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one of my biggest fear happened.. in need of some words of wisdom
No worries. I have done the opposite. Kept women who I thought were in labor only to leave work and return to find out they weren't in labor and the MD induced them just cause they were in the unit. GRRR!
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OB Rapid response team
I work in a 5 bed LDR unit with 11 PP beds. We staff 2 RNs and 2 LVNs at night. That would be the emergency response team. No one else in the hospital wants to come near our floor. We are very good at working together in bad situations. We do not have anesthesia in house 24/7. For a true stat c/s we have to get the OR crew there, CRNA and MD in less than 30 mins....not easy.
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Pit Inductions---How much do you increase?
Our orders are 3mus q 15-20 mins but I follow the national recommended standards of starting at 1-2mu's and increasing 1-2 q 30 mins. If you have access to any perinatal journals you will find articles stating that. Remember you are the one playing with the pit, not the dr. If he wants to push the limits he can come do it himself. Thats why I love working night shift. The docs aren't there to bug me on how I am running my pit.
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Narcan administration in newborns
Did mom get a narcotic within an hour prior to delivery? If she did and your baby is kind of "poopy" then you can rationalize that it is from the narcotic and you can give him the narcan. Now if mom has had a completely natural childbirth with no medication interventions you may have to assume something else. Remember to follow your NRP guidelines and call for help if you need it.
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Increasing maternal death rates - news story
Rarely does a c/s where I work have SCDs, no TEDS on either. Drives me bonkers.
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Finding the right words...
P.S. parents are going to do what they want to do with their kid. Sometimes there is nothing you can say or do to educate them regardless of their decision. I just know what my own opinions are and keep it to myself. And if the baby ends up in the NICU because they won't feed it and sugars are dropping then so be it.
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Finding the right words...
Nothing allowed but breastfeeding for that baby. PT ed consisted of all the normal stuff, of the couple of nurses working we would take turns going in to assess mom and baby and see if she wanted a bottle, etc. But nope. It all ended ok though with baby finally latching on. It was just gut wrenching for me having to listen to the poor little guy cry for hours.
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Do you have a baby nurse at delivery?
Just curious as to how other hospitals staff their deliveries? Do you always have a pedi present? NICU staff? Where I work we just have another RN or LVN run in to catch the baby and do the initial weight, vs, etc. We are a very small unit. I have been there well over a year now and I did my first delivery with a pedi in the room (thick mec) the other night.
- Hello! New here....
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Finding the right words...
I had a mom who let her baby scream for 15hrs straight because he wouldn't latch and she wanted to breastfeed only. I really wanted to run in there and shove a bottle in his mouth but I just sat at the desk (after pt education of course). Our pedis don't care if the baby doesnt eat for up to 24 hrs and blood sugars were ok, but still...... Eventually the baby latched on but I think making the kid wait 15 hrs after delivery for nourishment is cruel.
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oral fluids in labor
only 30 ml?! geez. But we allow only ice chips. As longs as your pts have iv's and are getting iv fluids that should hydrate them even though they might be craving something to drink.
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Vaginal Breech
Only our old school docs know how to delivery breech and will only do so if we can't get them back in time for a c/s.
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Curious about PP Methergine use
We have a very old school doc who schedules it for all his vag deliveries, I can't remember if he writes for 3 doses or 6 total. I usually do not give it to my pts, I discuss it with them, assess their bleeding and let them tell me they don't want it so I can chart refused by pt.
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L&D charge nurses required to have patients
Where I work we do about 80-90 deliveries a month. Charge always has a pt load. Espcially because they usually only schedule 2 RNs at night.
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Cervical exam/bimanual exam question
For lack of better terms. The cervical opening (when closed) feels like a nub.