profjanmc

I have been in L&D for 21+ years, did not do very many when we had an MD in house, but since we no longer have a doctor in house, I have done 3 in the past month. Mostly rapid progress that came faster than anticipated. Tonight I had a physician verbally abuse me in front of the patient for pushing with a primip before she got there! It really depends on your facility what is the average. You could probably find the statistics from your manager.

As far as the HIPPA goes, out hospital is investigating having them sign a release stating anyone in the room is authorized to hear medical conversations, including OB/GYN history such as herpes etc.... because you could get into trouble discussing the patient's medical history in front of everybody who's there in the room. Personally, I ask everyone to leave while we discuss medical history and domestic violence history.

Yep, they left to go to another hospital-we were glad!!!!!

I TOTALLY agree, we used to have a doc who used high dose pit until the kid proves himself, in other words pit them until they crash....never mind the postpartum hemorrhage that comes with the ton of pit! You did well, you did the right thing for the kid. Kepp your chin up! Jan

We have CRNA in most of the hospitals here in Sacramento, they are specialists in OB, but many of them came from high-volume places and did lots of other things first, good luck!

I had an OB patient tell me that her beaver hurt.... it's another furry animal I guess....

Most physicians don;t have patients sign an informed consent for amniotomies, they discuss it and then perform it. How about everybody else? Do your docs/CNM's have them sign an informed consent?

I teach in that program, it is GPA based admission, the ADN programs in the area are lottery admission based. Of course I believe it is better to get a BSN rather than an ADN, it takes about the same amount of time and it gives you more options in the long run. Good luck!

Maybe on the next contract, you could consider it, the manager there now is really wonderful!!! Good luck in your travels! Jan

There is a LIMITED application for amniotomies. Let's say, severe fetal distess, emergency situation, unable to trace fetus, an amniotomy could be performed using a fetal scalp electrode, really small hole, unlikely to produce a cord prolapse. Or at delivery, so the infant can take a breath....THIS POLICY SHOULD BE THOUGHT OUT VERY CAREFULLY or you will get those nurses who will choose to rupture when it isn't the best choice....IMHO

I actually was the manager in postpartum and special care nursery for about 4 years, and I worked in labor and delivery too. Thye hospital is pretty large and does about 250 deliveries/month, as I remember, mostly known for its cardiac program, it is in the midtown high-end residential area of Sacramento, a pretty nice location. We in Sacramento are about 1.5 hours from the beach (SF) and 1.5 hours from the beach at Tahoe, we are actually in a great little spot here in the valley!

I used to work there! Did you take the job????

I used to work there! Did you take the job????

Right on! That's what I have found in my study, two years is about right to become competent... Yes, I think it is the best job ever! ANd I am in my 20th year! Jan

Can anyone give me any insight as to how long it takes to become competant, and do hospitals usually provide enough orientation so that one feels reasonably comfortable before being on their own? Thanks so much. Catherine Wow! This is my dissertation subject, so far I have found that it takes almost two years for labor nurses to feel fully competent, but by about a year, mostg feel competent in low-risk, normal labor and delivery. Hospitals in Northern California generally give 6-8 weeks of orientation, usually with some classroom and the rest clinical with one-two different preceptors. That was generally considered too short and most of the nurses wanted more orientation. Some were able to get additional training, but had to ask for specific reason. Hope that helps. It is the best job in the world! Nothing is like labor..... go for it, you WILL be scared and uncomfortable, but it will pass...Good luck, Jan

You are welcome....I adore watching the students cry at deliveries, pick up a baby for the first time and call me after many years and thank me, it's very rewarding to help shape the future nurses. ...Jan

I can offer a couple of words of advice, get to know the staff and the routine of the unit you wil be teaching in. It helps the students get an "in" if the staff knows and respects the instructor. Knowing the routine, paperwork etc....helps the students avois having to ask so many questions of the staff members. If you can, work a couple of shifts to get a feel of the place (even if it's volunteer time). Skills lab is a lot of prep and set-up, tear down. The students are looking for positive feedback and constructive suggestions, let them do it, as long as they aren't hurting anyone. And remember to have fun, attitude rubs off on the students! Be approachable and friendly. Hope it helps, good luck!

YEAH!!!!!! RAH!!! I still remember that feeling and it was 20 years ago for me!!!!! Happy new nurse-love it!!!

I have been talking to other nurses about this subject, since no one discusses how to approach someone with digity and respect on an invasive exam such as a lady partsl exam. I know how I do it... I try to allow as much of the control to the patient. Lots of discussion about what we are going to do and a touch of humor (careful assessment of your patient to determine if that will be interpreted correctly). Good luck, most patients are really accepting of our many interventions!

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?CMD=History&DB=PubMed is a link to pubmed, I usually start there. Does your school have a library with on-line access? Many libraries have links on-line to free full articles, good luck.

I just got mine on ebay, new professionals (38) for 45.00 plus 9.00 priority shipping! Good luck!

Ditto, I agree, letting the woman labor down is helpful and much less work. Again, it sounds like the physicians need a little education about the benefits ;-) Oh well, another thread!!!!

You bet I do, I am trying to improve and improve our program too, many times I can better understand the anxieties of nursing students and try to be a cheerleader and encourager!

AMEN, I can teach the skills to just about anyone, but I can't fix attitude... Try not to take yourself too seriously and get stressed early in your career, enjoy the gift that being a nurse can be....