m0m2boys

I took the boards 2 yrs ago and got all 265 questions. I thought I failed, because a classmate had all the questions and failed. I however was lucky enough to pass. So don't give up hope. Keep us posted LF

Lots of luck!!!!:wink2:

For some reason our dr's are so reluctant to give anything for pain. I'm lucky to squeeze an ambien out of them. I will try being more assertive w/ pain management options & dr's. Thank u for your response. LF

Tons of great new tricks for me to try out!

Our protocol for accessing active labor is if the pt makes cervical change. We usually get a reactive NST and watch them for an hr, giving them the choice to walk for that time period or lay in the bed. Then we re-exam the cervix and if no change, hasta la bye bye. Obviously if they are in severe pain we will get an order for pain meds and reassess cervical change and if none they go home. I was just wondering if this is how it is done in other hospitals. Thanks, LF

I worked as a NAP (nurse apprentice program) in l&d my 3rd semester. I learned basic but essential info. Examples being setting up delivery tables, straight cathing pts after delivery, etc. When I applied at a different hospital closer to home once I graduated I applied for a med surg floor. I just figured no one would hire an RN w/o med surg exp. The nursing recruiter intercepted my resume with the NAP in l&d exp and sent it to the director of woman's services. I was hired as new grad in l&d. They sent me to a 8wk l&d course. I then precepted for a few months on the floor. Here I am a few yrs later, still working l&d on day shift to boot! LF

I agree there would be no reason to leave the room if the MD is doing a SVE. But now I'm wondering, what if a pt accused an RN of being inappropraite like the example of the female NP? I don't have another RN in the room when doing SVE. Of course I would never do anything inappropriate, but if a pt wanted to accuse an RN of that there wouldn't be another witness to defend the RN. Great now I won't be able to sleep tonight.

All I can offer is a simple hug and a been there and know how much it sucks. :icon_hug: LF

First of all I want to give you big hugs for having to deal w/ such an emotional situation. I have only been doing l&d for a few yrs and no matter what the gestation of the demise I wail like a child. I don't always do this in front of the pt, but just getting it out helps me feel better. Full term demises are the worst and I wish I could say that I have never had one, but that is not realistic. My last demise when taking pics of the baby, I took an extra copy just for me. The family was in such denial they did not want to hold the baby, see the baby or even talk about him. This was very hard for me, so I took a pic of him to remember him by, since I felt his parents weren't mourning over him. Long story short......everyone mourns differently. I happen to wear my heart on my sleeve. This particular circumstance the family tried to pretend nothing was even going on. As long as you show the family you care, offer them places to receive support and perform nursing duties for the mom I don't think there is a right or wrong way of doing things. If this is still bothering you see if your hospital has bereavement counseling for staff. *LF* :flowersfo

I'm sure it can be done. It has been over 5 yrs since taking those classes and I don't think too much has changed. However from my experience Bio 224 was harder than 223, so taking micro w/ it is going to take up a good chunk of time. Not to mention both classes have labs. I don't know what nursing program you are interested in, but if you take both and don't do well you will probably have to retake the class which is expensive and even more time consuming in the long run. Either way you go, good luck!!!!!!

I don't work Med/Surg, I am in L&D. I do know when I was in nursing school a few yrs back and did clinicals at St Rose Dilema their med/surg did occasionally go to 7:1. I also did a report in nursing school comparing the nurse ratio laws in CA vs. not having them here in NV. I called around to a few units in different hospitals. None of them had a set policy stating a ratio, which meant it could vary depending on the amt of staff vs pts. I wish you the best of luck no matter where you decide to go

I work at Spring Valley and really enjoy it. I don't know what Desert Springs Hosp has to do w/ your decision. As far as not having a union in place it has been more of a positive thing since the hospital is so new and demands are met fairly easily. The area of town is not in the ghetto, I'm sure other hospitals like St Rose are in better areas but considering we have Spanish Trails down the street we have rather decent pts. If you haven't already accepted a position at Mtn View I would reconsider your options at Spring Valley. HTH, L

I have been out of school for 2yrs now and did not do the adopt a stud program. I wish I had every time I pay my student loan bills. I work at Spring Valley and I love it! I started out in l&d and am still there now. I know a fellow student in my class did the adopt program and went to work at Summerlin straight to ICU. However I know that VHS won't let you work as an RN until you take and pass NCLEX. So if you do the adopt a stud program just be prepared to take boards soon after graduation and passing them or else they won't let you work as an RN. HTH, Lauren

In NV it is w/in the RN's scope to AROM, place FSE and IUPC's. I have worked w/ several RN's from other states that were not comfortable rupturing because the MD's did so where they were from. The atmosphere in Las Vegas L&D is a lot of elective inductions and elective primary c-sections. Almost any pt that comes in laboring on their own will be put on a pitocin drip if they are not cxting q 2-3mins for 60-90secs. We don't have any birthing centers in town and mid-wives are slim to none. Not that I agree w/ this way of laboring pt's, but this town is so transit that I think some MD's want them delivered before they decide to move on to greener pastures across the country. Since graduating nursing school 2 yrs ago this is my first nursing job, so I don't know any different. I know from reading articles and stories from others that this is not the way of the labor world in other states. We are very autonomous (sp?). The MD's get upset if they get called in for delivery and the head is not even crowning yet. So for them to come in and AROM a pt is unheard of here. This is one of the reasons I joined this site to broaden my horizons. I know the way some MD's practice here are not right. I would never do anything to put a pt or baby in jeapordy! I would love to learn some more non-pharmacological ways to manage pts other than pitocin and epidurals. Sorry this is so long. To answer your question, yes RN's AROM in NV.

Hey there. I am slightly beyond a novice in L&D. I have been a labor RN for 2yrs now. So take my advice w/ a grain of salt. I usually have difficulty finding the spines and gauge station by pelvic arch. If the BPD of the head is slightly above the arch it's a -1sta for my assessment. I do agree that textbook 0 stat is when the BPD is even w/ the spines. I will AROM if the head is -1 or even -2 stat as long as the head does not ballot out of the pelvis w/ a cxt and is well applied to the cervix. The hospital I work for usually is rather agressive w/ delivering in a timely fashion, unless of course the MD has a golf game;) . Lauren RN