USC2001

I would reccommend getting experience before starting an MSN program. I just finished my FNP program (yesterday, actually, I graduated). When I started I had 2yrs experience in L&D. I then switched to Home Health for the past yr. Its not impossible by any means, but you could tell a difference between the RNs in the program with at least 2yrs and the ones who went straight out of school. I think they had a harder time grasping and remembering some things because they did not have the work experience to relate to. On another note I would highly reccomend Home Health to anyone considering FNP or Adult NP. I have learned so much and seen so much in my year in HH. It is also helpful to be on your own and teaches you independence. Good Luck!

I am also starting w/ Novapro in Jan 2007. My friend traveled with them and really enjoyed her experience. They have been very nice and accomodating for me.

Hey everyone, I need your help with a problem. I worked in L&D for 4.5 yrs and then have been doing Home Health for 8 months. I am going to go do some travel nursing and the majority of the positions are in L&D. The problem is I let my NRP expire (I know... I'm bad:sniff: ) and the travel company wants me to find somewhere to renew it. My old L&D won't let me take a class there since I am not an employee anymore. Any suggestions? (I am in South Carolina) Thanks!

I worked 36hrs a week (nights) for the first year. When I started my clinicals I dropped down to 32hrs, which just those 4 little hours made a big difference in my sanity. However now that I am in my last semester and am doing clinicals all the time I just do 24hr. I have pretty much worked every weekend for the last 2 1/2 yrs. That is how most people do it in my class is by working all weekends. Good Luck!

I had a pt last night, primip, 30yrs, 1/90%/-1 (hey at least she was thinned out :)) contracting every 10 mins, 41 wks (hey- how did that happen- I didn't know you could stay pregnant that long under an OB's care :chuckle ), who was dying from pain so the OB kept her with plans to possbily induce if she did not change on her own. Anyway, she has one of her 6/hr contractions when the Ob is in the room and looks directly at him and in all serious says "I didn't think this would hurt". He was kinda flabbergasted and said "you mean having a baby" and she said "yeah". I did my whole "that's why its called labor, its hard work speech" but she still expected a painless birth. Sometimes I wonder where this "pregnancy isn't uncomfortable/labor doesn't hurt" myth comes from. Even the stupid baby story which everyone seems to watch shows "some" pain. Anyway....

Could the "sample of the cervix" been a Fetal Fibronectin (FFN) maybe? That is something they would do if you were preterm, but I don't know about at 36 wks (that would be too late I would think). Sorry for your experience!

I work in L&D and we had one come in the other night via EMS with baby in arms! Swears she wasn't pregnant! She had delivered at work (CVS) in the bathroom. She said she just felt "woozy" all day and then felt contispated and went to the bathroom.... Well it wasn't a BM that came out! Luckily her co-workers called EMS (becuase they heard her screaming). She and baby did fine (baby actually looked overdue) ,but she just kept saying "I can't believe I had a baby!". I think some people live in major denial!

Alot of our docs are too exam-happy for my taste. I try to minimize my vag exams. We have some docs though that will check a pt literally 5 min after you so they can say "she's 7-8" when you said she was 7cm. Ok...and how does that change our paln of care? none. Sometimes there are pushy pts and families that want to know every 2 hrs what "she is", even after education on infection, etc. "when you gonna check her again? huh? huh?" I love when you have a primip pt with an epidural and they are so worried that the baby is going to fall out in the bed (which yeah has happened, but rare for me) and you explain to them about pressure, etc. Then when they are 10cm they are like "now I know what you were talking about!"

I agree with Deb (of course :)). Even with an epidural I have found that most pts can feel the pressure when the head moves down to a +2 station, even if they couldn't before. One of the great things about working nights is you can labor down a pt becuase the doc is usually asleep in his room and has no idea if she is complete!

I had a heavy-set pt one time that went to her doc for dizziness, nausea, heartburn, etc. Her BP was up and they perscribed a BP med without doing the pregancy test. Well a couple weeks later she goes to the ER (of the only hospital in town without an L&D unit) and her BP is through the roof and her platlets are way low. Well, someone does a test and an ultra sound and she is 35 weeks. She is sent to us and has an emergency section due to pre-eclampsia. Within I think 4 hrs she found out she was pregant and had a c-section and was holding the baby. She was happy, but a little shocked! I have also had the "I'm in labor" pts.... oh wait never mind you just escaped from the pysch floor. We had one lady come via EMS c/o SROM at "8 months" no prenatal care. She wouldn't let us put the EFM on for anything. We though it was an abuse situation with the FOB so we sent him out but she still wouldn't let us. Turns out she was wearing a fake belly and had been lying to the "FOB" to keep him and that night when he threatened to leave she said her water had broken and he had called EMS. We ordered her a pysch consult and SW visit but she slipped out before they came (we unfortunately have a back stair door that no-one can get it without a badge but they can get out) Craziness! :rotfl:

I wanted to be a CNM too when I graduated nursing school. Well, I have gotten 2 years experience in L&D and changed my mind. I really would rather teach and work L&D part-time. I have alot of respect for CNMs and alot of the time I feel like I could manage the pts labor better then the doc, however I have also realized how much liabilty there is. Also, I really enjoy my role as a nurse with the pt. so, I would recommend getting experience first. As far as how hard it is to return well..I am going back this fall for a Family NP degree. It is hard but for me it would have been harder to go straight out of nursing school. I would have burnt out so bad and probably failed out! :) Good Luck in whatever you decide to do. Oh- and your original question- all the CNMs I know had previous experience.

I have even done the hands and knees position with an epidural when mom was small and didn't have too strong of an epidural. I was so excited the first time I was able to get a baby to turn by pushing in this position! I was bragging to everybody! :)

Allergic to: ambien ativan loritab phenergan demerol morphine etc Nurse- "have you ever had any surgery or been hospitalized?" Pt- "no" Nurse-"Any medical problems?" Pt-"no" Ok... how the heck do you know you are allergic to all these wonderful drugs then? In L&D the other night. Pt comes by EMS becuase she has been "pouring blood for 3 days" (thats what was written on the triage sheet). Is she wearing a pad for this "massive amt" of blood?... no. Is there any blood on her perineum or anywhere?... no. When I check her cervix is there any blood on my glove?... no. When I ask where the heck all this blood is she finally says, after prodding, that it just happened twice in the past 3 days when she wiped.. Ummm guess she wanted to ride with EMS or something.

Congratulations!! Enjoy your new baby and try to get some rest! :rotfl:

We use Pitocin on VBACs but are just real cautious with it. Our normal protocol is to increase by 2mu q15min. On a VBAC the docs usually do 2mu q30-40 mins and put a cap on high you can go up. I still think though unless you have been sitting at the same dilitation for 4 hours, have high BPs or the baby is in distress you don't have to have a c-section. You already have had a VBAC so you have a "proven pelvis" so to speak.