mer_RN

I have heard people talk about the Bradley method. They generally speak poorly of it. One doctor told me that she heard people who wanted to do the bradley method of labor, were told my their instructor not to tell their OB until they walked into the hospital in labor. This doctor was beyond being ticked off. What exactly is this controversial Bradley method?

We do the Duramorph then pull the epidural/spinal after delivery and they can have perc, motrin, or tylenol prn. the pts. really itch like crazy with the duramorph and some of them vomit a lot. anesthesia orders also have meds for these side effects. the pts who had general anesthesia for c/s get PCA's, usually dilaudid. i have never seen the pca provide much pain control at all. it just seems to make them very dizzy. when it gets to be about 18-24 hrs post op i usually call anesthesia and get the pca d/c'd for po perc and motrin. once they start taking the po meds they all say they feel 100% better and actually want to get up and walk in the hall and actually hold their baby!

I get so irritated when pts. say... "I want to give the baby my breast." I don't know what it is about that simple statement that just makes me want to jump through the ceiling! The other thing is when the family/visitors arrive to the unit before mom and baby because PACU can't stand it anymore. So you explain they can wait in the room, but when the pt gets here we need them to step out for 5 minutes so we can talk to mom and dad and make sure the baby is ok. They are always most receptive to this and very agreeable, but as soon as the stretcher rolls up you could light a fire under there butt and they wouldn't get out of your way!

call HR and ask the status of your application. I did this when I was a new grad and didn't get any callbacks. Many times they apologized for not calling and set up an interview immediately.

I worked in postpartum for 4 years when i got out of school and am now making the jump to L&D. PP was a good place for me to start because I am someone who likes to start "slow" and work my way up. But don't think PP is slow, at least not where I worked. The pt. turnover is so fast, usually 24 hours, it is just a lot of work admitting and discharging. I never realized when I was in school just how "sick" the pts. can be. In 4 years I have encountered PP hemmorhage (all PP nurses preferred emergency over all others), seizures, active TB, stroke (pt. still in nursing home), postpartum cardiomyapathy, heart attack (totally out of nowhere, i still worry about seeing that pts name come up on the labor room census again, she was advised not ot have anymore kids), PE (ending in death), Amniotic fluid embolism (died)...all of those have happened to my patients and then of course the patients with pre-existing medical problems-paraplegics, strange clotting problems, and of course all the ridiculous social and emotional problems people have today. It is a LOT of work and responsibility and a lot of pts are totally ungrateful but then you have those first time parents that are so thankful for evererything they make up for all the others and make it all worth it. As for the doctors, don't worry about them yelling at you, it doesn't matter what is best for the doctor or for you, it is about what is best for the pt.

i have found i always start feeling this way when i haven't gone on vacation lately. seriously, you really must take a week off about every 6 months. i have only been a nurse for 4 years but i have definitely noticed an increase in pt/family demands beyond reasonable nursing care.

our census in OB has been way down for about 4 months now. management tells us this is the case all over the country and no one has an explanation. summer has always been busy for us.

I'm sorry you feel like the nurses and the CNA's don't work as a team. The CNA's on my unit sometimes also say that the nurses are lazy. It is concerning that you feel the only things you aren't doing that the RN is, is assessments and meds. that is actually a huge part of what a nurse does and takes the most amount of time and responsibility for me personally. From the RN's point of view, at least on my unit where the CNA's primary responsibility is to get the pts. to the BR, do their vitals, we feel like we will be darned if we will go respond to the pts. call bell to go to the BR instead of doing our assessments or giving the pts meds they asked for while the CNA talks to her friends on the phone. But then again, I guess everyone also thinks "the grass is greener on the other side"

I reccomend working at Inova Fairfax Hospital and living in the West Springfield area. trust me you don't want to live anywhere near Belvoir, lorton or Woodbridge. West Springfield is a decent commute to the base and to the hospital (20 minutes). get in the west springfield high or lake braddock school district (not hayfield or lee) and stay away from north springfield! you basically want to live right around the rolling rd/old keen mill intersection. look into orange hunt or cardinal forest neighborhoods. if you are trying to buy an avergae house expect to pay at least $400,000-500,000. when i left the hospital i was making $28 with 4 years experience and they have great shift diff there. $8 more per hour for night weekends! good luck!

if you are miserable then STOP! the great thing about nursing is that you can work in so many different areas in various settings. If you want to do NICU you should definitely look into shadowing...but I reccomend working on a postpartum mother/baby unit first so you can get the whole picture. it's a lot easier to spot something wrong in a newborn once you know what is normal. good luck!

When living near Washington, DC as a new grad my base was $21.35/hr (that was changed to $24 a year after I started). Rent on my one bed apt. was $1250. Average price of a 3 bed townhome was $400,000-500,000. Forget a single family house for under $650,000. I recently moved to south carolina and my husband and i are both making about $3,000 more per year than we were in DC and out rent is $800 less per month. My last rent when I left DC was $1800 for a 2 bedroom! i would suggest moving to atlanta if you want decent pay and cheap housing. but if you already own a house then why not stay in florida...

I just went for my new employee physical and I am confused about the NP asking me about "fit testing." I told her that at my last job I "failed" the fit test because i could always taste the saccharine and bitter stuff when it was sprayed while wearing the mask. She was concerned because I will be working in L&D and obviously will have to wear an OR mask. The fit testing I was referring to was for the N95 (I think) TB mask. Why would I have trouble wearing a mask in the OR for C/S? Are the masks worn in the OR the same N95 TB masks? Having not worked in an area where i needed a mask I realized there may be many different kinds and we were possibly talking about a different type. I have no trouble breathing or anything like that while wearing anykind of mask. any insight?

