MichelleB34

When my kids were younger I used to calculate the amount of motrin, tylenol, etc. they should get according to their weight. I never went by what the bottle said.

Where I work we went to mom/baby care about a year ago. Prior to that they did have a postpartum nurse, L&D nurse and nursery nurse. Usually the postpartum nurse would round with the aid. The nurse would do her assessment while the aid would get the vitals. The nurse and aid would work together to get water, change the bed, get patients OOB, etc. Then medicate patients as necessary. Then start your charting. Do routine meds. Make sure labs are on the chart. Relay necessary information to the doctor and/or midwife. Note orders. Prepare the discharge papers and coordinate the discharge with the nursery nurse. Make sure first time moms have their teaching tools and have watched the teaching videos. Of course your routine may vary depending on patient needs but this is a basic summary of a typical day.

Thanks for the information. I was not aware of this particular issue. We give stadol most of the time. Any risks associated with giving stadol beyond the normal assessments when giving IV meds?

It is normal to feel uncomfortable when you first graduate. I always tell my orientees it takes at least 6-12 months to feel a certain level of comfort in your new role. Don't be too hard on yourself. Is there another nurse you work with that can mentor or precept you? How are your midwifes to work with? Our midwifes are wonderful to work with. They are always willing to teach and answer questions. Most if not all of our midwifes have worked as nurses before. Also two of our doctors have a computerized charting system that is used for every office visit. When a patient is close to delivery the ACOG is sent to our unit. There is a lot of information about the patients in the ACOG. I have learned a lot about routine prenatal care by reading the ACOG's. The most common meds our patients take are prenatal vitamins and iron. I hope this helps.

I work on maternity so obstetrical emergencies, gestational diabetes, and GBS are some of the topics that peak my interest and are pertinent to my practice. But if you wanted to do something different maybe you could do something on infertility. There are so many new treatments out there. If you know couples or could find couples who have gone through fertility treatment you could really bring the emotional aspect of wanting a child into your report. Having real life stories would make an otherwise dry topic interesting provided they are willing to share their experience. Have you started your clinical yet? Maybe you could get suggestions from the nurses if you are comfortable asking them.

Curious Jomo Nurse your age is 94? Was that a typo?

I'm curious, those of you who mentioned you have 4 beds to a room? Where do you live? Our hospital has only semiprivate and private inpatient rooms. Our old ER trauma/cardiac room had 2 stretchers on each side of the room (total of 4). Our ER now has all private rooms. The PACU is the only place that holds more than 2 patients with curtains in between stretchers.

I did med-surg for 11 1/2 years along with some pediatrics because it was on our unit. I wouldn't say I was burned out but maybe frustrated. Nurses are always being urged to limit their overtime. Towards the end of the last year I worked med-surg I remember commenting about how much harder this job has become since I first became a nurse. I wasn't sure I was going to be able to do the same job for the rest of my career. God has led me in new direction. One year ago I switched to maternity. The overtime issue is still there because I'm in the same hospital but I love my new job (most days). I feel like I have found my niche in L&D. The funny thing is I didn't think I could make the change because the thought of working in L&D made me too nervous. I have to say though that having experience has been helpful in making the transition. There is still stress at times and it is a different kind of busy but most of the time my stress level is significantly decreased compared to my last job. I know changing jobs is not the answer to everything but it may give some of you a fresh perspective.

When I have had similar orders I will sometimes use the shift flush(es) during my med pass. When you are giving metamucil you can easily give 200cc of water or more so there is your first flush. Also I wouldn't mix the metamucil until right before you give it. The longer it sits there the thicker it will get. I also mix warm water in with the crushed pills to help dissolve them.

Set up PM, not sure what you mean. I don't know if it will help but remember that all your new coworkers were new at one time. We all have to start somewhere. Just take it one day at a time. Good luck.

I think it is within the nurses role to answer questions from the patient and or family honestly and within the scope of our practice. But of course the decision to place the patient on comfort care has to be made by the physician after discussion with patient and/or family in regards to the patient's wishes. Once the decision is made to place the patient on comfort care the nurse is often taking care of the family as well as the patient. ie answering questions, assuring them their loved one will be kept comfortable, providing emotional support, etc.

LovingNurse- I love your word decootify. That's great.

At our hospital we have preprinted PCA orders. The doctor picks which drug they want and fills in the doses and the hourly limit. I think the form has the concetration of the drug on it as well. When we program the PCA the first thing we put in is the concentration of the drug. eg Morphine comes 1mg per ml.

I work with PCA's often. I alway take the order in the room when I set up a PCA. Any medicated gtt has to be checked by a second nurse. But most of the time I am picking up a patient from PACU who already has the PCA going. In that case I also check the formula on the PCA against the order because when I take over care of the patient I am responsible for what is going into the patient. I think the nurses involved should receive a med error. This is definitely and opportunity for staff education. The nurses could be subject to disciplinary action for not following hospital policy if that's what management chooses to do. But I don't think this is grounds for firing the nurses involved. Provided these nurses don't have a pattern of making these kinds of mistakes.

You were certainly within your rights to feel out a report if that's what you felt was the right thing to do. At our facility our meds are profiled by the pharmacy. ie During pharmacy hours we can't take anything out of the pyxsis until pharmacy profiles the med (puts it into the computer). With the exception of a few select emergency drugs. We have computer generated MARS. When you come on to your shift you have to check your MAR against the kardex. If there is any difference or a new order is hand written you have to check the original order. Also at the end of our shift we have to run a report to check for any omissions. So technically the day nurse should also have an error for transcribing the order wrong. The evening nurse would have an error for omission and possibly for error in checking practice (at our facility) provided the order was transcribed correctly on the kardex. That being said I probably would have not made out an error report. It sounds like you work nights? If I had caught the missed dose early in the shift I might have chosen to give it. Otherwise I probably would have just fixed it and let the nurses know because it was only pepcid. But if it was an antibiotic or bp med that would be a different story.