kdot2003

I've been a OB nurse now for >20 years and now we have a new doctor, again, who loves her some Pitocin. If you call her the answer is almost always -increase the Pitocin. 1. You cant rupture a primip's uterus with Pitocin 2. MVU doesn't matter 3. Tachysystole is fine if Category I 4. Keep going up, even second stage. 5. Start Pitocin at 6 am, doesnt matter if the bishop score is 2-3 6. Criteria for failed induction, Pitocin at 40mu/min x 4-6 hours and no cervical change. 7. Oxygen for decels concurrently with Pit is fine. 8. BTW her policy is start at 4 up by 2 q 20 (logistical nightmare) to total of 40 I am so tired of this. Management was supportive previously but now not so much. Our policy is the usual policy.... Then management says, "just write the order for whatever she says to do"....that doesnt help me in court does it? I need journal articles or something doctor driven to help this situation. Can anyone help? I've been scouring the internet and acog, awhonn, just haven't found the best source. Any ideas?

Still doing the 2 hour bath thing. Some patients want it sooner...

We are BIG on cervical ripening. In the old days we just used Pitocin. But we do 39 week elective inductions which is sad sad sad.

I think its ok....The baby doesn't "deliver himself" though as the video description suggests. They must have a larger incision than we have. I do wonder how you can do major abdominal surgery with no masks. Its cool the mom can watch and not have the high drape. Interesting.

I'm sad nobody posted a comment.

I really dont like bedside reporting. How are you going to say shes a G3....what if someone knows what that means or asks and she told them its her first baby. How can you say she has HSV or foul smelling fluid etc. You have to give a "PC" report and then a real report. Many of the patient's are asleep at 7am when I come on, especially if they have had a long night. Our midwife gets to the unit at report time and commences on breaking water etc. I am an "old" nurse but I think the report should be left outside. Now when you go into the room and speak with the patient you can do a mini recap and make sure everybody is on the same page....answer questions etc.

I would like to know about Northside L&D openings...

One doctor likes ultradex scrub and rinse with sterile water or saline. BUT if we clean it ourselves with a little water and it looks clean when they come to deliver they don't want to wash it again. The other doctor doesn't prep at all. We think prepping is ridiculous..us nurses.

I work in a small hospital and we stopped doing that in about 1998. Some of my patients were terrified of getting an enema..and it definitely doesn't stop poop! If a patient nowadays is adamant about wanting one the doctor will order a fleets. Nobody wants to do a soap suds enema unless its a terrible case of constipation!

At my hospital in rural GA we check almost everybody regardless of gestation. ..unless they have absolutely zero risk of PTL or labor. We do sterile speculum exams and FFN when appropriate. We have policies for FFN and speculum exams etc. I usually make an order for SVE to cover me. There are no doctors on site unless its office hours. If any new nurse or old nurse for that matter is uncomfortable with her findings we get a second opinion from a coworker or just tell the MD exactly what our concerns are. Theres alot of trust involved but it does seem kind of scary now that I think about it.

This may have been covered before but I have a few questions. I work in a small rural hospital in L&D. My coworkers are posting comments on facebook which I feel are inappropriate. Now these comments do not mention patient names or any specific identifiers. In fact, one of the coworkers insists its "legal" to post this content because there are no "identifiers".. But I feel some of the patients can certainly be identified. Some of the recent comments are: We had a rough night last nite, three patients got cut and another one will probably be cut soon. We had three new babies and one had a broken clavicle There are eight newborns in the nursery and three are sick We had a code last night but the baby is ok now I have been watching this situation from my facebook page for a few months now. I have tried to "warn" these nurses. One nurse had just recently passed boards. But nobody is listening to me and now they believe that its "legal". I don't agree but I need to find it in writing if that makes sense. I finally told my manager and she was shocked. She doesn't know much about the internet and had no idea. I didn't mention names. I don't really care if I **** off my coworkers. I think its immature and unethical. I am no Florence Nightingale but this just seems to be common sense. Any comments would be greatly appreciated.

Wow, I read all the posts and it gave me a tear. Thank you all so much for all the support and advice. I will think about it all very carefully, even if my heart is saying RUN.

I've worked L&D at a small community hospital ( Anyway we had a tragic event, a uterine rupture and a newborn death. It totally freaked me out. I was there when she came in, but not when it happened. I've always loved my job but now its different. I have been applying to insurance jobs, utilization review jobs, research jobs, although I have NO experience in these matters. I've thought of hospice or home health or anything considered less risky and less scary. This wasnt the first tragedy we've had but this one seems worse, or I've taken it worse. I keep thinking that I want a 7-3 job, no hollidays, no WE, non-clinical, something CALM. I've never wanted a desk before EVER. Help! Has anyone else felt the same way? I am trying not to make a rash decision but I still keep applying to other jobs. Does this make sense???????????

I've observed women cussing in general, usually it's not aimed at one specific person...unless its the nurse who's doing a lady partsl exam or trying to help get her back in control. I've seen a few women take a swing.... I think cussing out the FOB comes from the "old days" when the man "knocked up" the woman...