MalgaBSN

Exactly.

i looked into the who recommendations a little further and they came up with the average of 3 minutes as about when the cord stops pulsing. in my practice i have seen various lengths for the cord to stop pulsating.

there is nothing in your birth plan thats unreasonable and, in fact, these requests should be the norm whether a mother has a baby in a hospital, birth center, or at home. i disagree with most responses that racingmom4 provided-- not evidence-based.

Exactly. Just let me add that this is a possibility, people can have that care and you can be involved in it. Its called out-of-hospital birth ! Anyhow, I am also a new grad and when directly into L&D because my goal is to get my midwifery degree eventually. So, I have lots in common with Alisha and CrunchyLaborRN. Here is the deal-- don't change your mind based on the sad realities of hospital nursing, just take it all in as a learning experience. And to keep your sanity and view of normal birth intact take call at a free-standing birth center or work with a homebirth CNM if you can find one in your area. Thats what I did during nursing school and still do now occassionally. Its such a great reality check to how care can be. And just try to give the best care you can in your hospital work.

On our unit our patient satisfaction scores usually come back very low (press-ganey surveys). What are others experiences with patient satisfaction scores? My manager always ask why we think this is the case and it seems that no one has a response-- my only suggestion is that we are always staffed minimally (in my opinion) so if one labor patient walks through the door and stays we have to shift around all the staff or try to call someone in. I'm sure that patients "feel" that we are busy. Also, on postpartum I feel like a run my butt off and don't really have time to spend with the patients. I also think that a lot of the nurses are really damn lazy and do the minimal work (I just started doing PP and I get statements from patients like "I wish you were our nurse the whole time, we never saw our last nurse" etc) Thoughts?

Anyone else had experience with OBs saying "I'm going to check this patient now and in an hour and if there is no change we are sectioning her," and then wondering about the doc lying? I was in this situation the other day and it put me in a horrible spot and when I mentioned it to another nurse I work with she said that at least two of the OBs she knows does that to get someone sectioned when they want to get outta there :angryfire. I am relatively new (new grad-- 8 months in L&D on a unit that does about 1200 births a year) and I don't feel completely secure in my cervical checks all the time. I feel like if I did-- if I had been there longer, I could have felt confident in standing up to this doc more. As another nurse said "you would be blacklisted," but I don't care-- I'm not there to work in the docs best interest, but its such a hard situation.

I'm in the midwest, sadly, I bet our rate is closer to 98%.

I would suggest buying a good OB reference guide like the AWHONN perinatal nursing book (you can order it from their website). I would also suggest becoming a member of AWHONN because thats our specialties professional organization and they will send you journals, etc to keep you up to date. Look up common drugs used in OB (there is a thread already about that somewhere). I got a little notebook I could keep in my pocket to jot down tips to remember and keep a list of things you come across that you want to look up when you get home. You will constantly see new things-- I try to look up something everyday (I started in L&D as a new grad about 8 months ago.) Do you have any other specific questions?

Wildchipmunk~ We do have one of the highest newborn mortality rates in the INDUSTRIALIZED WORLD. In the studies that this information is coming from they are looking at LBW and premature births and comparing our rate to other industrialized nations and we are 25th on the list, right above Latvia. So, that information is correct: Download The State of the World's Mothers from this page (it takes just a couple minutes) and then check out page 42 on the US having a higher death rate than most other industrialized nations: http://www.savethechildren.org/campaigns/state-of-the-worlds-mothers-report/2007/ Its a real realty check.

Beckinben~ I agree. Maybe the inductions are just mostly for control on timing? Most inductions end the day they are scheduled or a c/sec is done around 5 anyway?! And induction schedules where I work are really crazy right before Christmas, Holidays, vacations, etc.

Anyone seen this yet or going to see it? Thoughts? Heres a trailer if you don't know much about it: http://www.thebusinessofbeingborn.com/

I agree with both of you. As nurses, we should be happy to support our patients in the decisions they make-- especially when the decisions they make are actually better for them and their baby! I mean-- thats a no brainer! We should be excited someone doesn't want an epidural because epidurals add risk. I think in OB sometimes we forget that we are supposed to be PATIENT ADVOCATES, not doctor, hospital, policy advocates-- yes we have to work within those constrants, but our ultimate responsibilty is to our patients.

Thats basically how it is for me too. I have to pick up two 4 hour shifts to be on-call every two weeks. I also get a couple bucks an hour to be on-call and if you get called in you get time and a half pay.

The ultimate OB nursing book-- evidence based and covers all perinatal nursing: http://www.awhonn.org/awhonn/product.detail.do?productCode=LPN-3 I have it and it is so helpful.

Sometimes there are positions that are internships in OB-- that would be a good place to start. Otherwise, get a job in a hospital with an OB unit that you want to work in and then transfer from within when an opportunity arises (better odds-- most hospitals hire from within first). You may have to take a crappy shift/hours. While you are waiting do some self study on Perinatal nursing, join AWHONN, and take some contiuing ed in perinatal areas because that will help to show your interest on your resume. Maybe get your certified lactation couselor training done (good healthy children CLC to find more). You may get into mother-baby first and then work your way to L&D.