Susgu

I've worked in both office and hospital settings. Just like an inpatient nurse, the outpatient/office nurse has opportunities to work in a variety of specialties. As a sort of fun post (as well as gaining knowledge for those interested in office nursing), what kind of office do you work in, and what do you do on a daily basis? I used to work in a dermatology clinic years ago, and I learned so much and had a great experience working there. I did a lot of patient teaching, administered treatments, drew labs, assisted the physician with specific interventions, and handled other administrative duties (front desk, telephone, scheduling, patient charts, insurance, lab results, sterilizing instruments, stocking rooms, all in all making sure the office ran smoothly) . Wear sunscreen everybody!

MelitaRN, NurseNora had a great suggestion of going over different scenarios with your preceptor. Talking through different deliveries can be helpful. And, to be truthful, you will learn as you get more experience. Every delivery is different, and sometimes out of the ordinary things happen that you may be unprepared for. As long as you maintain a calm and professional attitude, you will be able to think clearer and prioritize better. Always ask questions, and always ask for help when you need it! The best to you! :)

[our docs won't call them late unless they are truely "u" shaped and occur with at least 50% of the ucs (by the new guidelines). if they don't meet that criteria then they are considered variables, and therefore pretty insignificant in their eyes. what are your thoughts? my thoughts are that a late is a late is a late! chart it whether there is only one or if they are with every contraction. i also checked online to see if i could find references with a good definition for late decelerations. according to american family physician: interpretation of the electronic fetal heart rate during labor (1999): a late deceleration is a symmetric fall in the fetal heart rate, beginning at or after the peak of the uterine contraction and returning to baseline only after the contraction has ended . the descent and return are gradual and smooth. regardless of the depth of the deceleration, all late decelerations are considered potentially ominous. a pattern of persistent late decelerations is nonreassuring, and further evaluation of the fetal ph is indicated. persistent late decelerations associated with decreased beat-to-beat variability is an ominous pattern. www.aafp.org fetal heart monitoring principles & practices states that: late decelerations are quantified by their relationship to the peak of the contraction. the nadir commonly decreases by not more than 10-20 bpm and rarely 30-40 bpm (freeman, garite, & nageotte, 2003). www.awhonn.org i hope this is helpful!

Glad there was a good outcome for the baby. I agree with SmilingBluEyes in that one late is NOT a reason to call the OB. However, find out what the policy on your unit is for calling the OB provider. As far as watching the monitor and assessing your patient, you need to look at patterns and also at what else is going on with the FHR tracing. What is the FHR variability? Are there accelerations? What is the frequency of decelerations? What kind of decels are they? What is the contraction frequency, duration, and strength? What's the mother's cervical exam? How is she positioned in the bed? Take note of the mother's health, as well. Does she have any health conditions? Any problems with this pregnancy? Is she in labor, or is she being induced? Have her membranes ruptured? Is it clear fluid or mec? Etc, etc, etc... As you can see, there's a lot to keep in mind when taking care of a labor patient! There's definitely and art to it! If you see decelerations, first thing to do is go into the patient's room and reposition her. Get her off her back! Maybe you also need to give a fluid bolus and some oxygen. What are the mom's vital signs?...All these things like SmilingBluEyes mentioned. If the decelerations resolve, great! If the OB stops by the nurse's station, let him/her know what occurred. I will say, though, that if you ever have a gut feeling that something is wrong, or you are questioning something and need a second opinion, talk with your fellow RNs and call the OB. Never be afraid to ask and clarify. No one should give you grief for wanting to learn. And if the OB complains, that's his/her problem! He/she probably needs a nap!!!

I think that article in Parade Magazine can lead to some misperceptions. Right away many of us got defensive because nursing - an often challenging, rewarding, as well as humbling and thankless career - was grouped with other jobs that are not of the professional status as other professions we see in healthcare, business, technology, etc. I think the perception many of us had was that nursing was made to look like an "easy" job, one that didn't require a lot of intelligence or education (or pay!), a career that was not a profession. In that sense, it felt like an insult even if that wasn't the intention. I know and you fellow nurses know what nursing really is about! What I find unfortunate is that those not in nursing will view our field as it is sometimes portrayed.

Interesting places for births (that I've either seen or where I've taken care of the mother and baby right afterwards): - Standing up in the shower with the grandmother getting it all on video! - In the hospital parking lot as the husband and wife were getting out (at least attempting to) of the car. - In the car, on the way to the hospital (Dad eventually had to pull over to the side of the expressway). - Coming out of the elevator. Fun stuff, I tell ya!

1. Why did you enter the nursing profession? Interest in the medical field/health; opportunities in nursing 2. What do you like about being a nurse? Allows me to make a positive difference in people's lives; gives me variety; meet and learn about all sorts of people 3. What do you not like about being a nurse? Long hours; demanding/negative patients and doctors 4. Do you think you get paid what you deserve? Sometimes I feel I get paid less for what I have to deal with! 5. Do you think that nurses are respected by the doctors you work with? Yes, for the most part. There will always be a couple of those "know-it-alls," though. 6. What do you wish you would have learned in school to help you in the real world? Nothing. Sometimes the real world teaches you things you can't learn in school. (I do like what nurseklw72 said, though!) 7. What was the worst situation you have ever been in? Unit full (and overflowing - they just kept coming!) with patients, all patients high risk with a couple needing constant attention, one nurse left sick, call lights were not working, repair men were in the hallway trying to fix call lights, call lights kept going off because of the repair men working on them, phones were ringing non-stop (of all days), nurses' station a complete mess, and I was in charge! 8. What is the most rewarding thing about being a nurse? When you know you've made a positive impact in someone's life. When you hear the gratitude from your patients 9. Do you think new-grads should start in the ER? I don't necessarily think they should. They can if it's something they really want to do. However, know what you are getting into. You should be a quick learner, a good time manager, be able to work in a fast-paced environment, and easily deal with stress. 10. Are you thinking about leaving nursing? No, there are other avenues in nursing I'd like to explore. 32/Female/LDRP/10 yrs/BSN/MHA

As far as OB units hiring LPNs, it depends on the facility. You'll need to research the medical centers in your area where you want to work. Best of luck to you! :)

Bumping up the Pit every 20 minutes doesn't even allow for the mother's body to get adjusted to the current level! "Pit to distress! Pit to distress!" That seems to be the mantra of many providers/nurses these days, and that's unfortunate!

I'm pretty positive that the "baby nurse" was a labor and delivery nurse (providing care to moms and babies during the antepartum, intrapartum, transition, and sometimes postpartum periods). Sometimes labor and delivery nurses will focus care on the newborn right at delivery and immediately afterwards. Sometimes it will be the pediatrician or peds residents. Sometimes it's both. If you want to be a "baby nurse," you should look into working on a mother/baby unit. If you want to focus only on babies, then maybe consider the NICU. Good luck! :)

Thoughts, opinions, experiences on which hospitals/med centers are good and bad in the Dayton area (as far as working as a nurse goes.) Thanks!