L&DRN2008

I work at a small, rural hospital that does about 350 births/year. I recently started working there and am concerned about staffing. I often come in the morning and there has been only one nurse who worked the 7pm-7am shift (or the two scheduled nurses split the shift 6 hrs each). We don't use nursing assistants or any support personnel. There is no unit secretary either. They technically "staff" two nurses per shift, but one of the nurses is usually put on call at home and either comes in if a delivery is likely or splits the shift with the other rn. At this hospital anesthesia is also not in house on the off shift! I feel as though I am setting myself up for disaster by working here. I don't have a ton of experience either. At this point, I feel like I would be better off driving the hour to the closest large city to work where they staff using AWHONN guidelines! Thoughts? My family thinks I should talk to the mgr and see if they are open to change, but I find it hard to believe that over the years no one has ever brought this up!

The pt was being induced for absent end diastolic flow and sga. Her doctor did check her this morning and confirmed she was one. The resident ruptured her and placed an iupc after her exam of 1cm. The pt didn't even need pit because she was contracting on her own every 1.5-2.5 mins and had adequate mvu's. Honestly, I don't know what we were feeling during our check that we thought she was 5-6! To both of us she felt stretchy. I haven't done tons of vag exams, but I have usually been right on or off by 1cm from what my co-worker thought. The nurse that checked behind me has been on the floor for a year and said she was confident with her exams. We had 3 deliveries going on at the time, so the resident couldn't check her right then. The other rn and I thought for sure she was in transition with her shaking and vomiting!

I had a pt who was a G2 P0 receiving cytotec overnight. Pt rec'd nubain at midnight around 4am was crying in pain, shaking and throwing up. Resident said to check pt and call her for an order for pain meds. I checked the pt. thought she was 5 and had another nurse check behind me because I am new and still not 100% comfortable with exams. She called her 6. Resident ok's order for an epidural, pt gets the epidural and is able to sleep. Resident comes in an hour later checks pt and says she is 1!!! Pt's dr comes in and finds out she is 1cm and pitches a fit in front of the pt and her mother and tells her it will be very difficult for her to deliver vag because she got the epidural so early! I was furious! I have had docs order an epidural on a pt who was ft because they were a "hard exam" Any thoughts?

mom2michael, When are you planning to start? What degree will you do through Frontier? I have been thinking about Women's Health, but I need to have 1 year of work experience before I can apply to the program.

There is a "sticky" on the top of the ob/gyn message board page that lists awhonn's recommendations for staffing different types of pts, stages of labor etc. I have a friend who said she wished she had asked because the facility she used to work at had horrible staffing practices and she ended up leaving.

I am interviewing for a position at a different hospital and was wondering what type of questions I should ask to get a good feel for how the unit operates? I am planning to ask if they follow awhonn staffing guidelines. My interview is tomorrow!

I worked as a tech (I teched on a different floor and contacted the mgr on L&D) and was then hired as a grad nurse right out of school. I will tell you that it is difficult to right out of school! There is a HUGE learning curve and being a new rn made that learning curve even bigger! Having a good preceptor will make all of the difference in the world.

I would recommend using the Saunders book as well. I don't see how anyone could have taken the test in 20 minutes because there were 160 or so questions! I think the test was fairly hard and I am an A/B+ student.

I am a GN who will be starting my orientation soon. I have worked mother/baby as a nurse tech (contingent) for five months. I was informed that my orientation will be 10 weeks long. The orientation includes: high risk, l&d, OR and mother/baby (minimal since I already have some experience). I am completely freaking out over this! I know if they don't feel that I am ready at 10 weeks they can extend it a little, but there is a lot of pressure being put on the new grads because they need the staff! This is at a very busy urban hospital that has 4000+ births/year.