, resuscitation of the newborn, OR circulating, PACU,antepartum, and even couplet postpartum care- which is a bonus). You can go everywhere and anywhere you want with that kind of experience.
  4. AngelNurse2b

    Simple mask or NRBM?

    Hi Everyone! I've been to 3 different hospitals now as an L&D travel nurse and it's been interesting to see how different hospitals manage care. At my current hospital we use simple face masks instead of non-rebreather face masks for FHR decelerations and/or minimal/absent variability and I have never seen this type of mask used before for this purpose. The order at this hospital states "15L NRBM PRN for non-reassuring FHR tracing." Yet, we have no non-rebreather masks on the unit, only simple masks, which everyone uses. Does it matter which mask is used? It seems like 15L is too much. ACOG (2011) mentions that it should only be "8-10L/min" via 02 mask. AWHONN just mentions the use of the NRBM. The 2016 NCC Fetal Assessment and Safe Labor Management monograph indicates that 10L NRBM mask should be used. What do you think, are simple masks just as effective as NRBM for intrauterine resuscitative measures? Are they safe? If so, please site the evidence. Thanks for reading :)
  5. AngelNurse2b

    Is 28 too old to become a travel nurse?

    You're wise to take into account your childbearing years and desire to settle down and get married as you contemplate travel nursing. I am a 33 year old Labor and Delivery travel nurse and I have never been married and I have no children and I would like both. I started travel nursing this year and as soon as I left my town I met someone special from my hometown! It's hard because now I'm trying to find day-shift travel jobs near him so I can nurture our relationship. Long-distance is tough, but not impossible. If you meet someone promising during your travel adventure like I did you can extend your assignment at the hospital, look for other contracts in the surrounding area, or work per diem near him (which is what I'm doing). It can be tricky, but the right guy will be supportive of your travel career. If you're concerned about declining fertility as you get older and the quality of your ovum as you age, I would recommend banking your eggs (if that is affordable for you). Lots of my older friends have done that. Bottom-line: you're not too old, you have options, choose wisely, and live with no regrets.
  6. AngelNurse2b

    All dressed up, nowhere to go!

    I'm having the same experience as a first-time traveler. I have 7 years of experience, all my certifications, etc., but I know that I am competing with RNs with many years of travel experience. One thing that I have done that has gotten me 2 interviews this week and has worked for me is opening up to "less-desirable locations" and being open to doing nightshift for my first assignment. Now I have an offer and I'm just deciding if I want it or not! Best of luck to you on this journey!
  7. AngelNurse2b

    Labor and Delivery Travel Nursing

    I'm not at a teaching facility. We do cervical exams, place FSEs, IUPCs, Magnesium drips, Insulin drips, high-risk OB, etc. Since our OR and L&D are very busy all the time we have specialized OR and L&D staff for each area. Thanks for your thoughts! I will take a look at the thread you recommended.
  8. AngelNurse2b

    Labor and Delivery Travel Nursing

    After 7 years in nursing and 2 years in L&D, I have finally decided to pursue travel nursing in L&D. I have my ACLS, RNC-OB, BLS, NRP, and have taken AWHONN's Advanced Fetal Heart Monitoring class. My hospital delivers over 9000 babies per year, so I am experienced in L&D and high-risk antepartum. My concern: As an L&D RN, I have no OR or PACU skills. I have never been trained to Circulate OR and it seems like most hospitals require L&D RNs to Circulate OR. If you have experience with this specialty/situation, would you recommend: (a) getting another job at another facility to learn how to circulate OR or (b) learn how to circulate OR on a travel assignment? Any insight on this situation is greatly appreciated! Thanks for reading.
  9. AngelNurse2b

    How do you feel about having other nurses as patients?

