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rpbear

rpbear

L&D
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  1. rpbear

    Jobs in the Tacoma area

    My husband is being relocated to McChord AFB in June. I am an L&D nurse with over 5 years of L&D experience. I have looked at several hospital websites, but since I am not moving until June, I have not applied to any jobs. I understand that 8 hour shifts are the norm, is this correct? Any information would be helpful since I am just starting my search. I do not want to commute very far (30 minutes or so), and I am only looking for a per diem job. So where is a good place for me to work? Thanks in advance!
  2. It was not hard to start in L&D, it was what I wanted from the moment I started nursing school. I had 12 weeks of orientation on a very busy unit, it was more than enough orientation, but if you get hired on a smaller unit you may need more time on orientation, the unit I work on now the new grads get 16 weeks. I care for 1-2 labor patients at a time, depends on where they are in labor. There is no such thing as "typical" in L&D. Our nights vary from no patients at all, to all 13 rooms full, and someone delivering in triage. This has all happend in the last 3 weeks! Each unit is unique, the last hospital I work did 6000+ deliveries a year, the one I work now does about 1200+ a year, a big diffenrence in staffing and pt flow. If L&D is what you want then go for it!:spin:
  3. I think you will find that a lot of us did not start out on med/surg. I started on L&D, I love it! You have to find the right hospital that will hire new grads into something other than Med/surg. Good luck and follow your heart!!!
  4. rpbear

    Complementary Alternative Methods

    We have jetted tubs in each room, if the pt is able to ambulate then they are able to tub. There is a written policy about using the tub, we also have tub thermometers so the water doesn't get too hot. We have a waterproof doppler we use while in the tub. I have worked in another facility that did sterile water injection, they were done by the CNM only, we just assisted. They do sting really bad, but work well.
  5. rpbear

    restructuring the hospital into the Hilton

    I work in a hospital that has most of those services and although we don't have "visiting hours" we do have quiet hours, and we do ask our pt's and families to be respectful of others. We have couches and recliners for them to sleep in and I will bring them pillows and blankets, mostly because I want them to go to sleep! I like that they can order room service because then they don't ask me for food and drinks, they just pick up the phone and order whatever they want, pt's eat more because they pick what they want to eat. We have great security that will back us up with rude or disrespectful pt's and visitors. I also want to add that I love working at this facility, all the concerns that are being brought up are valid concerns, but it is not as bad as people are imagining it.
  6. rpbear

    What is considered a "busy" L&D unit?

    We get asked to float also, and everytime we ask them "Would you want to be floated to L&D?" The answer is always NO! wo we ask "then why do you think we would be comfortable floating to your floor?" They have stopped asking us to float! We will go and be "helping hands" which means we don't take a pt assignment we just help, that leaves us available to come back to L&D if needed.
  7. rpbear

    Intimidating Nursing Professor?

    Get used to that "grilling" because thats what pt's will do to you, they are always asking questions, and you must be confident and correct in your answers. Your teacher is not doing it to bug you she is trying to make you a better nurse. Embrace the challenge and rise to it!
  8. rpbear

    What is considered a "busy" L&D unit?

    I have worked on 2 L&D units, one did 600+ deliveries a month, the other does 100-150 deliveries a month. I feel 10X busier on the unit with less deliveries. We have less staff, we do overflow, we have AP's, we have PP's, we have way less rooms, so we are always doing the Pt. shuffle. "busy" is not about how many deliveries you do a month.
  9. rpbear

    I never imagined...

    I think every new person in L&D goes through the phase of having a "cloud" follow them. Your storm cloud will pass. In the meantime take each experience as a learning experience. I have been in L&D for 4 year, started as a new grad, and I still get freaked out! But, I have learned from each scarry experience and the next time it happens I am a little more prepared then the first time. On the other hand, if your issues are with dangerous staffing, horrible preceptors, or a unit that just doesn't support and help everyone out, then you might have to re-evaluate you work place and not the job itself. good luck and hang in there, it will get better!
  10. rpbear

    Going up against a doc...

    I liked the policy at one hospital I worked at, I order to call it failure to progress, they had to have an IUPC, the MVU's must be 180-200 for 2 hours with no change. I think this is a great way to trully say they are failure to progress. If the IUPC was placed and the MVU's were only 120, then you know that the contractions are not strong enough to produce change. Of course there are situations that this was not possible, but it took a lot of the questions out of the situation.
  11. rpbear

    Losing a Patient

    The first patient I lost was when I was a new grad on orientation to L&D. Nobody in L&D is suposed to die, it is the place for birth. A very young girl went into preterm labor before the baby was viable (23 weeks). The baby delivered, my preceptor and I dried it off and handed it to mom, he was breathing and trying to make noise. He lived for about 45 minutes, durring that time we took pictures, called the chaplin and helped in the blessing of this baby before he died. It was the hardest thing I ever did. I cried off and on for the rest of the shift. My preceptor told me that I did a great job and that the first is allways the hardest. I still cry everytime I have to care for a pt who loses thier baby. I don't dread these cases anymore, I know that these pt's need a differnt kind of care from me. As nurses we are trained to "fix" things, there are some things that you can't fix and you just have to help the family through it. It doesn't get easier, you just learn to do your job the best way you know how. This same girl came back 2 years later and had a healthy full term baby. :)
  12. rpbear

    Hypnobirthing?

    I have no problems taking care of well educated natural birthers or hypnobirthers. I say well educated because even though you don't want any interventions it is important to know what interventions might be needed and why they are needed. Durring labor is not the time to try to explain in great details these interventions and why they are needed (usually an emergency situation that requires quick action). So do some research about what interventions might be needed and why so that if they are needed you will know what to expect and understand why we are asking for these procedures. This will make your experience so much better for both you and your partner. Good luck and congrats!
  13. rpbear

    PBDS competency test for OB

    I took this test about 7 months ago. It was a little stressful. I think the best way to prepare is to start reviewing some basics and try to think like you did in nursing school. Basically you will be writing a care plan based on a certain situation. Think about what you would assess on the pt, what interventions and why and what your intended outcome will be. The most stessfull part fot me is that it was timed. I ended up running out of time on my last question but still did very well on it, the highest score my educator has seen so far. Try not to worry since it is not a pass/fail type test. Good luck!
  14. rpbear

    Longest you've had an AP pt on your unit?

    I remember a vasoprevia staying for 4 months I think. From the moment it was found until 37 weeks when she delivered via c-section. she had an INT at all times, and q 3 day blood draws for type and screen. She was a trooper, never once complaining. She left with a healthy baby.
  15. rpbear

    Oldest pregnant patient you have seen?

    My daughter is almost 11 and I cannot imagine her being pregnant. She has not even started puberty yet. I know some of the girls in her class are very developed, but that is still not right. Just imagine that 11 year old mom will only be 16 when her kid goes to kindergarten! The oldest I have seen is 52, the youngest 12 when she got pregnant, 13 at delivery.
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