obnurse13
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Our Doc's have us start pitocin with the Anterior shoulder as a part of active management, but they wait 30 minutes for the placenta before intervention. I've never seen anyone "pull" on the cord, and thank GOD they do have us premedicate in the event they must intervene. I've even seen them have anesthesia use consious sedation.
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I am an LPN and have worked in labor and delivery at the same hospital for @ 6 years. Under our hospitals policies I function pretty much independently with an RN charge nurse on the floor (most of which I trained when they were hired as new grads). Recently our Nurse Manager made a statement that our unit will not be hiring any more LPN's due to standards and recommendations. I was just wondering how other hospitals practice and what are common rules about LPN's in labor and delivery.
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I agree with sweettooth, but keep in mind, once you cut that cord you have to deliver. God forbid you have should dystocia after the cut. Also, there is a move called the summersault where you move the fetal head to the side to help you be able to deliver through it. Research that.
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I have worked Labor and Delivery for @ 6 years. Our department has all LDRP's and all nurses function in labor, delivery, pp and newborn care. I recently had a new grad midwife question my Apgar score on a delivery. I scored 8 and 9 apgars counting off for color. The midwife says that you can't give a 0 for color if you give a 2 for heart rate and respirations. I count 1 for color if the infant is pink centrally w/acrocyanosis and I count a 0 for color if there is any central cyanosis (circum-oral included). I have practiced this way for my entire career and have never had anyone question my scoring. Every APGAR chart I find is unspecific, it say 0 for apperance if the infant is blue/pale, and 1 for color if pink with blue hands and feet. My rationale is if there is any central cyanosis, it doesn't fall under the 1 category? Am I wrong? I am willing to change my practice if I can find documentation to back it. Any help will be appreciated.