momma/babyrn

Thanks for all the input about homebirthing. I was wondering also about how CNM's measure bilirubins in the home setting... or is that even done? Do the moms just take baby to the Ped the next day or so? Also, does anyone know if fetal monitoring is done during labor at home? :)

I have a few friends who've decided to have homebirths. I'm curious about this seemingly growing trend. I'd love to hear some opinions from those who've done it, participated in it, and delivered some of these babies at home. TIA!! :redpinkhe

:loveya: thanks all for the help!! I am feeling better now w/ the different ideas a sheets that have been offered. This was an amazing help to keep me more organized!!!

I was wondering if anyone is willing to share their sheet for taking report on mother/baby pts. I'm struggling w/ keeping everything organized on my paper. It's hard for me to see what I need to do next such as what labs need to be drawn, when to do the PKU, when to do the TCB... maybe this will just come quicker w/ time but I'm wondering if I'd be faster w/ determining these things if my sheet looked more organized. Any suggestions? Thanks in advance!! :heartbeat

I like it a lot so far. I can't wait to get really efficient and quick with things though. I still feel slow even though my preceptor tells me I'm doing great after day 3 -which was today for me. Where I work we do all computer charting. I like this method b/c it's fast but I'm still getting used to which order to do things and what comes next. I'm not crazy about the current sheet I take my notes on for my patients. It's just not clicking with me so far. I think it's just a matter of getting used to. Everything else is great. We had a fresh s/p c/s today who was having some issues w/ bleeding. We spent a lot of time w/ her and were massaging her fundus all afternoon. The MD didn't order Methergine but told us to just continue w/ the massaging and watch her. Her BP and HR stayed WNL thankfully. loving my job so far. :)

So, I just finished my first two days of orientation on mother/baby. For the most part I love it. My preceptor is really nice and so are all my coworkers. My only concern is that I noticed my preceptor seems to have lost that passion that I feel she should probably have. All I kept thinking as I watched her race from one task to the next was that I hope I never become like her. (that sounds horrible since she's such a nice person!) What I mean is that I observed that she just went from one baby check to the next without the tenderness and sweetness that I would think you would want to have with a newborn. Don't get me wrong, she was gentle with the babies but just quick in everything she did. It bothered me that she nonchalantly threw her papers at the foot of the inside of the bassinet, talked loudly and quickly to new parents, didn't seem to really be listening to their concerns b/c she was always in a hurry, and only spent 5 minutes with breastfeeding teaching today and none yesterday. Eventually the mom she tried to teach bf to, decided it was too difficult and went to the bottle. .. .. .I don't know, maybe I'm being too "sensitive" since I'm a newbie to this area. I just think more time should have been spent w/ the patients, but I could be totally off my rocker. All in all, I love my new job so far. I just know that when I'm out on my own I don't want to become calloused towards my line of work b/c when it gets to that point, I need to get out.

** Update ** Hi all! Just finished two days of orientation on the unit. Turns out I was able to pump in the lactation consultants' office. They were very kind and of course, supportive, of me pumping to keep up my supply so I used my lunch break to take care of business. It worked very well to just pump that once and then as soon as I got home I fed the baby and pumped any extra after he was done. On a side note, after spending my first two days out on the floor and watching the struggle some moms have with breastfeeding, I realize how blessed I am that it came so easy for me and both my babies. Watching other mom's try so hard and then not succeed makes me want to keep nursing all the more. Hopefully my good experience will be of some benefit to me in helping others. thanks again to all who replied. - Beth. :heartbeat

Hi, I'm going out to my car to pump b/c I'm still on hospital orientation and haven't started my preceptorship on the unit yet. When I start on the unit this week and get familiar with the people and where things are, I'm sure I'll find a room or place to pump inside. :)

Thanks to all for the input. I've been in orientation all week and found that during my lunch break I could go out to my car to pump just once during the day. I'd just sit there in the parking lot with my AC on and the front windshield shade up as well as a blanket over the driver's side window where I was sitting. Worked great for my first week of hospital orientation. I start on the unit this Friday so I plan to keep the same schedule of planning to pump just once during my lunch break. I don't want to be one of those who leaves for a break and all my coworkers are having to cover for me. That is understandably unfair. I'll just see how it goes day to day. There may be some days where I can actually pump twice during my 12 hr shift but I'll plan for just once. I'll be back to let you know how things go. thanks again!! :heartbeat

Thanks everyone for your replies. I'll let you know how it goes. I imagine that with how busy things get, I'll only be pumping during my lunch break. ... just a feeling I have. I don't want to deal with bad attitudes from colleagues about taking breaks to do this so if it's during my lunch break maybe they'll be okay with it. Thankfully it's only 3 out of the 7 days a week. Maybe my supply won't be too vastly depleted.

I'm about to start orientation this week for my new job in mother/baby. I have a 3 month old who I'm exclusively breastfeeding. My question is how will my need to take a break to pump during my 12 hr shift be perceived? I know that sounds weird since I'll be working on a unit that promotes breastfeeding but I was wondering if I should anticipate receiving any negative vibes from coworkers since I'll be using my break time to pump. Anyone else have experience with this? Thanks in advance!!

thanks for the reply. It's not regarding a current patient. I had this experience in the past when I floated to a PP unit from med/surg and was concerned about lowgrade temp for the mother but it turned out not to be a big deal. I was just wondering if that was common or if my concern was warranted. thank you again!

Is it normal for a PP mother to run a lowgrade temp in the 48 hrs after delivery? If so, at what point would the OB want to medicate? I'm just curious b/c I'm so used to medicating medical patients on the floor w/ Tylenol for anything above 101.0. Do the OB's usually have a standing Tylenol order so they wouldn't have to be called in the middle of the night? :redpinkhe

On the topic of newborns in distress, I have a personal scenario that occured with my newborn a few months ago and was wondering if anyone had some input on it. I nursed him within one hour of delivery and after that he was wisked away for his bath and other things. I received him again at change of shift which was about 3 hours later and he was lethargic and difficult for me to arouse. After taking his cap off him and unswaddling him he still didn't wake up enough to nurse. The newborn nursery nurse came in and began vigorously wiping his face with a wet wipe. I knew she was doing this for his own good and even though she didn't tell me, I'm guessing she was worried about his blood sugar running low. Well, the vigorous wiping of the face and entire head continued for 5 minutes or more. At times she seemed to cover his nose for too long.... at least in my opinion. Watching this whole thing was really upsetting for me and it was all I could do not to take my baby from her. I was wondering if this is pretty common to almost "rough up" a baby in a sense to get him awake enough to get that colostrum in him. This nurse was really rough!!

Thanks all for the newborn s/s distress. I was wondering what a normal set of newborn vitals would be. Especially resp. I'm sure all that will be covered once I get started but I was just curious if anyone had those values memorized off hand.