ScubaLvr

This drives me nuts.... the falling on BC is against my religion!! If I remember my Catholic roots correctly.... so is Premarital Sex!!

I'm from SoCal. If you tell which specific hospitals I could give you a better idea. I'm not sure I'd take anything less than about $38 to $40 US plus housing for your specialty. It's pretty expensive around here.

Where I work, we recently transitioned from using foleys right after an epidural to only straight caths. The OBs are adamant about it. They refuse to order it and we took it off our standard orders sheet. I guess evidence based "stuff" apparently shows more infections with foleys and now with Medicare refusing to pay for hospital accuired UTIs..... there you go!!!

Wow...You guys have me feeling very defensive now so forgive my tone. OK Note to self .... NEVER post at the end of a bad day!! Yes, I did mean EPHEDRINE. And I suppose I thought the IV was too obvious to mention... oh wait I did. She had 1400cc in in the 40 minutes we were waiting for anesthesia to show up in the first place. This place has in house anesthesia from 7am-3pm only after that we are on our own with no orders for anything. And YES...I ARGUE with the anesthesiologist... these Docs expect that after they have mixed up God-only-knows-what(because I'm NOT an anesthesia provider) combo of meds to prime, hook-up to the catheter, and start the EPIDURAL infusion. This I will continue to absolutely refuse to do. The very next day I had another doc prime, hook-up, and even load the pump but did not start it. Go figure. I've been in L&D for 17 years... I don't think Mom's BP tanking 20-60 minutes after an epidural is all that unusual. Thankfully the kidlettes usually do OK but, when they don't, I sure would like to be able to do more than O2 and squeeze the IV bag. This particular mom had NOTHING else wrong with her...but that was the longest 10min. of my life. I know I won't make any friends here refusing to start epidural infusions... the regular staff here doesn't seem to mind(I'm a traveller) I WON'T. OH-- another funny thing they do... they insist on continuous cardiac monitoring during epidural infusion... I'M THE ONLY RN THAT HAS ACLS!! What good is the strip if no one can read it??? I would however like to get them standing orders for ephedrine. Does anyone know whether that just requires sitting down with anesthesia and getting them to agree to standing orders or changing entire hospital policies??

OK, my first day at a new hospital, not only do I have to argue with the anesthesiologist that I will NOT start the continuous infusion but, 25 minutes later mom's BP tanks to 75/40 and FHT to 45 bpm and all I can do is start O2 and squeeze the LR bag because they don't have standing orders for epi.!!!! Oh and yeah, Anesthesia is in his car and 15 minutes away already but, OB is there ready to cut her. Can anyone share with me your policies on RNs giving epinephrine? I'd like to get this going on our unit. Any ideas?? What do we need? Just a standing order from Anesthesia? Do we need policies, too? What's the process? Thanks.

I just left Hoag Hosp. L&D recently. It's a wonderful place to be a new grad, and they are hiring. The unit is "just" busy enough and "just" high risk enough to get an excellent learning experience WITHOUT pulling your hair out. Too much anyway! The docs are mostly really great. Ratio's 1:1 most of the time. You'll see and do everything. The nurses are great! I returned to L&D there after about 8 years away - everyone was really patient catching me up on all the new stuff. PM me if you'd like me to review your resume....or just talk more about Hoag, PP vs. L&D, etc. I can give you contacts etc. You are obviously very intelligent and well spoken. You'll do well.