Drakebrn

"I understand your belly button is sore but that does not mean the cord is wrapped around the babies neck. Remember the babies cord is not connected to YOUR BELLY BUTTON!!! Here let me draw you a picture ..... again." Yes it's sad that this particular patient was a G5P4. Days like those you have to smile!

We give pain medication past 6-7cms depending on the individuals progress. I was just wondering if anyone used orders that correlated with dilation rather than pain scale. Thanks for the input!

Some facilities allow you to crosstrain into another area, even encourage it! You keep your regular position with the unit your on and orient to a new unit gaining experience in a new area. We encourage our L&D nurses to crosstrain to the NICU to get more experience with acute babies. It also gives you an opportunity to test the waters before making a full commitment. Talk with your nurse manager, it might be an option for you.

Not only is it unrealistic after 4 weeks of orientation for you to complete all those tasks, it could be potentially unsafe. Usually the more experienced OB nurses run our triage area at my facility, just like in ER. Those nurses start the admission process and then pass it on to a nurse working on the floor. When you are the nurse admitting a patient you need to feel confident enough to put on those monitors and be ready to recognize when urgent interventions are needed, such as a stat c-section. Your nurse manager should be encouraging you to take the time you need to feel confident in your FHR monitoring, vag exams, and assessments before putting time expectations on you. And it sounds like you need a new preceptor. Preceptors are suppose to encourage questions and promote education. We need more OB nurses!! Talk to your nurse manager and ask for a new preceptor. If you still get the same reactions, you might want to try another facility.

How ironic! Me and a couple nurses were just disscussing that same thing except we call it black cloud. We have had a rough 2009. 2 sets of 20 weeks twins both pprom, 38 week multip complaining of SOB ends up with a PE, a healthy 39 week primi with no prior complications recieves an epidural then lays down FHR 160's 10 minutes later baby decels to 60's and stays, stat to OR, baby has no HR and no respirations at delivery, we code baby, push meds, get heart rate but baby never initiates a breath. The staff was completely stunned with no obvious answer to what had happened, no abruption, no rupture, not even a nuchal. The baby was transferred to NICU and within 30 minutes began having seizures. When a pt wakes up from general and you watch her face as the NICU doctor tells her that her baby most likely has severe brain damage, it keeps you up at night. And that all happened in the last 2 weeks!

One of our nurse managers attended a conference last year that indicated the national standard for years experience required for charge nurse for L&D was 5 years. I have looked all over the internet for this national standard and I am unable to find it. Does anyone have any info on this standard please let me know. Also if you could include how many years experience required for charge nurse at you facility would be very helpful. Thanks!

I also work in a teaching hospital and have those same issues. Some residents have the attitiude " your just a nurse". Sometimes they just look at the patients as cases and not a real people. I know for young residents complicated cases are exciting, but when a resident breaks out in a smile and gets excited because a pt gets a 4th degree lac. I want to pull my hair out!!! As nurses we have to keep fighting the good fight for our pts and continuing to educate our residents, if that means going up the chain of command, so be it! BTW, I have a resident who wants everyone with no medical complications to have elective cesarean sections. He feels it's so much easier on the pt and family to plan out exactly what day, when, not "suffer" through labor, and don't forget the all important perineal preservation!!! Ugh !!!

On my unit we have standard preprinted Labor and Delivery admission orders. We are running into an issue with our narcotics. Trying to stay up to date with JCAHO guidelines we have added a pain score to the orders, for example: Fentanyl 100mcgs IV every 2 hours for pain rating 5-10 using pain scale. However, as many of you labor nurses know, especially with primips, they rate there pain 10/10 frequently and they are remote from delivery. These orders dictate giving a short acting med instead of something that will last her longer like Demerol. But because the order for Demerol is for pain scale 1-4 we can't use it. So then you have to call the doctor and ask him if you can give the Demerol instead of Fentanyl. For some reason docs don't want a 3am call for that! My question is does anyone have any information about medicating laboring pts usings dilation rather than pain scale. It might be a dream but since nurses no longer can use there own judgment on pain medication ,I'm hoping someone has some info!

Hello, This is my first time using this forum so I apologize if this question has been asked in an earlier thread. I currently work on a Labor and Delivery and have been there for 2.5 years (since graduation). I have taken every opportunity to advance my skills by taking additional training in advanced fetal monitoring, high risk obstetrics, and my RNC. My managers are always telling me what an asset I am to the unit. I am frequently put in our 4 bed triage room evaluating pts(which is off the unit with an OB tech), I am often given complicated or difficult pts. My issue is with the criteria for charge nurse. We have several nurses who have worked on the unit for many years (some decades) and are charge nurses because of the years of experience. They are known as "lazy" charge nurses. Often they do not help other staff members with there pt loads, they do not make deliveries, are not present during situations where more than one nurse is needed.Our managers are fully aware of which nurses have these issues. However our Nurse Manager states that 5 years experience is needed to be "charge capable" and although she thinks I would make an excellent charge nurse, if litigation would arrise during a time I was in charge and another nurse with more experience was on the floor we could be held more liable. This is extremely frustrating to me. I feel that hardwork should be rewarded not pushed to the side. It's like a slap in the face, " Yes we know Nurse X is a lazy charge but she has 15 years experience" or my favorite " Oh Nurse X is in charge so we are really going to need your help today". Where does that experience get you if that nurse is not running the floor!! There is nowhere in our hospital policy that states you need 5 years experience, it is up to the unit manager. Does anyone have documenation of this national standard of 5 years or a website I could look at?? I would really appreciate any input !!!