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janelrn specializes in OB; NBN; SCN.

janelrn's Latest Activity

  1. janelrn

    The film: Vaxxed.

    I think that the people who gravitate to these hypes are either: 1. Conspiracy theorist who believe that anything mainstream must be bad and controlled by "them".... I could explore why they are this way, but I think the movie A Beautiful Mind does it better... LOL 2. Cannot accept that there are "things" that happen to children that are bad that do not have a blamable cause. If something is wrong with a child, someone must be responsible. It is easier for them to accept this and spend endless time and energy calling everyone to arms against the "enemy" than to try to cope with not knowing what caused the "bad thing". The child was "perfect", someone did something to change this. Unfortunately, in the rush to protect children without problems, many turn to the anti-vaxx campaign as a mystical cure against the evils of modernization. Because children never had autism, diabetes, or cancer before we vaccinated.... They fail to realize that there was a huge child mortality problem, from these problems and from the diseases we vaccinate against. It is sad, but until their child contracts one of these diseases, they will not see and believe anything that takes away from their "magic protection" that they have in place for their child. And the rest of society pays the price...
  2. janelrn

    When you stop mag.....

    Does anyone have references for best practices that direct nursing care following the d/c of mag, for pre-term labor, or for seizure prevention? Trying to guide practice for that magical 24 hour mark. What monitoring (if any) is needed following d/c'ing mag....
  3. Our Nurse Residency program has our New Grads in orientation for a total of 22 weeks, which includes their first week of hospital orientation and multiple dates of didactic and simulation education sessions to enhance their critical thinking and knowledge base.
  4. janelrn

    The best ways for a new grad to get in L&D???

    As an experienced ("seasoned") L&D nurse, and now a Nurse Educator, let me tell you that your enthusiasm and strategies to prepare yourself to be the best OB nurse ever is wonderful. Now for the part you don't want to hear. Don't go straight into OB. Learn how to be a nurse first. Nursing school is sort of like Driver's Ed. It doesn't teach you how to be a nurse, but gives you the base information to start learning. Spend a year on a med-surg floor learning how to manage a patient load, time management, and picking up on the subtleties of changes in your patients' condition. Then, you will be ready to transfer to a specialty area, ready to concentrate on learning L&D / OB / etc. Otherwise, it would be like leaving Driver's Ed and getting behind the wheel for the first time for in the Indy 500.
  5. janelrn

    EFM tracing predictive of CPD

    Ok, so we all know that early decels at 4 cm can definitely be associated with CPD, but I have a question about another indication. I have heard, at some conference at some point in time, that contractions that are asymmetrically skewed to the left is also associated with CPD. I cannot, however, find any reference or source for this information.
  6. janelrn

    amnioinfusion contraindications

    OK, I'm trying to wrap my head around this and find documentation to back up our thoughts. If amnioinfusion can put a laboring woman at risk for uterine rupture, and tachysystole can increase risk for uterine rupture, wouldn't it make sense for tachysystole to be a contraindication for amnioinfusion??? We recently had an incident where this was called into question. Any thoughts, or better yet, anyone know of references to support this??
  7. I work in a hospital that has 2 sections of L&D (sortof). Side A is a 7 room LDRP only section. The rooms are arranged so that there is a small supply room between 2 rooms (think 2 bedrooms sharing a closet with a supply pyxis). Side B has 4 LDRs, plus 12 high-risk antepartum/labor rooms, 4 delivery/OR suites, and a 2 bed C-section/BTL PACU. Within the Women's division there is also a NBN/convalescent nursery and an antepartum/postpartum/GYN floor. We average 300-350 deliveries a month. Patients that meet LDRP admission criteria are given the choice (as available) of which type of rooming arrangement they would prefer. I work primarily on Side A and love it :heartbeat. I personally love caring for my patients from the time they come in to the time they go home. I love that the relationship that was developed through labor and strengthened with delivery is not "back to square one" with having my patient need to now form a relationship with a new nurse while also exploring the new dynamics of her family . Yes, noise can be a factor, but surprisingly rarely is. A baby who is crying all night because they have finished the "sleepy phase" is more disruptive. The factor that is more of a problem is when you have a mom that has labored all night, delivered during the day, then the first postpartum night is so exhausted that caring for the baby is pushing her past her limit . Having the nursing and family support is so important to make the mother/baby concept work. When our staffing is within target (4 nurses on side A), a typical assignment is a mix of m/b couplet and a labor. Ideal is to have the Charge nurse with a stable couplet, then each nurse has a higher acuity and a lower acuity patient. The CN can then step in to assist when care for one of your two patients makes it that you cannot be there for your other patient's needs. Of course, we all know that this is not always possible . It is the goal. But even when you cannot be in with your couplet as much as you need with 2 patients (or 3 couplets), is that any different than a m/b unit where 1:3-4 couplets is the norm? Hope this helps :typing! Janel
  8. janelrn

    Intradermal water injections for labor?

    Heck that works just as often as Nubain & Stadol (which seem to be the only 2 meds our docs seem to know how to order).
  9. janelrn

    Intradermal water injections for labor?

    From everything I've read, it's sort of like mag, no one really knows. One theory is accupressure, another has to do with the Gate theory.
  10. janelrn

    Intradermal water injections for labor?

    I will check the guidelines, have that book at work. Do you happen to have a policy? I'd love something to look at for an idea of what to draft and present for approval.
  11. janelrn

    Dealing with nasty OB

    We had an MD who was famous for being nasty if you woke him up. As a night nurse, and a patient advocate, I had to call him many times. For a while I just ignored his attitude and called anyway (I've got teenagers, he didn't scare me). Finally, one night after placing a cervidil, he asked if I needed anything (other orders, etc), I replied that I would just call him, demonstrating by holding a phone receiver at arms length. He just looked at me, then profusely appologized if he ever came across as rude. I made a deal with him, I'd only call him if I needed him, and he'd sign any reasonable order that I wrote. We went over a few things, and have never had a problem since. The joke broke the ice far better than if I "bit back". Don't lower yourself to his standards, be professional, but stick up for yourself. You shouldn't have to work with anyone who can't be professional. Also, does your Manager back you up, can she advocate for you? Use your resources!
  12. janelrn

    Hold that Push!

    Definately send that on to someone in risk management, or corporate compliance. You may endanger your job, but your other choice is to endanger your license and more importantly, the lives of your patients. Dr. E obviously isn't doing what she's doing because she cares about her patients. For your Manager not to go to bat for you and your patients is appalling!
  13. Hey there, I'm looking for information from anyone where intradermal sterile water injections for back pain in labor are actually done. It's one of those things that I only can find it in the research things here in eastern NC. The first thing I need is info: who is qualified to do these? what does a typical policy look like? that sort of thing. Thanks!

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