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nursing policy on handling infant that is not bathed
The policy at our hospital is to not bath the babies (or separate them from mom) for at least six hours after birth. Then the bath is done in the room with the parents and the baby is rewarmed by placing babe skin to skin with mom. A little sign goes in the bassinet that says "I haven't had my bath yet!" I'll echo what others have said about vernix being beneficial for babies' skin and add that the scent of amniotic fluid on the babies' hands also helps them initiate breastfeeding.
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Frontier in 2012
I'm planning to apply in 2012! I'm excited! I'm just trying to figure out exactly how I will pay for it :)
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how do you chart your prn narcs
We have to chart in the (paper) MAR and in the actual (electronic) chart in the pain assessment. It's double charting, but they will probably do it this way until we switch to electronic MARs Oh, I just noticed this was LTC nursing, I'm in acute care, but it came up on the home page, just wanted to clarify.
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(Postpartum) Are babies counted in your census?
I have no idea how your hospital could not count babies in its census! Our floor counts newborns and moms, they each have separate charts and MRNs. I don't understand your concern about moms dropping babies at night, that seems so random. I mean, if the mom is stable then at least the baby is getting 1:1 care. When we used to have a nursery the nurses would be at the desks in the other room charting and a bunch of babies would be in the nursery just chillin with no one watching over their every motion or noise (like a new parent does).
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NOT going to the pinning ceremony
Our graduation was just the School of Nursing, I might have had a different opinion on "pinning" if it was the whole University. Then I definitely would not have gone to graduation!
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NOT going to the pinning ceremony
I didn't want to go to mine, but they combined it with graduation. Walk across the stage, shake the Dean's hand, get pinned by a faculty member, go back to your seat. I probably wouldn't have gone to graduation, but my parents came and all of my friends were going to go. We made a pact that we would all go together. We threw a big brunch beforehand, had bloody marys and mimosas. Perhaps that's what made graduation more tolerable? Oh, and I have two previous degrees.
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Labor and delivery vs. Postpartum
The units where I am right now get along pretty well for the most part. We have gone through a lot over the last year with the transition to couplet care, which impacted L&D more than expected. I think that people ended up working together a lot during that and our Baby Friendly certification. I think that helped improve the relationship as well. We just had a potluck where each floor provided a course of a meal and then all the nurses traveled from floor to floor, eating, drinking (non-alcoholic of course) and socializing. It was lots of fun! Maybe you could start with something simple like that?
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Cultural Competency Training
Awesome! I ran a similar program almost ten years ago (!) except we did 3 hour in person trainings. We could never really get the time to train clinical staff like RNs and MDs, and focused mostly on LTC facilities, senior service providers (adult day health, in home health, etc.) If you're focusing on older adults I think that geriatric/rehab floors would be a good place to start, but honestly, I think every nurse needs this kind of training. You might try getting buy in from nurse managers on any floor. Start with the low hanging fruit (an LGBT workers group at the hospital, etc.) and use those connections to get in with nurse managers on different floors, etc. PM me if you want to chat more about it.
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code blue question
Perhaps you should consider taking a BLS or ACLS refresher course. I would also become familiar with my hospital's protocols for Rapid Response and Code Blue-if you are still in orientation do you have a clinical mentor you could ask?
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Looking for a resource on natural childbirth...
She should definitely look in to getting a doula for the birth. The Birth Partner is a great book and pretty much any book by Penny Simkin would be useful. Ricki Lake put out a book called "Your Best Birth" that is supposed to be good as well. Sheila Kitzinger's The Complete Book of Pregnancy and Birth is good and comprehensive.There are tons of other good comprehensive books out there: Birth Book (Martha Sears), Ina May's Guide to Childbirth, The Doula Guide to Birth (Ananda Lowe), Pregnancy, Childbirth and the Newborn (Janet Whalley). Other books that lean more towards specific techniques and coping are: Active Birth, Birthing from Within, and the Bradley Birth Book. She should avoid books like"What to Expect" or "Girlfriends Guide to Pregnancy", those are more pop culture and What to Expect is very alarmist.
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Mother/Baby VENT!!!
Reading your post I was thinking "Wow this sounds like X hospital!". I went and checked your profile and based on where you say your location is, I'm pretty sure I've heard complaints from Mom/Baby nurses at your hospital and the LCs as well. Another area hospital just got Magnet designation and their nurse:couplet ratio went from 1:3 to 1:4 and they're all stressing out. (They just went to couplet care about 2 years ago too.) It really sucks, I don't know how you all do it! As far as the 100% breastfeeding thing goes, there are definitely some policy and practice changes that need to be made to make your hospital breastfeeding friendly. I had friends who did clinical there, had their babies there and friends who work there. I've heard a lot of complaints about breastfed babies getting formula (excessive amounts) without mom's permission. Little changes could be made like making donor milk available for supplementation, not giving a pacifier to breastfed babies. Things like that. At the same time, there is no way any hospital will succeed on making EVERY mom breastfeed.
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Confused on how to start a career in OB
Generally you do, I have a pretty significant background in women's health and health-care and feel comfortable applying without it at this point in time. The programs I'm interested in all say they prefer L&D, but there are nurses in the programs without L&D experience. We shall see!
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Confused on how to start a career in OB
Thanks! I'm thinking that I will probably just go straight to midwifery school and not do L&D since I think being an L&D nurse would drive me . The "plan" is to work my Adult Medicine job for a year and then do Lactation Consulting while I'm in Midwifery school.
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baby not keen on breast and jiterry..what to do
Yup, it's pretty awesome! Some moms are like "ew, why would I give some strange woman's milk to my baby?" We bite our tongues, but I really want to say "and you're okay with giving some strange cow's milk to your baby?" It's a relatively new option for term infants so we're still figuring out what language works best and how to explain it so that moms understand it's pasteurized, moms are tested for communicable diseases, etc. Sometimes I think they think we just have a bunch of lactating women in the back hooked up to milk machines. It used to be under 36 weeks gave with mom's request, but now RNs are supposed to offer it for supplementation. All pre-term babies receive human milk until they are term, so it's either mom's expressed milk or donor milk if she can't express enough for her baby.
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Confused on how to start a career in OB
I had the same questions, but in the end it didn't matter! I applied to all the open L&D/Maternity Care New Grad positions that I could, but didn't get an interview for one. I also really only wanted to work at the hospital where I'm currently training to be an IBCLC because they're the only hospital in the area that's even trying to be Baby Friendly. Sadly, they had nothing open in Women's Services. So, I applied to some Adult Medicine positions and got one! I think that I'll be a really good fit for the floor and I know I'll learn a lot that will benefit me in the future. I also have experience as a doula and am studying to be an IBCLC, so I'm getting my mom/baby experiences in other ways.