RAIZIE

We are about to get the Baxter smart pumps house-wide but I didn't think they had smart syringe pumps. We are looking for a syringe pump for SCN and Peds because that's how our pharmacy prepares the meds. Can you clarify please exactly what pump you are using? And, BTW, I believe you are 100% correct about liability if one bypasses the guardrail system.

We are just starting to research "smart" syringe pumps for our SCN and Peds units. Can you share what pumps you are using please? And how they are working out for you? Thanks!

Hi- Trying to "benchmark"....... If you use IV stadol in labor, what is the usual order for dose and frequency on your unit?

Hmmm - and I thought cold stress was BAD for infants! Now they are saying the cold kept her alive?

Thanks so much - you have given me a good view into faculty life. I'll let you know what happens tomorrow - & I'm SURE there will be more questions!

Looks like my questions are on track for the most part, but the "team teaching" concept is a new one for me. Definitely something to ask! What I know so far is that I would be lecturing 3 hours a week and have 2 clinical days. I assume it is 2 different groups of students. In addition are office hours (3 scheduled, 3 by appointment) and I'd need to be available for "meetings". That's about all I know. I definitely plan to ask about orientation/mentorship as "I know what I don't know." What is your experience with control over your schedule from semester to semester? Do you have input into your lecture hours and your clinical sites? (One of the things that appeals to me about this program is that most of their sites are Magnet hospitals- exciting because I have been working in a smaller community hospital.) And, of course, I'll need info on salary and benefits. (My current ones are rather excellent.) BTW, what courses do you teach? Strictly OB or any other areas?

I am master's prepared and have spent almost 19 years as a CNS in MCH. I was a clinical adjunct in a community college program while attending grad school and am eager to return to nursing education at the BSN level, but...... Assuming they offer me the job (interview is Friday) they would want me to give my notice and start teaching several weeks into the spring semester. I would have to do all my lecture prep as I go while doing clinicals and everything else. I don't know if that would be realistic or if I'd be setting myself up for failure. My strong preference would be to start in the fall, resign my current job before the summer and have several months to prepare lectures etc. From those of you who are doing this, how many hours a week does one actually put in as full-time faculty? I am also interested in any input as to important questions I should be asking at the interview. (I have a whole list but want to make sure I've thought of all the important stuff) Thanks!

I'm so happy to have found this Forum!! I will be interviewed later this week for a FT faculty position in a BSN program. When I sent my resume in mid-Dec I was thinking Fall 2008 would be realistic though the ad was for a Spring opening - but the Dean I spoke with is definitely talking Spring. I would need to give 4-5 weeks notice at to my current hospital employer - and I have obviously not had any time to prepare. Is Spring truly a realistic consideration? Also, any tips for my interview?

Thanks everybody for your replies! This is more confusing than I thought it would be. I will need to check with the NY BON as there seem to be different policies by state. I do want to clarify however that the major issue that AWHONN has is about the management of epidurals when there is a fetus involved. I don't think it is even controversial for RN's to manage epidural infusions on med/surg. I believe that is done all the time. (This is apart from the issue of removing the catheters which is what my question was about........There is no way we are managing the infusions!!)

FYI: AWHONN's Position Statement is that no one other than a licensed anesthesia provider should be bolusing epidurals or adjusting infusion rates.

Hi All. AWHONN position statement says that RN's can remove epidural catheters "if educational criteria have been met". I would like to know: 1- Do L&D nurses at your facility remove epidural catheters? 2- If so, what were the "educational criteria"? Who developed/conducted the educational program? How is competency validated? 3- How does your facility define "readily available" anesthesia care when regional analgesia/anesthesia is administered? Is anesthesia available in house any time any epidural is in use (even if they are not in house 24/7) to back nursing up in case of any epidural issues? Thanks in advance for your input!

Hi All- Question for you! In NY State, do LPN notes etc require RN co-signature? What is the practice in YOUR hospital? Also, what are the PRACTICAL differences in what RN's and LPN's do where you work?

Thanks, Karen, for yet another reference!

