babynurse357

I know mandatory overtime has been discussed numerous times. I've found plenty of cons about it but no benefits to it. I'm working on a project for my RN-BSN program regarding mandatory OT and I need to list both pros and cons. The only thing I can come up with is from a financial standpoint a facility probably saves more by paying OT than they would providing benefits for additional FTE's. Anybody have any other insight for me? Thanks!

Well as of right now we do staff 1:1 with our labor pts. It was just that somebody brought up staffing guidelines the other day and I'm a little concerned that when we do start having more babies he'll hold us to to 1:2 without central monitoring.

I agree with HeartsOpenWide. In early labor when they have pit already going and start coupling I turn it up as coupling is a dysfunctional pattern.

Approaching the board is out of the question because our OB/GYN is the head of the board. It's a new physician owned facility and he hates central monitoring. He wants the nurses at the bedside and says with central monitoring nurses spend too much time at the desk. It's expensive I know but cheaper than a lawsuit in my opinion.

I've looked on AWHONN's site and can't find any recommendation about staffing when you don't have central monitoring. I've been a labor nurse for 6 years and I've always worked in a facility with central monitoring and the place I am working at now doesn't have it. We deliver about 20 babies a month give or a take a few. A few labor nurses (myself included) are concerned about the safety of having 2 pts on continuous EFM without central monitoring. Most of our pts end up with pitocin during their labor either for induction or augmentation. Then there are a few nurses who think it's no big deal to have 2 inductions at the same time. I've done 2 labors at once but never without central monitoring. Can anyone shed some light on this? Is the AWHONN guideline the same regardless of whether or not central monitoring is available? Pitocin is a high risk drug and 2 inductions per nurse without central monitoring seems very unsafe. Thanks!

Yes the baby is in an open crib and she has the light practically resting on the top of the crib. I do think we have a meter just haven't ever messed with it because I've never needed to with these lights. What's the recommended reading with the bili-meter to be in the right range?

What is the distance the Olympic Bili-lite (the overhead light with like 6 or 8 bulbs) should be from a baby? We are having major disagreements about this at work and don't have the manual. The unit was a used one purchased from a small hospital that no longer does babies. I'm thinking it's like 18-20 inches and another nurse has the light like right on top of the crib which I think will burn the baby. Thanks!

Can somebody tell me the correct distance to have the Olympic Bili-lite (the old one on a blue stand with casters) should be from the baby? Our hospital just bought a used one without a manual and there is some major disagreements about the proper distance. I think it's like 18-20 inches but one of our "seasoned" nurses swears it's only like 20cm and has the light practically on top of the crib. I'm afraid she's going to burn the baby this way. Please help if anyone uses this type of light. Thanks!

Shoulder dystocia is my greatest fear because you never know when it will happen and how bad it will be. We had a t/f in with dystocia, the head was delivered and all attempts and maneuvers they tried to deliver the rest of the baby failed. They put her in an ambulance with the head left out. Needless to say the baby was already dead when they arrived. It's totally a personal choice and I respect that, just wouldn't be my preference.

I think I heard my best/dumbest one yet the other night. A laboring pt's sig other says "too bad you couldn't be like my aunt, she had my cousin an hour after she went into labor." No bid deal I thought until he added "but he came out really fast because he had a cleft palate, that helped" I had to pick my jaw up off the floor then turn around so I wouldn't laugh. Some people shouldn't be allowed to have kids lol.

Let me clarify myself. I was referring to hospital based birthing centers. If there even was one around where I live I'd consider one. Simply saying delivering at home wouldn't be my preference. Kudos to those that do, I've just seen too many deliveries that would have been really bad if they had happened at home.

I'm all for birthing centers that are more like home and use midwives. I'm totally not into delivering at home. Too many things can go wrong-not that they do very often, I just would rather not risk it. Many birth centers with MWs still do intermittent monitoring, etc. A "controlled" environment would be best for me but everyone is different.

That's just dumb that she's angry with you for having the pt push! She should be thankful that you tried the other interventions but had the common sense to know that this baby didn't like where it was at and need to come out. Good judgement call. Doc or no doc you had a healthy baby! Oh, and I definitely would NOT sign that paper. You'd be in big trouble if you had a bad outcome because you wouldn't let a pt push.

Points off for tone and breathing movement. He claims her strip was nonreactive but at 31 weeks looked fine to me. Intermittent minimal variability, but also average at times, 10 X 10 accels, no epidsodic decels even with occasional ctx. What more could you ask for at 31 weeks? She came for decreased fetal movement, also states she hadn't eaten anything but breakfast and it's now almost 8 pm. DUH-feed and hydrate her! I brought this to his attention but he didn't care. He already had his panties in a twist because I wouldn't start the pit. (and yes I was patting myself on the back when I heard she was sent home the next morning and everything was fine-she didn't need to be t/f'd in the first place!)

Definitely ok to cry, it shows that you care. I've had several demises and cried almost every time. A while back I had a mom come in to deliver her 1st baby-not a demise but her husband was in a very tragic (and very preventable) accident just 6 weeks prior. He was killed instantly. Her mom was with her and she had an 8x10 wedding picture in the window (they had just gotten married within the last year). I tried so hard at first not to cry because the pt had requested to her doc that nobody talk about it. After she started pushing I couldn't help it, she was crying and frustrated and sad and excited, as was her mom. How can you not be emotional too? These are the moments that pull at our heart strings and I think God makes our assignments those days. Like it or not, he picks the best nurse for that particular pt and whether you realize it or not at the time you will always have a special place in that family's heart for sharing that memory with them.