jhhrn68

I got into maternity nursing after I burned out in another area. I spent 28 years in long term care so I went from one end of the spectrum to the other. L&D can be very stressful, not unlike the ER. I think I kind of thrive on the stress. On our unit, we also do post-partum and newborn nursery. We have not ever developed the couplet thing, although it has been tried. MB couplet care works best if you don't have a nursery. I think our biggest problem is that we have too many nurses who have worked way too many years on the unit and are used to having all the babies in the nursery, especially at night. Night shift can be hard. When I was younger, I couldn't tolerate the nights. Now, at my advanced age, I find it much easier. Maybe I don't need as much sleep as I used to. If you don't mind the stress, day shift on the L&D might be the thing for you. You will learn something new every day. It will probably be feast or famine. As for staffing, our unit is very well staffed. Not having enough nurses is rarely ever a problem. You need to know how many active laboring patients you might be expected to care for. You can't be helping 2 mothers push at the same time. We have also had nurses leave L&D in a hurry when they find out what it involves. Things can happen in a hurry there. You can go from no patients to several in a matter of minutes. If you think you are the type that will like this kind of activity, then I would say go for the L&D on the day shift.

Our unit is combined L&D, PP and nursery. Everyone is cross-trained and I started in L&D. That is still my favorite place to be but sometimes PP is a nice break from the chaos that L&D can be. Good luck with getting into L&D.

Our moms stay 2 hours after the doc is finished doing whatever he is doing - like stitching. The baby stays with mom for about an hour then goes to the nursery where they do all the other measurements, give Vit. K, Hep B and do a gestational age assessment. Once the baby goes to the nursery, then we get the mom up as soon as the epidural has worn off, pull the epidural catheter, d/c the IV, assist her with peri care and sometimes let her take a shower. Our PP unit also has showers down the hall rather than private ones.

To the tune of Jungle Bells: Dashing room to room checking vital signs cervix getting thin visitors walking in ha ha ha Phone it keeps ringing MD checking in I need a drink or a break right now My nerves are getting thin Cervix closed She's a prime The father she can't name Oh what fun it is to be In L&D today Dashing room to room Checking epi drips Pee is on the floor I hope nobody slips - Ha Ha Ha Birthday chimes they ring Making spirits bright Oh what fun it is to be In L&D at night! Refrain: Metadone, she is stoned Baby's on the way Oh what fun it is to be In the labor suite today :chuckle

If you give a patient an injection against their wishes, you can be charged with battery so I would assume the same would hold true for IV access.

Most newborns are not at risk for contracting Hep B as they are not having sex or using IV drugs. I think it is recommended because they are a captive audience, so to speak. If the mother is HbsAg postive, then that is a different story. Otherwise, there is probably no good reason for vaccinating newborns for Hep B.

We only got busy again this past week, before that, things were really slow.

We have no openings on our unit and haven't had any for some time. I work casual labor and am not getting many hours on OB and now cannot get a regular part-time job. So I pick up some hours on med-surg and rehab. I think there are just fewer maternity units. A lot of hospitals are shutting theirs down and those nurses have experience and are looking at other places. So there is a lot of competition for those OB jobs.

We do not float off our OB unit. I am a casual nurse so I sometimes volunteer on other units, but it has nothing to do with working on my unit and I don't do both on the same day. But we have had MRSA mothers on our unit and last week, we had a pt. with C.diff. She had developed an ileus after a c-section and c.diff after a week on antibiotics. But she had diarrhea for three days before anyone thought to send a stool for c diff toxin. She was hysterical when we told her she could not go home and she had to be in isolation.

After reading this thread, I think I am going to propose self scheduling, or at least a little more input from the staff about the schedule. I know we always have to have someone working that can scrub and someone that can circulate and someone that can be the charge nurse. But we are all intelligent adults who work well together, usually. right now the scheduling is in the hands of one person.

When I was pregnant with my first, no one was doing routine US. But many people had little ways of predicting the sex of the baby and everyone was predicting boy. Just before delivery, I was given general anesthesia and my husband was not in the delivery room when our daughter was born. The doctor walks out with the baby to show my husband, who took one look and said "That's not mine. We're having a boy".

We admit for ROM. For contractions, we have a 2 hour protocol. We monitor, check the cervix and then re-check in 2 hours. If no cervical change, then pt. can go home without being seen by doc. Sometimes the doc will want us to keep the pt. overnight - still as an outpatient - and he will see them in the AM.

I have to agree with a previous poster - it depends more on the doctor than the nurse. You should be good with a midwife, though. We see very few natural births where I work and that is because we don't have any MD's who are supportive of natural birth. Just be sure you are well educated and you and your SO go to LaMaze classes. It is really important to be prepared! I had my second child at home with a midwife and it was an awesome experience. I wouldn't trade it for anything.

Nurses on our OB unit are not floated to any other unit. Of course, if the census is low, we may be told to stay home. I work med-surg sometimes for extra money but only when I am not scheduled on OB. On OB, we have to change into scrubs at work and wear shoes that have never been anywhere else. I would hate to leave the med-surg floor and go to OB without changing clothes.

I am not a big proponent of early vaccines for infants. Their immune systems are not that well developed. The only reason to give Hep B to newborns is that they are a captive audience. Breast feeding will protect the little ones from many diseases through immunity in the mother's milk. If only more people would breast feed.......