Supersleuth

I left Houtson in 2002. I worked there for 4 years as an OB nurse at a Level III nurs/Level I trauma hospital--Hermann Hosp. I also did research for the med school in the same L&D unit. Many of the patients are on studies which is exciting to me. They practice evidence based medicine there and it is very pro breastfeeding. I have to say by far it was the best experience I got as a nurse. Mostly high risk patients. The wages are way better than here. I think my first year as a new grad I made 44K take home witch then was a lot. When I left you could work float pool (Special Care Nurs/L&D) for over 30 bucks and hour with med benefits. The hospital built a brand new building for OB/GYN/Level II,III nurseries as well as CCU. It is beautiful and all of the 35 L&D rooms are LDRP capable with huge recusitation rooms in each of them, a huge 6 room triage area. All of the same people who worked there with I left so to me that says something. To tell you the truth, I miss it. My very close friend is a CNM at Galveston--not the same story as far as the way the OB's/Pedi practice--a little old fashioned and behind the times so it can be frustrating to be a nurse who has worked in a place that practiced much different. I don't know too much about Women's--but they also have a Level III now too. St. Lukes I really nice and it is assoc. with Tex Children's Hosp so they also have high risk/Level III. The pay is comperable since they are all located in the Med Center. Outside the med center--the pay is not as good. Any more ?? just let me know. Houston is a great place to be a nurse if you can put up with riding a bus into work from the parking lots and mucho traffic!! Erin

We used this drug like it was going out of style at the last place I worked. I think it works so much better than cervidil too. All night long on cervidil and then in the morning Pit lead to more sections in my experience. I think that it really depends on the dose. The university hospital I was at used 50 mcg and it worked very well. It is also unbelieveable at stopping PPH--just make sure the Pit is off if you give a ton of Miso! At the next place I was at they used only 25 mcg q4h and most of the women need at least 2 doses to ripen really well. I RARELY saw hyperstim. My own personal experience with Misoprostol was very much the same as I have in practice--41 4/7 weeks, no CTX. Cervidil all night, Pit all the next day--NOTHING. Miso, 2 doses the next night and the next am I was 3 cms with little to no cramping to speak of. Maybe I have been lucky all these years-but in 6 years I haven't seen any cut and dried "It must have been the cytotec" reasons for bad outcomes. Erin

I can't believe that this is still the way your docs practice!! Are they really Board certified in Pediatrics?? Do they even do their CME's??? How old are these Pedis? Infants who are deprived feedings get cold, hypoglycemic and then require more interventions. Not to mention the insulin rush babys get when given D5---then they plumit their sugars. They need FAT--hello!! If I were a mother there I would FREAK!! Who's baby is it--the pediatrician's or the MOTHER'S?? Sorry, this is sounding like a vent now but it burns me when docs do not read current literature and update their practice guidelines based on current theories/studies. I have worked at a teaching facility for many years (several of them) and have never heard of such rudimentary practice. Erin

I haven't seen a scalp pH in a while. I think that some teaching facilities are using it just to teach the residents. But even when we would do it, the sample was always clotted and could never be read--useless. I think everyone has decided that it's just not good info anymore as there are other ways of determining acidosis without cutting the fetus' scalp open. If it were me, I would never consent to a scalp pH--cut me instead, not my baby! Erin

It's so funny that I am reading this at work after a hellish couple of days--I have had two things working against me here. It is a full moon tonight and a snow storm is coming tonight as well. We have been completely FULL and out of rooms and just had two SROMers walk in the door. I am soooo glad I am off tomorrow!! I used to live/work in Houston and it seemed true that when a big storm would come, the labor bus would drop off a load of laboring women--seems like many of them would SROM/PROM and would have to be induced. Same deal here today-two SROM--no labor. Hmmmm??? E.:)

The youngest patient I have had was 12 years old. And like several of you all experienced the child life department brought in crayons, coloring books, sewing kits, and other kid stuff for them to do while in the hospital. I tend to see that the really young patients have PIH and PTL more not so much CPD though. It can be really frustrating to take care of such young patients, but I can also say I have had some really tough elderly primips to take care of that were more of a challenge than the teens!!! Erin

When I first stared as an L&D nurse 6 yrs ago, all we used was Demerol and Phenergan. Some docs liked to use Stadol 1-2 mg. I liked the Stadol although some patients experienced really strange hallucinations on it. Last year we stared using Fentanyl 100mcg with 50 of Benadryl... "Fenadryl" as we called it. I thought it worked really well. At my new place they use Nubain or MS and I don't think either of them work as well as the Fenadryl--we don't have the option for epidurals here (only intrathecals) and surprisingly, not many of our patients get ANY pain meds. Very fast laboring population of women!! Erin