LINUS

You're right. I'm talking about the suction catheter, not probably the type of deep suctioning they use in L&D. Sorry!

Thanks for the help. We have to do NRP every two years too, but I think we have to take a refresher course every year. I've already signed up for one, but it still scares me when the babies choke. I've deep suctioned twice (with a more seasoned nurse standing by my side. I'm just afraid of the vagal thing that I hear so much about. Does that really happen?

I know how to use the bulb syringe and I do teach parents how to use it as soon as they're admitted to my unit. My hesitation is when to use the wall suction to deep suction. I don't want to use it if it's not necessary because I've heard horror stories about how that can cause a baby to have a vagal response. That's what scares me. Also, I did take NRP when I first started on the floor, before I was a new grad, still in orientation, and I was so overloaded with so many things all at once. Since we never (knock on wood) have to resuscitate our babies, it's not always the first thing on my brain. I still new at this....

I've been working in a mother/baby unit for almost a year now. I love my job, but on occasion a baby in the nursery will start making choking sounds out of the blue (in their sleep sometimes). Usually turning them on their sides and patting their back will loosen whatever is caught and it comes up no problem. But, on rare occasions, the baby can't gt it up and they start arching their backs and turning blue in the face. Usually there is a seasoned nurse around that I can turn to for help, but it still scares the heck out of me and brings back a fear of going to work the next day. When this happens, I freeze and can't think of what I should do. Usually we can suction the baby and give it O2 and it's fine, but I'm worried about suctioning because I've never had to do it before. Any suggestions or helpful hints on clearing the baby's airway any easier??? We have bulb syringes in the cribs, but we've always been told NOT to use it down their throats, only in the mouth.

Not to sound harsh, but speaking for the other side, I work midnights and was working the night of a huge snowstorm (17 inches) and when I got off in the morning after working 12 hours, only two day nurses showed up for work, which meant we were required to stay until more staffing could come in. Most of us stayed until 11am, some later. Half of the day nurses that didn't show up called in before the snow even started falling. The other half didn't even attempt to drive it. Yeah, snow sucks and having kids at home sucks, but it also sucks to have to work for hours after your regularly scheduled shift because the next shift of nurses just didn't want to risk it.

I lived in Wilmington for five years while going to RN school. The big hospital there is New Hanover Regional Medical Center. It's a trauma hospital, so they get trauma cases flown in regularly. New Hanover also owns Cape Fear Hospital, which is on the other side of town. Cape Fear is known for their ortho unit, but they also have a small ER and med/surg. New Hanover has everything else, plus maternity. It's a very nice hospital to work for, but with a small town comes small town politics, so make sure you don't get on anyone's bad side. When I graduated in May 2003, the starting pay for new grads was $17.52/hour. I'm sure it's gone up since then. They have a good shift differential (20% for 7P-7A shift) and they also have a weekend shift differential, which I think is 15%. I ended up moving out of state after graduation, and have noticed a bigger increase in base pay in other areas, but with the shift differential and the beach nearby, it's worth it. I have a ton of friends who still work there and like it. They do hire new grads for L&D and Post Partum, which are on two different floors. They also have a GYN Med/Surg on the same floor as post partum, so you could be cross trained if you wanted. Otherwise, you just do mother/baby. There are other hospitals in the area-- Pender Memorial Hospital, which I think is now also part of New Hanover, Dosier Hospital (in Southport, an island south of Wilmington) and Brunswick Memorial Hospital, which is also south of Wilmington. Brunswick is probably the biggest of those three. Hope this helps! Oh yeah, the housing in Wilmington is reasonable, depending on where you live. Of course, if you live near the beach, it's more expensive, but live in town and you can find affordable housing or apartments. If you live in town, you're still only about a 10 minute drive to any of the beaches.

We aren't allowed to push supplementing with formula, but if a mother requests it, whether she's BF well or not, we will give her one. It's the mother's decision, not ours. If the baby is not BF well, and is jaundiced and under bili lights, the doctors will usually write an order to BF, pump, and supplement up to 30 cc's if needed-- they can use give the supplement via a bottle with a cross cut nipple, SNS (which is pretty useless unless you have a personal lactation consultant for each patient for every single feed) or syringe. I think it's the mother's choice and if she wants it, then give it to her. I have never seen a baby get nipple confused in my whole career.

I worked med/surg for a while in Charlotte and now work Mother/Baby in the midwest. I really like Mother/Baby and would love to do travel nursing but it doesn't seem like there's much need. I loved Wilmington, and even though one bitter charge nurse has the capability to screw me over, I still liked the hospital. All hospitals have problems. New Hanover isn't much different than any other hospital.

Starting pay for new grad nurses is $17.56 plus there is a 3p-11p shift differentials (15%), as well as a 7p-7a (20%) and weekend differential (I think it's 10%). The shift diff's make up for the low starting pay. Good luck! Hope that helps!

