RNLaborNurse4U

RNLaborNurse4U has 10 years experience and specializes in L&D.

RNLaborNurse4U's Latest Activity

1. 

   What's the max dose Pitocin is allowed at your hospital?

   RNLaborNurse4U replied to violet_violet's topic in Ob/Gyn

   20 mu/min. If you hit 20, and the doc wants to go higher, they have to write a progress note and an order to go higher. I have gone as high as 36 mu/min. Don't ask. I wasn't happy about it.
2. 

   Allergic to the delivery room?

   RNLaborNurse4U replied to itsnowornever's topic in Ob/Gyn

   I have a latex allergy - it can be worked around! I've been an L&D nurse for 11 years.
3. 

   "Not allowed" to perform vaginal exams

   RNLaborNurse4U replied to Kayla.J.RN's topic in Ob/Gyn

   What about if the doc is not readily available and you have deep, repetitive decels? You need to check for a cord prolapse immediately. Learning cervical exams are a basic assessment skill that all L&D nurses need to have. Double check with your state nursing scope of practice, but I'm sure it's within all states nursing scope. (Speculum exams are a different story though.)
4. 

   Prep for vaginal Delivery

   RNLaborNurse4U replied to Goodlaura6's topic in Ob/Gyn

   I don't do them. If the doc/CNM insists on a wash, I use very diluted hibiclens hand soap with tons of water. A quick splash, that's it. No need to do a prep before a vaginal birth. I think I read a study (a while ago) to support NOT doing betadine prep because of the potential for excessive fetal iodine uptake increasing the level in the baby's thyroid.
5. 

   Can you briefly tell me your Group B protocol?

   RNLaborNurse4U replied to MomBabyUnitRN's topic in Ob/Gyn

   We overtreat. All known +GBS women get PCN Q 4 hrs in active labor, until birth. (Or the alternative antibiotic regimen if PCN allergic). Known -GBS women do not get antibiotics. Unknown GBS status, are all treated as if positive GBS. (Not following CDC guidelines to only treat if risk factors are present!) We also treat with antibiotics if mom is GBS neg, but ROM x 18 or more hours and no s/s of infection (once again, not following CDC guidelines!).
6. 

   Rant

   RNLaborNurse4U replied to TECHTORNHOPEFULLY's topic in Nursing

   I'm in school for my MSN (3 yrs part-time, done, 1 year left) in midwifery. I do bring school work in to work, only to be done during downtime or on my meal break. I don't bring my laptop in. I only bring in a folder with articles and modules to read -- IF I have free time to do it. Most of the time, I don't even get a meal break, so guess what? I'm NOT doing school work while I'm at work --- I'm too busy WORKING!
7. 

   Vent about healthcare

   RNLaborNurse4U replied to MomRN0913's topic in Activism

   I also have BC/BS (of PA) and your annual pap visit to the OBGYN is preventative medical care, and there is a $0 co-pay. Now, if you go to the OBGYN for a problem visit, that is a specialist co-pay service. My plan is $40 co-pay for specialist visits.
8. 

   Newbie advice- Ob 1st job not going so well

   RNLaborNurse4U replied to NuNurse<3's topic in Ob/Gyn

   You need to be full-time, with the same preceptor, for at least 12 weeks of births. How many births does your unit do each month? I'm guessing you are not a very busy unit if you were on orientation for 6 months, but only had 5 births. We do about 350-375 births per month, and our low risk L&D orientation is 12 weeks. You get LOTS and LOTS of births in that time. Both vaginal and c-section. You become VERY proficient in labor care (intrapartum), deliveries, and baby care. Can you be the 2nd assist RN at births in addition to the births you do attend? That will also give you more experience in the immediate birth experience. It takes a good two years of fulltime L&D nursing to really feel proficient at it. It takes even longer to get proficient in the multitude of high risk complications. I've been on L&D for 10 1/2 years, and I still learn new things.
9. 

   Dealing with OB docs...

   RNLaborNurse4U replied to Bridget41040's topic in Ob/Gyn

   That MD is just being an ass. No need to be snippy at you like that. We carry spectralink phones -- can you do that, and page the MD from that phone to call you back? You'd be able to answer it in less than 45 seconds ;-)
10. 

    Long hair for interviews

    RNLaborNurse4U replied to maria25's topic in First Year

    Just keep it neat, professional, and nothing too fancy (nor too "thrown back"). Wear it how you would wear your business casual clothing. I have very long hair, and I just make sure it's styled neatly, with the top and sides pulled back behind my ears.
11. 

    Showing a nurse for an interview

    RNLaborNurse4U replied to Newrngrad1's topic in Ob/Gyn

    Just watch and absorb what you see the RN doing. I love having new nurses/potential hires to follow me on L&D. I actually try to do some teaching and discuss why I am doing what I am doing.
12. 

    Do you have gifts for your new moms??

    RNLaborNurse4U replied to shortstuff31117's topic in Ob/Gyn

    We just started giving out these little (maybe 4-6 servings) of locally made cakes. Cost to the hospital is reported to be $22 per cake. I think they can spend the money more wisely by investing in a good catering/food service that is available 24/7 for the new moms/dads. The biggest complaint is the lack of food after 7pm (our food service stops at that time), and it's just regular old hospital food. Our hospital cafeteria also closes at 7pm (6pm on weekends!!) so there is no other alternative for in house food service for moms that deliver on 2nd/3rd shift.
13. 

    Adoption ethics

    RNLaborNurse4U replied to DebblesRN's topic in Ob/Gyn

    If a nurse was interesting in adopting the baby, she would have to have NO contact or care of the mother-baby couplet in the hospital. The potential adoptive mother would need to go through the usual channels of adoption - her attorney would need to contact the birth mother's agency, and go from there.
14. 

    Blood pressure monitoring during an induction

    RNLaborNurse4U replied to cgunkle's topic in Ob/Gyn

    With pitocin inductions, we take a BP with each dosage increase (depends on if it's "slow pit" or "rapid pit"). Rapid pit is Q15 min, slow pit is Q30 min. Maintaining the pit drip is BP Q30min.
15. 

    holding legs during pushing

    RNLaborNurse4U replied to mamawof2's topic in Ob/Gyn

    Those looky-loos in the room doing nothing to help mom out with her labor contractions -- guess what? They get put to work during pushing. They get to hold mom's legs!
16. 

    Straight cath or foley cath for labor patients??

    RNLaborNurse4U replied to shortstuff31117's topic in Ob/Gyn

    I can't find the study that shows an increased risk of UTI with the use of a foley, versus use of straight caths. I know I have that study printed out somewhere in this mess of an office/house!!! Anyway, the rationale for using intermittent caths after epidural placement is that there is less trauma to the urethra and bladder, and decreased exposure to bacteria and other organisms. If you have a foley in place, you have that constant irritation of the catheter tube in the urethra (creating micro tears, allowing organisms an entry port into the urinary tract and bloodstream). You also have that constant open port for organisms to travel up the foley catheter into the bladder, by having a continuous catheter in place.