UNC_nurseL&D

Our RN's both circulate and some of us scrub as well. I actually like scrubbing and will miss that if I am going to a unit that doesn't do scheduled c/s. Well, there are always the stat ones i suppose.

The hosptial I currently work for is huge. We have 15 LDR rooms, a NICU, 30 PP rooms and three ORs. We do at least 2 scheduled C/S's a day.

How do you nurse a baby period while you work 8-12 hrs a day/night? I assume the answer is pumping.

I am currently chatting with a potential new employer on a L&D unit. It is a medium sized LDRP unit. They do have one OR for emergencies, but the scheduled C/S are done in the main OR. How common is that? Can't say as I would mind, I find scheduled C/S a little boring from a nurse standpoint (no offense meant to c/s parents, it is still miraculous to bring a child into the world)

Hi folks. So, I was ridiculously lucky and got an L&D day shift position right out to school. I love it. Problem is I am moving home next year and I will more that likely be on nights. My question is, if you work nights, do you love it or hate it? Does it make your life unbearably harder, are you tired all the time. Do you feel like you never get to see your family/significant other? I am also a little worried about the resources available at night in the hospital. Just want to hear the ins and outs of night shift on L&D.

Well, I wasn't working in L&D ten years ago, but I am now. Now, at my hospital, we put healthy babes directly on mother's chest at delivery, where babe can stay as long as mama wants. We breastfeed right away if baby shows cues. During labor moms are intermittently monitored if low risk. If they must be continuously monitored we have telemetry units so that they can still be up and walking if they want. They can eat a regular diet until active labor. Clears after that. Ice if they have an epidural. No enemas, no shaving. We use jacuzzi's, the shower, birth balls, and other positioning devices. OB has always been way behind in evidence based practice, and I would love to see more of that used instead of the "well this is the way we've always done it" method. As far as epidurals go, I don't feel like nurses or doctors force them on their patients (for the most part). It is usually the patients themselves requesting (somtimes demanding) an epidural (often before we even get them admitted :-) ). It seems like a lot of women today think they need an epidural to make it through labor, or just don't want to deal with the pain/the pain was more than what they were expecting. My practice is to explain pain medications before the pt is painful (if possible) and then tell them that if they want something, they will have to start the discussion with me because I won't ask them. There are a lot of inductions and c/s. In my opinion this has to do with 2 things. Again, women of this era want complete control of the situation. Picking a day that they can begin labor allows them to plan around a busy schedule. Unfortunatley, the c/s rate correlated with elective inductions is quite high, a fact that many women are not fully informed on. And of course c/s are so high because dr's are increasingly fearfull of litigation, with good reason. The other reason for increased c/s and inductions is that a lot of the women getting pregnant these days just aren't healthy, therefore their pregnancies aren't healthy, and the baby needs to be born. With increased diabetes, heart disease, and obesity, the longer the baby stays in, the bigger the baby, and the more strain on mom's body. Again, it is unfortunate that medicine doesn't seem to be able to trust a woman's body to care for itself and the baby, but in some instances, it is right. All in all things are pretty good in L&D now. Especially with the resurgance of midwives for normal healthy pregnancies. OB is trying to change to more pt/family centered care and is making a good effort. It's a good time to be an L&D nurse.

all he showed with that statement was his ignorance. Midwifery is alive and well in the US. Both of the Hospitals I have worked in have had midwives that delivered pts there as well as a birthing center in the town. Midwives are making a comeback as women are regaining their concept of preganancy as a normal healthy event and not a medical emergency. Midwives are a great option for healthy stable pregancies, and are covered by doctors for anything that is outside their scope of practice. That being said it is important to make a distinction between CNM's (certified nurse midwives) and lay midwives. CNM's have a master's degree in nursing. Lay midwives are women with minimal training (comparatively) who do not have a governing body to provide standards are care. I even go to CNM's for my annual and love the level of care I recieve.

Raleigh has one of the more expensive housing markets in NC because it is growing so much. You might want to look at Rex Hospital, they may pay more than Duke or UNC because they are private. Look outside of Raliegh in areas like Chatham county, Hillsborough, Carrboro, and places like that, the housing will be less there.

I have one year experience in L&D. I am a huge fan of natural births, especially when the mama is prepared for it. A lot of Latina moms are especially fabulous at natural births. I will say though, I have seen mama's come in who really want that natural birth, but are just so TIGHT, with nerves and fear and tension. I had a mom like this and nothing I (a DONA trained doula as well as RN) or her doula could do to make her relax. And her cervix just wasn't changing. She finally asked for an epidural. She relaxed with the epidural and the baby was out in 3 hrs (after 10 of natural labor). I am by no means an advocate of the epidural, I see a lot more of babies getting put into OP or transverse positions and not being able to get out of them because of the lack of mobility of the mom, but they can be a useful tool when used properly. Oh, and nurses that ask their patients if they want an epidural every 5 min are a huge pet peave of mine. My style is, find out if the mom is going to want pain meds, if so I talk to them about their options before they are in labor (if possible) and I don't bring it up again until they do. Lazy nurses are the ones who don't like natural labor because it requires so much support. but guess what...you are a LABOR nurse, not a sit-at-the-desk-and-gossip/chart nurse.

Hi there, I am an NC native born and raised, and I love the South, but I will tell you, the pay in NC is pretty low compared to the rest of the county, and the staffing can be sticky. I live/work in Oregon now and if you are used to west coast nursing (i.e union nursing) NC will be a bit of a culture shock. Also, if you are looking for cooler weather, NC is temperature cooler, but if I were you I would look up a little thing called the "heat index". The 100% humidity and 98 degrees can make it pretty stiffling from about May to October. I am not trying to scare you away from NC, I am moving back there next year, I have just known lots of people who have moved to NC without ever visiting before and it was not what they expected. Good luck!

Hello, I am looking to relocate to the Hickory area and was wondering what the nursing opinions of Frye Regional and Catawba Memorial are. I am a Labor and Delivery Nurse, and I like working in hospitals with a wide range of patients. Where I am now we have everything from midwife patients to high risk patients under our perinatologists. If anyone can let me know which of these hospitals are better, or just better for L&D let me know. Thanks!!

If you don't mind me asking what are your hours like? Do you feel like you have time for yourself and your family? I really want to be a midwife but I am afraid I will be overworked! I am an L&D nurse now and our midwives always look so beat!

Um...wow, you pretty much described my exact same feelings!! EXACT! I could have written that! I might print it up and hang it on my fridge :-). It's nice to know there is someone else out there with the same ideas!

Is anyone out there a FNP and CNM? If so, did you get the FNP or the CNM first? How do you integrate the two in practice? I know what I want to do with it, but I want to hear if there is anyone else out there who had the same idea. Thanks so much!! Oh, and if anyone did the went to Frontier for their two certifications how did that go, I have heard a lot of good things from them. THANKS!

Hi there, is anyone out there dual certified as a CNM/FNP? I was wondering how they utilized these degrees. I think I would like to be dual certified for these professions, but didn't know if I would be able to use them together. Ideally, I would like to form a practice with other NP's and CNM's that could care for individuals throughout their lifespan...pipedream, I know. But it's nice to dream. Also, for CNM's working on their own, what do you do for patient who need emergency C/S's? Is there an OB associated with your practice? Thanks!