OMG, for a second i was sure we worked at the same place! i would consider leaving, maybe doing something outside of the hospital-school nursing, health dept, something like that, you certainly have the experience to do it. but seriously, administration doesn't care what we think, the bottom line is they will save a dollar at the expense of every employee in the system!

I don't live in greenville or spartanburg, but i went to nursing school at Clemson, which is about 30 minutes from g-ville (before moving here you must choose Clemson or USC, there is no neutral here! :-) ) after graduating and moving back to virginia from south carolina i don't think a week has gone by that my husband and i didn't want to move back to south carolina. after 4 years we ended up in charleston which is on the other side of the state from greenville and we LOVE it! i definitely reccomend SC and greenville is a really nice town, everything seems very safe and clean, not very run down and very affordable housing. good luck!

i understand your pain. i too am terrible at chemistry. i think it totally depends on the teacher you get. i ended up taking chem 1, 3 times. and it didn't make a bit of difference. i have yet to be denied my first choice job based on my chemistry grade. and the only thing chemistry has been good for, for me personally is just knowing what KCL and NaCL stand for so i get the correct IV fluids! chemistry doesn't even teach you the norm K and Na levels as it pertains to humans. it may be important if you maybe get a job in oncology or dialysis, but even then i think you would be hard pressed to find a unit that would not teach you what you need to know to be successful in their unit.

fortunately/unfortunately they both sound like really good hours to me. i just personally would take the 8-12 just because i can't stand that feeling of being irritated that i still have to go to work later when my family is home relaxing, going to bed etc. and for me it doesn't matter how hard i try, but working any kind of night shift messes up my sleep patterns. good luck with the decision!

personally the CNA's at my work who are going to LPN or RN school often make the comments when asked where they want to work when they graduate often say they do not want to work in postpartum where they are currently because all the nurses do is "change diapers, help breastfeed and and look at crotches." they never notice when you are getting their patients up to the BR, filling their water pitchers, doing their vital signs, and oh also a little busy giving O2 to a baby that is desatting and having resp distress while you wait for nicu, or while you are trying to keep your pt who is hemmorhaging conscious until the resident can get there. i have no advice as to how to make them do their work more efficiently, i guess when they get to their dream job of working in cardiac or med-surg where they can do "real" nursing and suddenly realize they are the one with all the responsibilty on their shoulders they will wish they had done their vitals with a better attitude! no advice, just a vent!

i agree with everyone else that it is the parents right to watch whatever they want. however many of them want to watch the circ and VIDEOTAPE! it. who in the world wants to sit around and watch the kids circ on tape? many of the ob's feel the parents just want to use it to sue them or whatever if the circ looks "ugly" a few years down the road. who knows. i think most parents just want to watch the bath etc. so they can learn everything they can whille there is someone there to teach them.

people at my work, including myself sometimes unfortunately had a tendency to get a little "burned out" on students. some semesters we would have 10 students per day on a 26 bed unit all five week days. the most frustrating thing for me though was when they would show up with no stethoscope. we use our stethoscope on every mom and every baby, it was very frustrating to not bring something so basic. it seems like a really small thing but the small things are what matters. good luck!

i think that many OB doctors don't even realize their patients are getting as much fluid as they are post delivery, vag or c/s because they don't bother to write a d/c IV or hep lock order. therefore the fluids technically should be continued indefinitely. then if you call the resident to get a d/c IV order for a completely normal pt they flip out like you are wasting their time.

i work in ob so i was also totally in disbelief when i was floated to peds and had a 5 years old that was bipolar (and had been for a while) and the parents were also both bipolar. i wondered if this little boy truly was bipolar or was misdiagnosed due to his parents.

I just accepted a job in L&D, I start in 3 weeks, and only get 8 weeks of orientation. Any suggestions for books specifically about labor and delivery (I already know the PP stuff)? I would like to brush up on those things since it has been 4 years since learning about it in school. Also, apparently the L&D nurses also function as the C/S PACU there, any books I should read about that?

I am interviewing for an L&D position at a teaching hospital soon and I was wondering the same things you are. I have 4 years of experience aleady at a very large hospital, they do 12,000 births a year. After working with a lot of residents and med students i think i have come to the conclusion tha i like the idea of working in a teaching hospital especially when starting in a unit where you have no previous experience. Plus I think they would have more comprehensive orientations. I think in an area like L&D it is important for the orientation to include classes based at the hospital so you learn specifically how things are done there as well as orientation on the unit. I just don't think in a small hospital they would necessarily offer that because there would not be that many people starting orientation at once. Plus, personally I think it is good to go to a large hospital so you get the volume, doing 2 deliveries a day vs. 30, you are going to get the hang of it much quicker. And...i like that there is always an OB there whether it be a resident of attending. one of the OB's where i work told me one of their postpartum pts went by ambulance a few days after d/c to an er (where their group didn't have privileges) with PP hem. and there was not one single OB in the entire hospital to assist the er dr. who said they didn't feel totally comfortable handling the pt. anyways...good luck, you can tell i have already wayyy over analyzed this in preperation for my impending interview!!

I also have always drawn it from the port on the tubing closest to the pt, but...have always wondered while I am standing there waiting to get enough urine to collect why you could not just collect the urine out of the bag especially for things such a drug screen. It makes sense to me that if you were collecting the urine for a UA then you would want it to come out of the port especially for OB pts who are bleeding, but wuld collecting it out of the bag really be that different if not better than a clean catch because it would be minus the lady partsl bleeding that inevitably ends up in the specimen cup no matter how careful they are?

give yourself a chance. it definitely takes at least a year to feel confident of what you are doing. maybe try a teaching hospital, they seem to have good orientation programs. best of luck!