I went to nursing school in Wilmington and worked at New Hanover and Cape Fear (they're under the same umbrella-- New Hanover Health Network). It's a great hospital and I have a lot of friends that work there still. Wilmington is a booming town and nothing beats living at the beach, but the :) one thing I can say against it is, even though Wilmington is booming now, it's still "small town" and you piss one person off in the hospital and they can make it hell for you. That's what happened to me-- four years of perfect attendance and never being written up or verbally warned, and I pissed off one charge nurse my last year of school and somehow got blacklisted and was not able to get a job there when I graduated to save my life. Other than that, it's a great place to live and New Hanover is a great place to work. :)

I work in mother/baby now and am interested in travelling, but the websites I've looked at don't seem to have much need for this type of travelling nurse. Is there not much of a need for Mother/Baby travelling nurses? If so, what firms should I look at? Any suggestions?

I can totally feel for you! I worked med/surg for six months, then moved to a new hospital to work in PP. I feel likeI did when I started med/surg. I've been here a month and I still feel pretty overwhelmed. Assessments just drive me crazy. I finally can count apical pulses on the baby, but counting their respirations is hard, especially when you have mom/dad/family/etc. trying to talk to you at the same time. I don't have any kids myself, so this is all new to me. I still don't know what I'm actually looking at when I check their incisions (perineal incisions). I know what a hemorrhoid looks like, but stitches? I know they have them, but I don't really see them. I feel like a fish out of water here.... Any helpful hints from anyone on doing assessments? The people here don't listen to lungs or bowel sounds ever! How do other hospitals check their patients?

Oh great, if this doesn't work out, will I be totally unqualified for another job? I really think Mother/Baby is my calling. I hope I'm making the right decision!!

Well, after five months of feeling totally overwhelmed and uninterested in med/surg, I'm finally moving to a new hospital and to a new department-- mother/baby. I've always wanted to do this since nursing school, but thought I needed the med/surg experience first. I have learned so much in med/surg, but I am so happy to be going. I'll miss my friends there because they were such a friendly and helpful group of gals, but I can't wait to start this new job. I hope I like it! If not, then I'm just going to drop out of bedside care and go towards a pharmaceutical research company... Anyone out there that works in mother/baby have any good thoughts for me?

Med/Surg... I absolutely hate it! I'm a new grad, and I've only been doing it for five months, but that's five months of pure hell. I can't stand it. I've taken up smoking just for the mere fact that nothing else would calm my nerves before I go to work. I never wanted to work there in the first place, but the teachers at my school said it was the best place to start. Well, I started there, and it's making me rethink the whole nursing profession... I just took a job in mother/baby and will be starting in December. I hope I like it better!!

I've always thoguht of doing LTC, but then I heard that the ratios are 40 patients to one nurse, and it scared me to death. That just doesn't seem safe! I know you have CNA's to help, but where I've worked in the past, good CNA's are few and far between, which means the workload is even more chaotic.

I am a new grad and finishing the fourth month into my nursing career. I can honestly say I hate my job. I hate the chaos, I hate the stress, I hate crying the minute I walk into the door just because of sheer terror of what might happen during the next twelve hours. I hate that we get so many different conditions/diagnosis on our floor that I can't retain how to do anything or protocols for each patient. I've heard that people either love or hate med/surg, so I'm hoping that's all there is too it-- what I mean is, I hope all of nursing is not like this. I hope I didn't make the wrong decision when I went through nursing school. I just don't learn very well in such chaos. I'm one of those people that like monotony-- same thing over and over-- because then at least I can get a routine and feel confident. Right now I just feel very incompetent. I feel like a cop-out, but I'm ready to march into my manager's office and tell her it's just not working out and hoping she'll let me transfer, even though my six months isn't up yet. Does anyone have any suggestions as to what department I might be better suited for? I thought about OB or Post Partum. I did well in school there, and I'm totally fascinated by the whole process of pregnancy. I also thought about rehab. I just wonder if I'll be able to handle ANY type of nursing.

You have all been so great! Thank you so much for the helpful hints! I feel much better now.

I gave Dilantin IV to a patient the other day. He had D51/2NS going through his IV, and since Dilantin isn't compatible, I had to stop the IV and give the Dilantin through his saline well. I'm still a new grad in training, so I asked my preceptor how to administer it (I knew there were precautions, but not sure what) and she told me to just push it slow (150mg over three minutes). Well, after about two minutes and only 25mg given, the patient started howling and saying his whole hand was burning... If I run into this situation again, how should I administer it? What was I doing wrong? Thanks!

I'm thinking of transferring into OB or Post Partum. I had clinicals there in school and loved it, but really didn't do much but observe for three days. It was also my best subject in school. Can someone please tell me how their days go in that department? In medsurg we're constantly turning patients, changing linens for the incontinent ones, handing out meds, and changing dressings. I'm just wondering how a normal day goes in OB or Post Partum. I like the excitingness of L&D, but I also like the new mother teaching in Post Partum too. I can't decide...

Yeah, everyone did tell me to start there. THey did warn me that I'd probably hate it though. I think for some people who like the chaos, it's probably OK. But, for me, a choatic environment just adds to my stress. I learn better doing something over and over again. At least with OB or Post Partum, they're pretty much doing the same thing over and over. I know the delivery part can be very hectic though. I worked as a unit clerk at my old hospital and some nights was great, some were out of control. I expect that, but with med/surg, it seems like everything is ALWAYS out of control... maybe it's just me. Thanks for your input though!