    Great topic! Yes, as I new grad I would feel anxious caring for nurses as patients. As an experience RN, I actually enjoy caring for fellow RNs! Since we both "speak the same language" I connect with them and find them great to work with in collaborating with their care.
  10. Klone, I have 4 years of inpatient high-risk antepartum experience.
  11. After much encouragement from this thread, I approached the union for advice. My union representative informed me that since a Performance Improvement Plan is not considered a formal disciplinary action, I don't necessarily need union representation. I now know where to turn when I have questions and am no longer afraid to involve the union if I need to. After reviewing my action steps and clarifying goals with my manager, she said that she thought that I would be "successful" with this Performance Improvement Plan. She apologized for the vague and disorganized fashion in which the plan was written. I only have 6 months of experience with this new speciality so I really want to make it on this unit until I at least have one year of experience (preferably 2-3 years). Otherwise, I'm not fully developed in this speciality and am therefore not as marketable if I want to go on with Labor and Delivery. I'm giving this plan 110% and watching my back at every turn. The morale on the unit is low, so I have to just keep quiet at work and just keep on working hard at this. I am still scared, but I am hopeful and determined. I have 30 days to prove myself.
  12. FlyingScot, I appreciate your thoughts. I have been keeping this to myself, wondering who I can trust/speak to in this situation. I am so glad I have not said a word to anyone yet, because upon further thought, I know you are right. Thanks for your insight on this!
  13. Thank you for your thoughts on this, Jadelpn. Yes, I do have a union, but I have been unsure about approaching them because I fear that it will create even more tension with management. As for certification, I already have my RNC-OB and I plan to start working on/studying for another certification (C-EFM). Speaking to my nurse educator is a great idea. I hadn't thought of that. I will ask her today about any classes on effective communication. I started updating my resume last night and posted it on Monster.com, for starters. Thanks again for your great ideas!!
  14. Hi Everyone, I'm an experienced RN who just recently changed to a new specialty 6 months ago. Everything has been going well until management put a Performance Improvement Plan (PIP) in place last week. My concern is that this PIP is partially potentially subjective and poorly supervised. The tone and the unorganized fashion in which it was constructed is concerning to me. I have attracted the management's attention, my performance and everything I do or say is under a microscope and I feel that they are waiting for a reason to terminate me. Here's the story: One day last month I got so caught up in charting that I did not look up at the monitor in time to recognize an electronic fetal heart rate tracing that needed interventions. Though the patient was not harmed, I recognized that I wasn't fast and vigilant enough in that particular clinical situation. Now, I watch my monitors like a HAWK and respond quickly when interventions are needed. I KNOW I messed up in that clinical situation and I have already started to implement and document change in my practice in a personal notebook. While I understand that I need improvement in this particular clinical area and that there is a bit of a learning curve going from a slow- to a fast-pace clinical setting, the other areas mentioned in the PIP are nondescript and potentially subjective. One point mentions that my communication style has been interpreted by some as being rude or condescending.” When I asked what I said or did that was rude or condescending” management said they could not give me any examples of this behavior. My manager just told me that someone had slipped a note under her door that informed her that I was rude to them. I have never been told that I have been rude or condescending in a professional setting in my life, so this was quite shocking to me, as it is not in my nature. What is most concerning is: how will management objectively measure improvement in this behavioral area when they can not even objectively inform me what I am doing or saying that constitutes as rude” behavior in the first place? For all I know, someone who just doesn't like me could be fabricating this. The rest of the PIP is a laundry list of points that I have not even had issues with, but they are listing them anyways (i.e. I will consistently exhibit professional and positive behavior with patients and families”). The management and my patients have never informed me that I was non-professional or not positive and I have had good interactions with patients and families, so I don't even know why points like this are even listed in my PIP if I don't need improvement in these areas. It seems to me that they are listing all of the areas that could potentially go wrong. My proposed solution: 1. Since the PIP does not mention a timeline (start or end date) or how my performance will be objectively measured, I am planning to find out what the expected timeline is and create a feedback tool/checklist to track and measure my progress and present it to my manager. I would like to take this tool to the charge or resource RN near the end of each shift to evaluate me on the points that I need improvement in. 2. I'm working on my resume and will start applying for a second job, just in case I lose this current position. My questions to those in this forum: 1. How do I address the perceived rude and condescending behavior? How do I improve is this area when I don't even know what I'm doing wrong? 2. Do you have any other ideas on what I should do in this situation? It seems to me that they are trying to find reasons to fire me. Should I just resign before they fire me? Your feedback and insight would be greatly appreciated. Thank you in advance for taking the time to read and help.
  15. AngelNurse2b

    Poll: Nurse and law enforcement couples

    I'm in San Diego and my last two boyfriends were Navy SEALS. There are a few military bases here so SEAL/RN and Navy/Marine and RN couples are common. We actually have a huge statue of a salior kissing a nurse here too by the bay! Not sure where ya'll are meeting these cops though.
  16. AngelNurse2b

    Cervical Exams- locating the cervix

    Hi everyone, I just recently transitioned into L&D from 4 years of high-risk antepartum nursing and I absolutely LOVE it on L&D! I've been doing L&D for two months now and I am still not 100% accurate with my cervical exams. I have read almost all of the threads on cervical exams in this forum. But I have a few specific questions. Sometimes when I go in to do my cervical exams it just feels like vaginal "mush." Its like I get lost in the vagina and just can't seem to find the cervix sometimes, especially when my patient is 100% effaced. Should I just search right, left, up, far posterior? What do YOU do when you can not find the cervix after searching for a minute or two? Should I elevate my patient's hips to raise the pelvis? Would that make it easier? Please share your thoughts, tips, and answers. Thank you very much :-)