melmarie23 MSN, RN

L&D/Maternity nursing

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All Content by melmarie23

  1. melmarie23

    Up the Pit or stop it?

    melmarie23 replied to APL&D's topic in Ob/Gyn

    We have a great algorithm/policy for managing category II tracings. With the limited picture you painted, it would have instructed me to first decrease the pit (by half) and do my intrauterine...
  2. melmarie23

    Dansko, Sorry, DO NOT GO WITH DANSKO

    melmarie23 replied to suzyqart's topic in Scrubs, Uniforms, Gear

    I'm taking mine to my grave! I love them that much! They are the only show that gets my feet and back through a 12hr
  3. melmarie23

    Baby Friendly

    melmarie23 replied to l/dmom's topic in Ob/Gyn

    Remember skin to skin will help regulate blood glucose levels. So if the baby as risk is stable, skin to skin is only going to help. If we need to do an accucheck earlier (baby is symptomatic) then we...
  4. melmarie23

    Baby Friendly

    melmarie23 replied to l/dmom's topic in Ob/Gyn

    Our policy/algorithm for LGA/SGA/GD babies is a blood glucose level within the first hour and a half...so weights can absolutely wait til after the first hour. We also do our checks in the room. It's...
  5. melmarie23

    L&d/nicu departments common?

    melmarie23 replied to kateee's topic in Ob/Gyn

    My hospital has LDRP and our SCN (level II NICU) all on the same unit. I currently do LDRP but am starting training to the SCN as well. About half our nurses do
  6. melmarie23

    nicuguy is now LDRP&NICUguy

    melmarie23 replied to labordude's topic in Ob/Gyn

    Awesome!
  7. melmarie23

    happy to join you all! I just got my unofficial job offer

    melmarie23 replied to melmarie23's topic in Ob/Gyn

    Almost all my classmates got a job right away after graduation/passing the boards. So in my experience, it didn't hinder my cohort at all. And I'd say about a third of my class are now APRNs (went on...
  8. melmarie23

    happy to join you all! I just got my unofficial job offer

    melmarie23 posted a topic in Ob/Gyn

    I had posted about two weeks ago about how I had landed an interview for a per diem LDRP RN position. That interview was last week, and this Monday they had me come in for a job shadow. I received an...
  9. melmarie23

    unit "culture"

    melmarie23 replied to cayenne06's topic in Ob/Gyn

    I work on an 18 bed LDRP unit. We average 1200 births a year. We have 3 OB practices, one with one midwife. There are also 2 family practices that deliver with us, one of whom teaches and has...
  10. melmarie23

    My patient dropped her baby!

    melmarie23 replied to perfexion's topic in Ob/Gyn

    this exactly. Its what the vast majority of cesarean patients on my unit receive. Its rare that we have a mom on a
  11. melmarie23

    Postpartum couplet care

    melmarie23 replied to KYgirlRN's topic in Ob/Gyn

    my unit follows AWHONN staffing guidelines. We average 3 mom/baby couplets, and never have more than
  12. melmarie23

    Anyone switch from L&D to MB?

    melmarie23 replied to Calinurse4's topic in Ob/Gyn

    we are a LDRP unit, so I do both. I love that I can do either or, depending on my mood, how the previous shift went etc. Sometimes there is no option and I get what I get, but for the most part, we...
  13. melmarie23

    Understanding TOCO Monitor (Tocodynamometer): How to Monitor and Read Contractions

    melmarie23 replied to Wendy Sutas's topic in Ob/Gyn

    I perform a modified version of leapolds before placing the EFM for heart tones. It certainly helps if you are able to palpate where the fetal back is and know whether the baby is cephalic or breech....
  14. melmarie23

    Question for upstate NY nurses

    melmarie23 replied to eifan115's topic in Ob/Gyn

    Ditto. I am in NH and we are LDRP and do couplet care. We never have more than 4 couplets at a time and try and staff so that no RN has more than 3. We also get the occasional gyn surgical as
  15. melmarie23

    Difference between L&D and PP nurses?

    melmarie23 replied to PincheVanessa's topic in Ob/Gyn

    The others covered it. It's possible to be both though. My unit is LDRP so we're trained to do antepartums and Labor as well as mom baby (couplet Post partum care). I like being able to do
  16. melmarie23

    Going to L&D

    melmarie23 replied to MadpeysRN's topic in Ob/Gyn

    Some of our nurses are scrubs as well (if they happened to start on the unit as a LNA bc we train all our LNAs to scrub in), but all RNs are trained to circulate. So if your labor patient needs to go...
  17. melmarie23

    For Those Who Offer VBAC...

    melmarie23 replied to mommy2boysaz's topic in Ob/Gyn

    Our VBAC rate is consistently in the upper 70-low 80%. I just wish more would opt to
  18. melmarie23

    For Those Who Offer VBAC...

    melmarie23 replied to mommy2boysaz's topic in Ob/Gyn

    Yes we have anesthesia in house 24/7. Our OB has to physically be house too, not at home (most are good about staying anytime they have labors or inductions over night anyway). They're typed and...
  19. melmarie23

    Harder to have a new baby in school, or as a new nurse?

    melmarie23 replied to MountainBikeChick's topic in General Students

    I finished my program pregnant with my first and has him 3 weeks after graduation. I applied to jobs while I recovered and started my first job when he was 14 weeks! I have been working as a RN for...
  20. melmarie23

    Advice on finding a job in NH

    melmarie23 replied to Jhncath005's topic in General Nursing

    If you are looking for a hospital position then you will have weekend obligations if you are FT or PT. You may get away with not having weekend obligations as per diem. I worked at CMC as a new grad...
  21. melmarie23

    Couplet care/ discharge nurse/ baby friendly

    melmarie23 replied to PediatricRNTX's topic in Ob/Gyn

    They'll take a labor if there is a new one admitted or be triage RN. Or the couplet assignments get rearranged. Sometimes someone get sent home to down flex or will be floated there is no assignment...
  22. melmarie23

    Couplet care/ discharge nurse/ baby friendly

    melmarie23 replied to PediatricRNTX's topic in Ob/Gyn

    We flex down staffing accordingly. So sometimes someone will get sent home or called off. But usually as we discharge patients more labors or antepartums and surgicals are coming through the
  23. melmarie23

    Couplet care/ discharge nurse/ baby friendly

    melmarie23 replied to PediatricRNTX's topic in Ob/Gyn

    Oh and we have no dedicated discharge RN. We all discharge our own
  24. melmarie23

    Couplet care/ discharge nurse/ baby friendly

    melmarie23 replied to PediatricRNTX's topic in Ob/Gyn

    Most shifts we staff so that we have 3 couplets. Occasionally when we are real busy we will be assigned Four, but 3 is the norm. I am very fortunate to work on a unit and hospital which recognizes...
  25. melmarie23

    Epidural / Spinal Block (confused)

    melmarie23 replied to j0yegan's topic in Ob/Gyn

    Most of our epidurals are fentanyl and