PyshRN

Thanks for all of your responses. I found out when I went back in to work the last time that the pt ended up with a lady partsl delivery anyway. I didn't get to speak to her delivery nurse to find out how it went. Janey W, I have not joined yet, but I was hoping to soon. Maybe someone (my hubby) will suprise me with a subscription?!?

Thanks for the reassurance. I'm somewhat new at L&D nursing (7 mos on the floor). It does seem like we 'pit to distress' a lot. They always want the pit upped. Well sorry if she's contracting every 2-3 and making change in her cervix then why? At least I know I can go home feeling like I was being an advocate for my patient and her baby. I get so frustrated with these residents lately. I used to work in critical care where when you called a resident, they would listen to your suggestions and at least consider them. Where I'm at now it seems as if you suggest something you might at well not waste your breath, or even worse expect the total opposite!

So, I'm extremely frustrated about my night last night. I had a 39 wk G1P0 who came in with SROM. She was contracting at this point about every 5-6mins and at 3cms. We admit her. The doctors decide that she should be put on pitocin. Apparently they hadn't looked at her strip while deciding this. So, I bring it to their attention that the baby is flat, no accels, no decels, and absent to minimal variability at best. Our protocol states that in order to start pitocin they must have a reactive strip. She clearly did not. They decided to wait an hour and reassess her. In the mean time, I gave her a little bolus, turned her on her side, and gave her an ice pop thinking that the kiddo might perk up. No go. So I "buzzed" the baby. She perked up for a whole 5-7mins then went back to her flat little self. Finally, I call the doctors let them know the situation had continued to be the same and I didn't start the pitocin. He and his upper level review the strip. They proceed to inform me that the baby can still have a good strip even though it has no accels and wanted me to start the pitocin. I still called the variability absent to minimal, no accels, no decels. In the meantime, they checked her she's 4cm's and they put in an FSE and IUPC. I know the pt is on a "clock" so to speak being ruptured and all, but I just can't bring myself to start pitocin on this lady. At the same time, she's not getting anywhere fast with her body's inadequate effort. Which brings me to my question? Was I right to not start the pitocin? Clearly not the worst strip I've ever seen, but doesn't look good enough for pit to me. Some people at work were telling me as long as I was documenting that they reviewed the strip which was non-reactive and that they told me to start the pit anyway I was covered. In the end, if (god forbid) something were to happen to that baby, I'm the one that pushed the start button on that pump not the doctors. I'm also that one thet is responsible to follow protocol. Correct? What is the point of having a protocol if you don't follow it? :angryfire

I'm kind of feeling as if I as jipped on orientation. I'm working in a high risk L&D unit. Granted I was not a GN and I have critical care experience, but I recieved 12 weeks of orientation and 2 of those weeks were learning to scrub for c-sections. Do most places get 6 months of orientation? Or is that just for new grads?

Wendy's Produce Girl for Grocery Store Personal Care Attendant for Assisted Living Center (While working at the grocery store RN!

I agree... teamwork, teamwork, teamwork!!! In my experience, days or nights both have their periods of difficulty... it just depends on the day and the patient mix. One night might be quiet, but the next your putting in a v-cath, running your pt to ct scan, and getting several admissions on the floor, etc. Its just depends...

I too take my husbands insurance because is a better package than what I am offered by my employer. Funny... hospitals don't seem to take excellent care of the people that are taking care of the patients. For example, one lady working on our unit has been having PT three times a week. How does a $30 copay for PT sound? (PT guy says the hospital insurance pays them $18.) Sounds like a discount plan to me. LOL. Something seems messed up with this system. My .

This happens sometimes on our floor when people forget to turn off their IV when drawing from a line. Usually, the lab calls us if the results look odd. Our techs actually ask us to stop IV's if they need to draw on an arm that has an IV infusing (if it is allowed to be stopped for a short time). We get a lot of patients with poor veins and they sometimes have to stick them in an undesireable location.

I was in charge last night and 5 of 15 patients on our floor were GI bleeders. I'm with you. :)

I worked for an assisted living one year while I was going to nursing school. The patients that we took care of were pretty self sufficient. They had to be ambulatory, or be able to roll themselves to the dinner hall, and they didn't have anyone who required lifts. I think there were about 30 or so pts to 3 aides. In addition, there was an alzheimers unit with 8-12 pts with another 1-2 aides. I passed meds, helped with ADL's, and collected linen and laundry to be washed. There were three levels of care - independent - who were just there in case they needed assistance, semi-independent - who required assistance with baths, and complete - these people needed help with most ADL's, most of the completes were alzhemier pts. I don't know a whole lot about the regulations, but this is the experience I had. I really enjoyed the job. Hope it helps!!

So, here is the story... At the time I first interviewed for a position at the hospital, I was told it was for an OB position. When I showed up for the interview, I was told the position had been filled, but there were several openings on different units where I could work until an OB position opened. I chose a critical care unit and have now been working there for over a year. Now, my questions... 1. How hard will it be to make the transition into OB from critical care? And assuming I get the opportunity to transfer to OB... 2. What do I tell people when they look at me like I'm crazy (or so I'm told) for wanting to do a "total 360" in nursing? I'm glad I was able to gain experience in critical care. It really helped me work on assessment skills, and helped me learn to be comfortable with things when they go wrong. I'm just looking for some feedback... thanks in advance.

It is hard to believe the government is unwilling to compensate the people who are caring for the ill and elderly. I think a few people need to look into the future and pray that someday they won't need a helping hand with what are for some of us "simple tasks". But then again, the people who are making these decisions probably won't ever get to a point where they can't afford to pay for their own help, or rely soley on Medicare/Medicaid. Frustrating!!:angryfire

I went through a tough period when I started my first nursing job. I'm just passing the 1 year and 2 months mark on my floor. The first floor that I worked on was horrible. The staff was rude and unsupportive. I asked to be moved to a different unit, and things were much better. The staff was wonderful and supportive. I found some really great mentors (my "go-to people). They took the time to teach me and show me the ropes. After all the time and effort you've invested in this career, don't give up on nursing after yor first job. Stick it out. There are a ton of other positions that may be a better fit. Maybe you should try something different? Good luck making your decision and best of luck to you!! :icon_hug:

Sorry to hear of your loss! Our hospital is going to a totally non-smoking facility. Quite a few people are upset about the change, but I think it is a fabulous idea. If people choose to smoke and harm themselves it is one thing, but it is another when they are putting others around them at risk. It is a shame that they are putting those who may already have respiratory compromise at risk, and those who are healthy at risk.:angryfire