Heather A.

I recently changed hospitals and am now working at a facility that is LDRP, rather than just L&D which is what I am used to. Our dept. is also classified as a Level 2 nursery; we generally keep 34 weeks and up, CPAP for 24 hours. Anything more critical we stabilize, vent, place UAC/UVC, ect. then ship. All nurses are expected to be able to function in all of the areas, including special care nsy. I was wondering how your facilities managed to crosstrain the OB nurses in all of the areas. I have not had any training in special care nsy., my background is strictly L&D. I am very concerned that we will have one of these early or very sick babies delivered on my shift, there will be no one else working that has experience, and I won't know how to assist with stabilizing these babies but still be held liable. How do your facilities crosstrain and what are their expectations? Also- any ideas on what I could do independently to prepare would be greatly appreciated. Thanks!

Quick question- Just wondering if any of you guys currently use the computer charting system Cerner? If not, do you use another computer charting system? I ask because we are going live with Cerner in March- and the L&D nurses are going crazy because the amount of "forms" that needed to be completed in Cerner are 3X what we were doing on paper. I fear the patient will be delivered by the time we have their admit orders enetered into the computer! Anyone have any thoughts on this, or experience with Cerner in L&D? Please tell me it gets better- any hints greatly appreciated. The crazy thing is that we also have Watchchild which we use to monitor baby and record BP's on, but we will have to manually enter the info. into Cerner from Watchchild because it doesn't correlate. That means 2 computers in each room! Yikes- I fear I will have no time for the patient coaching/ care that I love! Help........ Heather A.

Hi everybody, just wanted to give a little update. Thinkgs are going well at work; the doctor involved has been wonderful to me, he has even requested that I take care of his patients when at all possible. He has been kinder to me than I would have ever expected, and I feel stronger and strangely enough, everyone's support has made me feel like a better nurse. My nurse manager had a "staffing crisis" the other day, someone was out sick and she desperately needed someone to come in and work. She called me, and I went in to work. she was very appreciative. One thing that I didn't mention in my original post is that my NM is also new, she's been in that role for 1 year. I told her that I approaced the physician in person and apologized and she was ASTONISHED. She couldn't believe that I did that and she hasn't made any other mention of him being upset with me. There is a lot that I don't know because this is my first job as a nurse, but I am beginning to wonder if my unit is adequately staffed. I just moved to day shift 2 weeks ago, and it seems like there isn't a day that goes by that we aren't completely swamped. Somedays it is difficult to get a bathroom break, much less lunch. The atmosphere is always HURRIED. This does not in any way explain/ excuse what I did; I take complete responsibility for my actions and it will never happen again. It has just got me to wondering if this is acceptable/ normal on an L&D unit. ChaosNurse- I just wanted to add that you are completely correct. I should have marched my behind right into my NM's office that very day and spoke with her. Actually, it should have never been an issue because I should have called the MD back into the OR right then; that is what I will do in the future. One thing you might find interesting, however, is that my NM waited an additional 24 hours after I reported the incident before she nofified the MD or proceeded with an x-ray. I think maybe she didn't know the proper way to proceed. As far as what being a Christian has to do with any of this, it is everything. My faith affects every part of life. I think we all answer to a higher authority and the fact that I failed Him is what tore me up inside. My faith in God is what should always guide my decisions, and I obviously failed this test. My foremost responsibility is to my patients and my Heavenly Father; I have never seen that more clearly than I do now. Thanks again to everyone. I feel I have supportive friends here.

Hi everybody! Just wanted to let you all know that I am doing better. I went back to work on Saturday, and my very first day I ran right into the doc. involved in this situation. I could not wait to speak with him, I just had to apologize in person. As he started to leave the unit, I followed him and asked if I could speak to him privately. I admitted my mistake to him, apologized, and told him it would never happen again. He amazed me by saying he forgave me; he was so kind. He said he was very touched by my honesty and ability to come forward to my boss, and said I was the very kind of nurse he wanted to take care of his patients!! I couldn't believe it. He said he appreciated me apologizing to him in person and having the courage to approach him about it. Later that day, I had to go back to the OR to scrub in and assist with him on a C/S! He was so wonderful to me. I will always remember the way he handled this situation. My nurse manager has not mentioned it to me again; I still feel ashamed when I am around her, but I am holding my head high and just absolutely doing my very best as a nurse. Our God is so good; he is always there for us. I feel like he handled this entire situation for me and gave me peace. Once again, thanks so much to everyone who responded. Your help and support means so much. Thank you!

All I can say right now is thank you all so very much. I can't stop my tears as I am reading each of your responses. You've never even met me, yet you have helped me more that you will ever know. I have just felt so ashamed; I was almost too afraid to post this on the board because I was terrified of what everyone would think of me. I return to work tomorrow and I do feel a little stronger now thanks to all of you. Please keep me in your prayers as I face this challenge head on. I have asked my heavenly Father to forgive me; He is the only one who truly matters. Sometimes the hardest thing is forgiving ourselves I guess. Thank you all so much. I will treasure, and reread, each and every reply many times.

Thank you so much to both of you for your replies. I needed to hear them. I was questioning my ability as a nurse and a person. Thanks for listening and responding. I appreciate it.

