jenny456

Hi Everybody, This morning I went to a site called PDR.net (Physicians Desk Reference on-line). I was flabbergasted to see that in order to use the professional portion of the website you had to be a "medical professional"--all others are sent to a general site. Here is what they feel constitutes a medical professonal: physician resident nurse practioner CNM clincal nurse specialist nurse anesthetist P.A. dentist medical student optometrist Excuse me, when is a RN not a medical professional? I am denied membership because I am a registered nurse. At the bottom of the page I clicked on Thompson Reuters who publishes and sponsors this site and wrote a complaint email. Aren't we the ones who administer medications and have to know the side effects and risks to our patients? Although there are other sources for medication information, this is suposedly the most comprehensive. In my opinion, this organization subtly undermines and devalues registered nurses. If you are as appalled as me, go to the site and email them. I just did.

Hi Sorry to hear about your troubles. Definitely take the one-week Kaplan review course. Without it, I never would have passed. It does an awesome job of preparing you. Also, remember, do not read too much into each test question. My nursing instructors always said "if you could do only one thing for the patient, which choice would be the best (of the choices listed)"? That advice helped me so much.

Dear Cutiedear-- Hi, I am an L&D nurse and I have been a NICU nurse and have done some motherbaby. After working in med-surg, you would love mother-baby. It would seem like a vacation--almost no meds to give out compared to med-surg. People are young and healthy (generally) and the babies are so cute. L&D is a lot of work, and depending on your unit, can be non-stop running around and emergencies--you also have to circulate in the OR. Many days I can not get to the bathroom when I need to or eat. I also have a health condition that is aggravated by the stresses of 12-hour shifts so I am interviewing for a home health position. Maybe you could consider that? Go to the home health specialty board to read up on that. Take care

Hi-- Does anyone have any opinion about VMT school in Washington DC? I have not read good things about them. Thank you, jenny456

HI, I'll try to answer some of your questions. I am currently not working while I recover from illness, but I was an L&D nurse at a high volume, high risk L & D. We delivered about 5000 babies a year and rarely accepted anyone less than 20 weeks. lady partsl checks were done by the nurses. For someone 34 weeks or ealier, lady partsl checks were done on admission by the nurse (only if the patient is really contracting away or complaining of abdominal pain.) If the patient is there for some other reason--such as high BP or illness, usually a sonogram was done which will reveal any possible dilation and cervical thinning. Doctors would sometimes do a speculum exam to peek in there, but most often, we nurses had to do a gentle vag exam (only if it was warrented). Overall, lady partsl exams were kept to a minimum anyway and is some special cases (buldging membranes), speculum exams replaced lady partsl exams. Just as I left the facility, we were being trained to do speculum exams ourselves and to collect fluids around the cervix for testing. We nurses already frequently did nitrazine tests for rupture of memebranes, but the doctors were responsible for interpreting the fern test. We always had anesthesia 24/7 and could also call a second anesthesiologist in if necessary from another part of the hospital. Personally, I would never work anywhere where there is not 24/7 anesthesia--too dangerous. Also, there is always an OB 24/7 called a "OB hospitalist" who covered other doctors until they arrived. Doctors from the various practices that delivered at our hospital took turns being the hospitalist. Hope this helps some. Maybe contact AWHONN and see what they have to say about this.

Sorry you had such a bad experience! It sound like you did the right things. The person at fault here (bedsides the ignorant father) is the pediatrician who gave the order to keep the baby--he/she should have initated a dialogue with the family directly and explained what is the problem and why--not just dump it on the nurse. Families naturally would be upset and would like to ask the doctor questions. We as nurses must insist that the doctor contact the family immediately. I would bring this up with your nurse manager and see if a policy could be put in place about that. Take care :)

The L&D I worked at previously tried to require nurses to wear eye protection and did provide eye shields, but almost no one liked them and so the hospital gave up on trying to enforce the issue. I believe that if nurses don't want to wear protection, they should be required to sign a waver form from the hospital and assume all potential risks. For me, I have never had any fluid go in my eyes. I have had fluid go down my leg, which no available protection would have prevented. The greater risk to us are needle sticks--which has happened to me when the inconsiderate doctors have left needles on the field after stitching a perineum. If you want protection, you should buy the "goggles" at the uniform store or nursing supply. You can at least see better through those.

ooops--typo--"immediately"--sorry!

I would IMEDIATELY contact the board of nursing for your state AND The Joint Commision on Accreditation of Healthcare Organizations (JCAHO). Hospitals are terrified of JCAHO. My hospital almost lost its accreditation because of a tragic patient death that was highly publicized in the media. The pressure was so great on my facility to change " its evil ways" that it resulted in many firings of problem management, nurse patient ratios were lowered, and the hourly wage dramatically went up. Many new policies were put into place to protect nurses and patients. Do you have a union?

Would any certified nurse-midwives out there be able to comment on how your practice works in terms of office hours, on-call hours, etc.. and whether you are able to have somewhat of a sane life? I am interested in possible becoming a CNM but I have heard so many bad things--that it is one of the worst nursing areas for having any normalcy or family life. This kind of depresses me--and makes me think I should consider other advanced degrees. I believe that balance is the key to happiness and that is the lesson I have been working on for a few years! However, as a L&D nurse, I love women and babies!!

