RNBelle

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!

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.

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.

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.

Rarely does a c/s where I work have SCDs, no TEDS on either. Drives me bonkers.

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.

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.

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.

Welcome!

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.

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.

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.

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.

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.

For lack of better terms. The cervical opening (when closed) feels like a nub.

I got about 8 wks orientation to L&D so you are lucky. It will take atleast 6 months before you feel like you even have a clue and about a year until you fill comfortable. And you will always have questions and that is ok. Good luck!

We give everyone a 18g, unless they have tiny crappy veins then I will put in a 20g. We just switched over to nexiva IV catheters.....talk about a learning curve. The only ones who are doing good with those are the new grads because they don't know anything different.

One placed I worked it as advance as tolerated, I would start off with juice or broth, depending on what the pt wanted, then crackers, etc. Never saw anyone with problems. Where I work now it is clear for 24, then full liquid, then soft, then regular. I think it is cruel to make a person wait 2 full days before then can eat something with bulk and texture. I know I would eat my own arm if that happened to me.

We are a small unit but it is all encompassing - L&D, PP and nursery. We usually only have 2 RNs at night and then a couple of LVNs, no scrub tech. If there are no L&D pt's they will cut the LVNs and leave the RNs. If there is absolutely no one on the floor they will leave the 2 RNs to hang out and wait for someone to pop up. Every now and then one of the RNs calls out and then you have 1 RN and some laboring PTs, horribly unsafe and scary. So I think 2 RNs and a scrub tech is pure gold.

I say go for it. But you have to find a unit that is cool with having a male on it. I am pretty sure the unit I work on would not be able to handle a male RN. I am totally cool with having a male RN in L&D. I am actually cool with anyone who will come to work and work. Good help is hard to find and if you are up for the job that is more than half the battle.

Wow, sounds like it was pretty impressive and stressful. I don't have much OB experience but I had a pt one night where the FHR was making these huge arcs. Baseline 170s and then would arc and drop to 110 and back up again, very strange. Baby got tachy too up to the 220s prior to the arcs forming. Stressed me out for hours. I bugged the OB so much he finally came in, looked at the strip and then went home. Go figure.

We usually staff 2 RNs at night. Usually it is 1RN: 2 pts regardless of acuity. But we have been so busy lately it is just suck it up and deal with inductions, ob checks, observation pts and walk ins with no prenatal care.

I believe they use the 25mcg in the office. The PTs are to immeadiately come over to the hospital, but sometimes they decide to run errands and do not know the power of cytotec. Then by the time they get to us we are way behind the power curve as far as admitting them, etc.

It's ok what happened. I am still a very new L&D nurse - been doing it over a year now. But there are still moments with doctors, co-workers and PTs where I stop and kick myself and think "next time I will handle that differently". That is how we learn. Its not until you have those situations that catch you off guard where you figure it out. You learn where you draw your lines in the sand, you learn what battles you fight and ones you don't, you learn that you do have the "balls" to a doctor and tell him politely to leave your PT alone until you think the time is appropriate for whatever the intervention is.

We do not do our own c/s. The OR crew is called in for all c/s. The L&D nurse will be the one to catch the baby. The OR crew does their own circulating and recovery of the mom. We do not have the staff to do our own c/s at any time of the day.