mjb324

We just currently changed our pit orders. We have low dose and high dose pit. Low dose start at 1mu and increase by 1mu every 30-45min. up to 6mu. The high dose starts at 6mu and increase by 6mu every 15min until you reach 40mu. We had to do this because of the different thinking between all the docs and midwifes. I truly haven't seen a greater difference with high dose except certain practioners are hung up on the numbers.

We do 2000 deliveries, When the pt is very close to delivery, the nurse calls out and a nursery nurse comes to catch the baby. If we have simultanious births than the charge nurse will run in to catch one. Then in a couple of hours if all is well with the couplet they will be transferred to mbu.

We have 8 obs and 6 midwifes, all of them use cytotec. Some use 50mcg po and some use 25mcg vag. We do roughly 2,000 deliveries per year. We have been using cytotec for at least 6 years. We have standing orders for both vag and po. The nurse administers the first cytotec. We are all very comfortable giving it. We also have guidelines too. The only complications we have run into is hyperstimulation, which was immediately corrected with terb. We use 200-400mcg po for demises with good outcome.

we took pictures of our set up and individual instruments made a "flash card" game for the new people. comes in handy

pt was explaining to the DCF worker why she was positive for cocaine. " I was swollowing my boyfriends manly fluids and he was doing cocaine."

I have been doing L&D for 20 years and would have it no other way. I felt I have done alot of med surg type things on my unit. I have had pts with central lines, colostomies, wounds, appendicititis etc. Not having a med surg background never hindered me. Plus, with the "economy" I think we will see a boom, (because what else will people do? ) We have had recent lay offs at our hospital and OB was the only unit no affected. (thank God) We are the busiest place in the house. So go for it and live your dream.

We give Stadol 1mg with Phenergan 25mg iv q2h prn

I find doulas to be very helpful. As a l&d nurse it is always helpful to have a extra pair of hands, especially when laboring more than one patient. It is nice for the patient to have someone by her side giving her constant support. I consider the doulas part of my team and we get along well. I do know some of the more "conservative "doc's completely ignore them and act sarcastically to them. Even some of the midwifes seem a bit put off by them, guess they think they are moving in on their territory. Anyway, I think doulas are wonderful and they also provided great breastfeeding support once you have gone home.

I have interviewed many nurses for l&d positions. I love new grads because they are so full of hope and passion and I know they have little experience. I will tell you some of the reasons I did not hire someone. I asked a new grad, why did she choose ob. She told me it was to face her fear of blood. Plus, she said she thought birth was really gross and she did not really have a interest in it at all. Big waste of my time. But it gives me a good story to tell. I also had a nurse who was so timid she could never take her eyes off of the floor and I had to lean it close to hear her one word answers. Didn't hire her either. The last one that stands out in my mind is the nurse that came to the interview dressed in a very short jean skirt and a revealing tank top, she reaked of cigarette smoke. She was very messy and unclean looking. So if you go to the interview, with a friendly, professional personality, a passion for ob, dressed for success and honesty you should do just fine. I am very proud of all the new grads we have hired they are becoming strong nurses. good luck

Absolutely!! We give motrin 600mg q6h and percocet 1-2 tabs q3hr prn. We have been doing a pain study over the last year and with this combo our pain satisfaction scores soared. Plus, on a personal level, this combo worked great for me after my c/s. I found I only required the percocet at night to help with sleep.

When we renovated our unit, we did not purchase any stirrups. Can't use what you don't have. The docs adapted rather well. They still break the bed down and use the foot holders, but then midwives just deliver in the bed and it is much easier and more comfortable for the patients.

Our warmer is draped with sterile drapes and the person who is assisting the doc brings the baby over.

We had a dad come up to the nurses station yesterday demanding to know who checked off caucasian on the birth certificate because he and his wife are both AMERICAN !!!! We all had a good chuckle

Go for it!! Alot of our cna's on our unit have gone through school and are now working as RN's one of them is now assistant DON. You have to start somewhere. Good luck !!!

Don't give up. I assist with the hiring of new staff and have conducted many interviews. We are currently hiring in L/D now and have taken on RN's with no OB experience. The deciding factor for me in an interview is enthusiasm. I am drawn to the nurse who has a positive outlook on life in general, who demonstrates a passion for OB, who looks put together and speaks well. I look for confidence. I also like honesty. Someone who is clear on their strengths and weaknesses. I have hired many new grads because of their eagerness. Adult nurses bring wonderful experince to our team. I have hired two med/surg nurses whose skills have been very beneficial. They spent three months in our preceptorship program and have become excellent perinatal nurses. We chose them because over experienced OB nurses because of their personality type. Good Luck!