L&Doldtimer

Been working nocs for almost 30yrs. now-less chiefs running around, after 9 or so usually less visitors, more independence. Best nurses work nocs! :) But gotta be able to sleep during the day-will NEVER work if ya can't. Positive attitude-sometimes at first it freaks ya out thinkin about bein' up all noc, but it really isn't that hard to adjust for most. Trouble is, it's really a "daytime" world for everyone else-once ya get them trained when and when not to call, etc. you can deal with it! Good luck to ya!

Do a rewrite on that paper stating what it REALLY says-"Dr. E doesn't give a _ _ _ _ about his pts or their babies, so if there are problems, remember-Dr. E's ego ALWAYS comes FIRST!

Never seen a cervix go from 5-6 back to 1.... Did you or the "seasoned RN" recheck the pt after the resident? I would trust a seasoned OB nurse before I would a resident! Don't know why it should make it any more difficult to deliver her lady partslly just becos she already had an epidural-just get her BOW ruptured, start the Pitocin and keep repositioning her, etc. (I take it she was being induced for a medical reason so sending her home was not an option?!)

Thanks...once had a doc tell me he almost always told his pts. they were farther along than they were the previous visit! Then they get to the hospital and we have to explain how one "goes backwards" in dilatation!!

Practice, practice, practice! And then you'll find a doctor's 4 is your 2!

I, too had a cerclage placed about the 15th wk of my pregnancy, but it was for cervical dilatation, not shortening. Does anyone else out there use the fetal fibronectin test for possible PTL threats? We have started using it-too early for me to evaluate... Connie

Shortened cervix as a diagnosis?? Are these pts. ones who previously had a preterm delivery? Noncompliant pts. that the docs want watched? I personally haven't heard that one yet, but it sounds a bit fishy to me...

Shannon, Sounds to me like you are in a much better situation at your present hospital-even sounds like if L&D didn't work out, you'd probably not have a problem going back to what yur presently doing (good NM support can make a WORLD of difference). I'd say give it another chance-I've been in the OB field for 29yrs and I wouldn't trade it for anything! It can be really rewarding, but it also takes time to get a "feel" for it (I'm talking about L&D here). Don't be so hard on yourself and ask lots of questions-get lots of experience-give it a couple of yrs. at least and then see if you don't feel different. L&D isn't something that's learned overnight and NOBODY is born with the knowledge! We all started out knowing almost nothing but textbook and we all know L&D is almost NEVER textbook! On a good unit, with supportive docs and a knowledgeable NM, you should do great! Good luck to you! Connie

Thanks for all the responses-wow, quite a diversity! Our hospital only does 50-70 dels. per month, so we are not staffed quite as well as most of you are-only have 21 nurses that work our unit, so 4 procedures before noon puts quite a strain on us. We all work all the areas, so L&D is not a separate entity, either (means that after 4:00pm the nurses are the ones answering all the call lights, the phones (our security system is set up to be answered by the phone also), etc. (no clerks or CNAs). Anyways, it was interesting hearing how other units work. Connie

Hello all-I would like to know what other L&D units out there do as far as the number of procedures (inductions and c/sections) they allow the docs to schedule per day... I have worked in one hospital where there was a schedule book that was kept and no more than 2 procedures were allowed to be scheduled per dayshift and two per nightshift-the docs would call from the office and the book was consulted as far as when and what and why. If we were busy, the inductions got postponed. The hospital I now work in, the docs schedule as many procedures as they want-never consulting the nurses as far as if the staffing is such that we can handle what they want to do. We had 2 c/sections, 1 version (that was pretty much guaranteed to be a section) and 1 induction scheduled the other day. Our usual staffing numbers can't handle that load and so they beg everyone to work extra, but I believe the situation is still unsafe for everyone. I think the procedures should be limited and we have discussed this at staff mtgs. and agreed that 2 per day should be our limit, but no one around there says "no" to any of the docs when it comes down to it. I think we should band together and not come in when they do things like that, but there are always those that come in anyway and so they get away with it. How do other units handle this problem? Any discussion on this issue? Connie

Elizabeth-Have you been to the forum at Delphi-"Traveling Nurses and Therapists"? It is all about traveling and most questions get answered by other travelers speaking from experience. Where are you working now? Where is it you wish to travel? They have great advice on the agencies, contracts, etc. on that forum. Connie

Hello-any nurses originally from Iowa who are now traveling? Would just like to chat about differences, etc. Want to travel but just can't seem to make the final committment. Labor and delivery is my specialty BTW. Connie

Wow! You measure their member? I can just see the arguments that would ensue at our hospital over that one! I think having them do the circs in the office would be great-that way the whole procedure, along with the tylenol we give before and 4 hrs after, wouldn't throw such a kink into the whole breast feeding process. Tough to get a baby awake sometimes afterward and if they were done later perhaps the breast feeding hurdle would be past. Connie

Crystal013, I agree with you for the most part, except for the epidural part-I take it you are not all for them...? Frankly, I think epidurals are comparable to sliced bread in OB. A comfortable, enjoyable birth experience-why not? What I DON'T agree with is, the patient getting her epidural and the nurse sitting at the central monitor, doing her charting or whatever else because now she isn't "bothered" by the patient anymore! I believe in actively turning your pt. every 20 minutes, side to side and letting her "labor down" so the pushing is not started too early resulting in loss of maternal push power at the end. I support whatever method my pt. wants to use for delivery, but I'm also the first to question their decision to rule out an epidural from the git go. I do get into conflicts with our docs over letting them labor down (I don't think they've even HEARD the words used before at our hospital) due to impatience and the belief that pushing has to start right away at 10 cms. If the woman is having a fast labor, that's one thing, but it tears at my heart to have my pt. progressing slowly when the pain is so great. Just MHO! Connie

I see this is old, but maybe we can start it up again... I am originally from Fort Madison, now across the river from Burlington in Illinois (FINALLY the road is open both ways across the river-that flood was something I'll not soon forget). Work at GRMC in West Burlington now-thinkin' bout traveling-was looking at L&D position in Cedar Rapids at Mercy-shoulda gone for it.... Ah well.... Connie