OK - here I go. Please, nobody be offended by what I am about to say. It is SO important in nursing that we practice evidence based care, when it exists. Thank you to the person who asked for a reference. I used these, and others, in writing my hospital's policy - which goes to committee today. AWHONN. (2001) Perinatal Nursing (2nd Ed). Mechanical methods of cervical ripening. Pp335-336. Karjane, N. W., Brock, E.L., and Walsh, S. W. (2006). Induction of labor using a foley balloon, with and without extra-amniotic saline infusion. Obstetrics and Gynecology There is a lot of opinion and misinformation that sometimes appears on these threads. I believe it is important to differentiate opinion from evidence when practicing/teaching etc. A couple of examples: according to the literature, the foley balloon DOES ripen the cervix through mechanical pressure and release of prostaglandins. The change in Bishop scores is measurable. It is used to increase the effectiveness of a pitocin induction (unless mom spontaneously goes into labor!) so it does not follow to say, if you're going to use pit, why bother with a foley. Also, most of the literature indicates that this is NOT a painful procedure (unless mom spontaneously goes into labor!). I hope you get my point. Anyway, I can only encourage us, as professionals, to review the literature when a new practice is proposed - Cochrane data base can be VERY helpful. If you are a staff nurse and don't have the time, ask your CNS or educator to review the new practice. And when something new is introduced, it may be important to do some type of performance improvement monitoring for a while to make sure the new policy is being followed and that it achieves the outcomes we anticipated. I'll get off my soapbox now. Have a great day everyone. Raizie

Excuse me......supine is the position mom should NOT be in due to risk of hypotension.

This is really interesting - I had no idea this thread was still active as I haven't gotten an e-mail about new responses since 2/14! I have skimmed all your messages and will have a response for you soon. Raizie

Yet another example of how the "same" labor process varies infinitely from woman to woman - and from pregnancy to pregnancy! Can't get bored, even after 30+ years!!

Thanks for sharing your experience! Those WERE long labors! Enjoy those "fruits of your labor"! Another thing that interests me is that my sister (also an L&D nurse) says they used the foley balloons at her hospital for a while and then stopped. She doesn't know why - just that they're using cytotec and cervidil now.....anyone else start, then stop, using balloon inductions?

So, the plot thickens. May I ask the 2 last posters the reasons for their inductions (by the midwives)? Granted, the foley balloon is non-pharmacologic and does not seem to cause hyperstimulation / fetal distress. But I am still concerned about whether this will make for even more elective inductions,,,, Your labor was really short for a primip, BouBou. what happened to you CEG?

Thanks for your responses. It's so interesting how all 3 of you do things slightly differently. Saline infusion vs. traction; monitoring/no monitoring; followed by AROM vs. pit.; I am currently writing the policy for my hospital and have seen so many variations in the literature. The most recent studies have pit infusing concurrently with the Foley balloon.....with or without the saline infusion; no traction because it is hard to quantify etc! Next question: are midwives inserting the catheters or just docs? And are nurses inflating the balloon or is that done by the person inserting the Foley?

Anyone out there have a policy/protocol to share?

How many of you are required to be ACLS certified to work on L&D? Is the course a worthwhile investment? If your OB nurses are NOT ACLS, what are your standards for recovery of C/S patients? Thank you for your input.

Ok - OB nurses everywhere- Are you ACLS certified? Are you doing cardiac arrythmia monitoring on all post-op patients?

Just found this thread while browsing. I have been a CNS in Maternal-Child Health (mostly OB but inherited Peds a couple of years ago) for 16+ years. I work in a small community hospital, primarily low risk. As far as education, I have a Master's in Nursing, specialty certification in Inpatient OB. The traditional CNS role incorporates education, consultation, clinical practice and nursing research. Some roles (not mine) also have a management component. I am a childbirth educator, teach fetal monitoring, neonatal resuscitation etc. I am involved in new staff orientation, competency assessment, development & validation, writing evidence based standards of care and protocols, etc etc. I am called to consult on complicated patient care issues. Also, I am involved with CNS's in other specialty areas as part of nursing leadership. Hope that helps.

I am also interested in exploring Nursing Esthetics. Any info would be appreciated....especially as it might apply in NY State - I live about 25 miles north of NYC. Thanks!