Shift change reports were always a problem in my unit. My feeling is that it is the hospital's responsibility to provide a private area/report room for reports. We usually did change of shift at the nurse's station--but people could walk by there at any time. Then we we told to do it in the patient's room--well that is not feasible since there are often visitors there, or the patient is trying to rest. It can also be a source of anxiety for the patient to hear about themselves and their medical complications. Also, there are times when it is necessary to warn the oncoming nurse of problems--such as if the patient is abusive, etc...and I don't think stating that in front of the patient will go over real well. In any case, we never did resolve the issue of where to give report.

Hi, Sorry you are having such a bad time! I know many people who chose their major in college based up how soon they could get out and how much money they would get (they generally had many regrets later). Everyone I know, regardless of their degree, has changed careers fields eventually anyway. You need to follow your heart, and everything will fall into place. If you are crying all the time and needing medication to get through the day, your soul is screaming "no to nursing"--and you should listen. The stress is not necessarily going to be less when you work as a nurse, it is actually more sometimes. Do yourself a favor and take time off to figure out what you are good at, what you love, and how to honor your intution to make better choices. Enlist the help of a career counselor. Maybe you need to work for a while until you know what you want to do. Good luck :)

Congratulations! You need to tell your supervisor immediately that you are pregnant. Otherwise you are putting your baby at risk by taking assignments that are not safe or appropriate for a prenant nurse. I worked in L&D but my friend worked in ICU and had 3 pregnancies while there. They were very good about giving her assignments that were safe. You sure don't want to be left to move a heavy patient, or be given one that is highly infectious, etc... If you had an office job, you could keep the pregnancy a secret, but in nursing things are different because of the inherent risks.

Hi, The easiest thing would be to work straight weekends, or do what I did and work 7p-7a 3 times per week. Your husband can be home with the kids in the evening and night. Then please send them to daycare in the a.m. so you can sleep! You can pick them up in the late afternoon or have your husband pick them up on his way home from work. Best wishes!

Mindy, Your story really moved me. You are exactly what patients need, what the field of nursing needs. You will be a wonderful nurse. I believe that that young man's spirit is grateful for your loving care. When it is my time to die, I hope I have a nurse like you.

Here's my tip-- Have a cup of coffee at 0300-0400! I'm not kidding you. Without that, I could not function past 0500 and probably would have driven into a tree on my my home at 0730. By the time you get to bed, most of the caffeine should be worn off. When I used to work 7p-7a, I made sure to have high protein snacks through out the night. which keeps the brain awake. I also always carried mint or cinnamon gum and would chew that when I felt sleepy--it really works! Good Luck!

Hello, If I were in your shoes, I would get the education done first!!! You are still very young "obstetrically" speaking and the demands of getting a degree while having a baby to take care of are tremendous--you will feel pulled in every direction and chronically exhausted. When I decided to change careers and go to nursing school, I had a 12-month old, and 3 other children under the age of 7. I was in an accelerated BSN program that lasted 16-months and while I managed to hold it together and get good grades, I feel like I lost that time with my children and the baby, I was often a basket case, and I wish I could have done it differently. My 4 kids knew their babysitter better than me! I missed many of the "firsts" that moms cherish with their babies... Don't fall into the trap that you have to have everything at once, or that you must be superwoman. Also, what you may not have considered is that you mentioned a finance--you did not say when you are getting married. There is a necessary adjustment time of several years when you get married that makes for a solid foundation in marriage. Getting married, having a baby right away, and pursuing a demanding degree is a recipe for trouble. You can have it all--just don't do it all at one time. When my parents married, I was born 9 months and 4 days later and then my brother arrived 19 months later. My parents divorced after 5 years of marriage. They said they never had the chance to know each other first as partners. Being married is diferent than living together. My husband and I have been married for 24 years. We dated for three years before marrying. Even though we thought we knew each other and we loved each other dearly, there was often tension and arguing the first year as we adjusted to each other. Things settled in place after the first year and we felt happy and contented. We waited until our 4th anniversary before we started trying for a baby and it was the best decision ever. If you were 40 years old, I may have had different advice, but you are still very young and have much time. Good luck with everything!

If you want a non-medicated birth and want to be in control, then use midwives--I love them--I am speaking from experience, I have 4 kids! However, I am also a labor and delivery nurse and me and my other nurse colleagues have found working with midwives in the hospital setting to be professionally difficult, because they don't always like to follow hospital protocol when delivering their patients there. So, it is great to be a patient, but not great to have to work for one.

Look at Stevenson University and Johns Hopkins--both in Maryland. Both have a "second degree" BSN program in nursing for people with other degrees. I graduated from an accelerated BSN program from University of Maryland but they have discontinued that option, apparently.

Hi, I believe you can buy an EFM book directly from AWHONN on their website, but you may have to join, I'm not sure. Two years ago our hospital started teaching the AWHONN EFM course and we each got a book for free that way.

Hello Fellow Nurses, I am a labor and delivery nurse and have been out of work since spring 2007 from physical health problems. (I hope to return to some form of nursing this fall). Anyway, I have come to realize that I must have some form of PTS stemming from several traumatic incidents that occurred in my labor and delivery unit--some were my patients, some were other's patients I helped with during emergencies. I am having recurrent nightmares about returning to hospital work and reexperiencing those same scenarios. Does anyone else ever feel traumatized by things at work? How do you deal with it and not let it frighten you? In my case, I'm taking about women and babies dying (yes it happens sometimes), delivering a dead baby myself that the doctor didn't want to deal with, women bleeding out, bullying doctors, bad O.R. happenings, etc...Fortunately, this was not the bulk of my experience, but I have had enough bad things happen that I feel frightened when I think of returning. I am thinking of going into home visit nursing. Thank you