As I am writing this I am completely distraught so if this doesn't make sense, I apologize in advance. I am a new nurse (my 1 year anniversary is this month) and I have been working in L&D for my whole 1 year career as a nurse. Up until today, I have felt like I was a good nurse. There are many times when I still feel unsure and lost, but I feel like I am learning a lot and that I take good care of my pts. I love my job as an L&D nurse, I feel that over the past few months I have earned the respect of the physicians I work with and the management. I have had numerous patients make positive comments about me on surveys, and even had the highest number of positive comments this past quarter for our entire dept. All of this is well and good, but fast forward to the events of a day ago. I was working on what was an extremely busy day in our unit. I offered to watch another nurse's patient for a few minutes while she did a delivery on another pt. While I was looking out for this pt., the MD came in and decided to do a C/S on her, right then, for failure to progress. I went back to circulate the case and handed off report on my other patient to another nurse. The whole scenario was a big mess, a big HURRIED mess because the MD wanted to hurry up and finish the C/S before the next scheduled C/S was due. The case was proceeding well, I performed my counts before the case started, upon closure of the uterus, and upon closure of the peritoneum. All were correct. Just before the doc closed the skin, I performed my last sharp/ sponge count. I counted 10 laps in the kick bucket, 3 on the table, and what I thought at that moment was 2 on the pt. That makes 15. The case ended, and I proceeded to gather washclothes, ect. to clean up the pt. and hurry on to the recovery room. When I approached the drape covering the pt., at this time I only saw 1 lap, not 2. I froze. I KNOW beyond a shadow of a doubt that I should have stopped right then, went and got the doc, and redone the lap count. But I was scared. Scared and intimidated, afraid to inconvenience everyone because they were in a hurry, and just plain spineless. I hate myself for this, but I didn't say anything at that time. I knew, logically, that all the laps had to be there because my first 2 counts were absolutely correct. I am such an idiot; I took that pt. to the recovery room and didn't say a word. It ate me alive. I couldn't sleep last night, I can't eat, I just cry. This AM when I woke up I couldn't stand it. I phoned my nurse manager and told her the entire story. She was very upset with me; I deserve that. But THANK GOD she did say she would talk to the doc. and do an X-ray to make sure. She did say that there was really no where the lap could have got off to since the first 2 counts were correct, but she was quite cold. She just called me back and THANK THE LORD there was no laps inside. I am so glad and relieved because I was so worried about the poor pt. I could never live with myself if my lack of courage had caused her pain or worse. My nurse manager was still very cold to me, she proceeded to tell me that I would be written up and that the doc. on the case was furious with me. She said to expect that he might say something to me. I am so scared. I have never been written up in my life, and I feel so horrible and dirty. I thought I was a good nurse, and also a decent person, but now I feel like a nothing. I don't know if I can walk back into that unit again. How could I do something so horrible? I know that I did the right thing by calling my manager, but I sure don't feel like it. I did the right thing, but just too late. I hate myself right now. I am a Christian and I feel like I have high moral standards, I just don't see how I could have messed up this way. Is it hopeless, should I find another job? I am so afraid. Thanks for reading this. I know it was long, I just had to tell somebody and I feel like I don't have anybody.

I'm a new nurse as well who has had major issues starting my IV's. Something my preceptor pointed out to me that has helped me IMMENSELY: insert my needle a little slower and watch for my flash. My preceptor noticed that I was inserting so quickly that by the time I noticed my flash, I was all the way through the vein and had blown it! I go in right on top of the vein at about a 30-45 degree angle just a little bit and wait/watch for my flash. If I don't get one, I advance a bit farther and watch for my flash. After I get a flash, I immediately stop advancing, drop my angle, and advance the needle just a bit farther. Then i thread my catheter. So far, this has been working well for me.

Thanks so much for those of you who responded. That makes me feel better. Smilingblueyes- I am learning how to scrub in. I will spend 2-3 weeks orienting to scrubbing, then I will start training to circulate. YIKES! Just say a prayer that this goes smoothly. Thanks Heather

Hi everybody, I have a question I hope someone can help me with. I am a new nurse, I've been training in L&D for about 7 weeks now. Up to this point I've been strictly orienting with laboring patients; however, next week I will start learning to scrub in on c-sections and I am TERRIFIED! I was wondering if anyone has any hints on how to remember the names of all these instruments that look alike to me!! Any helpful hints on learning how to scrub? Any ideas would be greatly appreciated. Thanks so much!! Heather

Hang in there and keep calling them. I am also in Georgia- I know what you're going through. You will get your info. I would call them every couple of days until I found out what was going on- you usually talk to a different representative each time you phone. You will get to take the test!!! I called Pearson today and I am testing on June 30. I could have tested sooner but chose to wait until the 30th. So there are still times in June. Hang in there- I will pray for you.

Hi RN-to-Be- Just wanted to let you know that you are not alone in your waiting. I have been calling Pearson & my state Board the past few weeks because I have not received my ATT either, even though most of my classmates have. I strongly urge you to contact your State board as soon as possible. I finally found out that my state board had already declared me eligible to test, but for some reason, Pearson hadn't received the info. My state board had to declare me eligible again (last Thursday), and I just received my ATT through my e-mail as I am typing this!!!! So contact your state board- they might need to declare you eligible again. I am going to get off this computer and schedule my test!!! Good luck to everyone-