L&D_RN_OH

Try collaborating with your pharmacy.

Wow! what interesting stories. I have had one pt lose her uterus, due to uterine atony despite meds and massage. We also lost a pt to AFE last February. She coded, then went into DIC and started bleeding out while we tried to resuscitate her. From S...

Our OB's do them daily, if the consent is signed by the parents. The CNA's on days assist since they are done after morning rounds. I'm thankful I'm not required to assist as I don't think it is a necessary procedure. Even the AAP says it's not routi...

I don't tell them it is an off label use, but I do tell them it is an ulcer medication that has been found to ripen the cervix, which I guess is telling them of it's off label use in a round about way. I guess I just meant I don't actually say "Thi...

Cytotec is a pill. Cervidil is impregnated on a thick tampon like string. They are both inserted vaginally, both used to ripen the cervix, and both can cause hyperstimulation.

Were you told that treatment of PTL is an off label use of Brethine? Many drugs have off label uses that they are effective for. No, I don't tell pts it is an off label use, because I think it is a moot point. I do tell pts what they are being induce...

This sounds like my facility. We're had great results with very few cases of hyperstim. In those cases, if you review the strip and the contraction pattern, generally the last dose shouldn't have been inserted. That is a nurse error, not a med error....

I read an article awhile back about that. I believe the possible side effects are the same, but it is not always as effective given po.

Is it possible you were checking for protein in the urine, since she was probably on Mag for PIH? Mag sulfate does help prevent eclamptic seizures but it doesn't necessarily control the spread of the disease. Women can go quickly from PIH to preeclam...

Definitely! We have a little more freedom on nights.

Moms with positive UDS get a chemical dependency consult and a SS consult. If baby pops up positive, it is referred to CPS. Where it goes from there depends. If mom has a history with CPS, they baby may go into protective custody, or be sent home wit...

I read all the horror stories about Cytotec too, and was shocked that anyone would keep using it. However, since I've been working as an L&D nurse, I much prefer it to Cervidil. Our cervidil inductions require continous monitoring while Cytotec d...

I agree with Deb. If Mom has no urge to push, then by all means let her labor down. If however, she feels the pressure and wants to push, and baby is at +2 station or more, than go ahead and encourage her to push. Some docs will insist pts start push...

I occasionally chart on the strip just as a reminder to chart in the computer. We do save our strips, although if they are not labeled and we cannot id them, they get tossed. They are downloaded every morning onto disc anyway.

I've never heard a doc request fundal pressure during a routine delivery. Only once did we use it. The pt "seized", collapsed, FHR dropped to 70's. Pt went from 1-10. Pt alternated between being lucid, combative,and unresponsive. She was barely able ...

Rarely use stirrups. Many of our docs don't break the bed down and those that do still don't use the stirrups. We do 100-125 deliverie/month and rarely see a dystocia. I think the last one we had while I was at work was several months ago.

We use it frequently for cervical ripening. Generally, it is placed every 4 hours. Monitored 30min prior to dose, and 2 hours after. We do not give the next dose if the pt is contracting , 5 min apart and/or there is cervical change. Personally, I pr...

I agree with the others. What is "unstable"? Some of our PP nurses seem to think if a pt is unable to void during their recovery period, they shouldn't be moved. That is definitely not unstable. Pts with high BPs, on Mag won't be moved. But since pr...

That sounds similar to our setup. Although L&D nurses do keep PP pts if our load allows it. But our PP nurses are not crosstrained to L&D, so if L&D is busy, we give up our PP pts to a PP nurse. We also do not AROM or place IUPC's at my ...

We have 12 LDRPS, and avg 100-150 births/month. Which is an avg of 3-5 deliveries per day right? Of course some days we have 1, and other days we have 8, but...... I'm not sure where we are this month but I can tell you our record date was March 31. ...

We allow 4 visitors in L&D. We do have visitors who scam the system somehow and have ended up with 7-8 people in a labor room. It can get ugly when trying to explain the visitor policy over and over to people who insist they must be there. We hav...

Don't know where to point you for statistics. At our facility, we were LDRP's when they created the new unit several years ago, then were LDR's. We are now transitioning back to LDRP's. I think it is consumer driven, and would be interested in seeing...

Have pts complained? Do you have a breastfeeding policy? I have had a problem with one nurse who has fed my breast babies bottles, without a medical indication. Pts have complained, and since it goes against our breastfeeding policy, incident report...

In Southwest Ohio, new grads start out at a little over $19/hr, plus shift differentials.

This is how open glottis pushing has worked for my pts. I encourage them to grunt or moan lowly while pushing if that helps them. It's hard to hold your breath and grunt. :) For my pts that have little feeling due to an epidural,who may be more quiet...