StarrySkies

Thank you so much! :tku:

From what I can see even Public Health RNs make more than I do in a hospital. It seems like a good field with a lot of autonomy and opportunity to really help people.

That is exactly where I am heading I think. Also, I am thinking that the CNMs that have talked (a tiny bit) about salary with me are calculating how many hours that they work in a week, and dividing their salary on hourly wage. Frankly, as I work nights many times the CNM will be sleeping until delivery just as the OBs are. Are we counting sleeping time here? Probably.

Thank you. I have actually been looking at UCSF trying to find salary figures, but have been unsuccessful. I am going to keep searching.

I am trying to figure out if it makes financial sense for me to go to grad school. I am a RN in CA and already make about 100k/year. I am in L&D and have had several CNMs tell me that nurses make more, but no one will give me actual numbers. I am open to Midwifery (my preference actually), WHNP, and even Nursing Education. The main issue right now are the dollars and cents. Yes, I want more autonomy. Yes, I want to further my career. But, I am a single mom and a Dave Ramsey student so the bottom line has to be in the black for me to be able to go forward and justify the expense of grad school. Can anyone give me some real numbers or point me to information on the web? Thanks!

I am also one of the nurses on strike who was locked out for 5 days. I blame the lockout- not the strike for this patient's death. The hospital wanted to punish us for striking for one day. Instead of putting patients first, they locked us out for 5 to punitively strike at our paychecks. I still believe that the strike was necessary. I still believe that the reasons for striking were valid. I am terribly sorry for the person who lost their life and for their family, but I know that it was NOT my fault. It was not YOUR fault either. We all know as nurses that medication error is possible. We all triple and quadruple check ourselves, our meds, and our orders before giving any med. This nurse made a terrible mistake. A terrible mistake. She and the hospital are responsible for this death. Not the striking nurses.

Thank you craig1978! That is exactly what I was looking for!

I have had 2 out-of-hospital births (one home and one at a birth center). I teach childbirth classes and I am a L&D RN. I have an acronym for the pain in childbirth that I teach my students and patients. P- Purposeful. This is not the pain of a broken arm or a gall stone for example. This pain has a reason! A- Anticipated. You knew it was coming. You had lots of time to practice relaxation techniques to help you cope. I- Intermittent. It comes and goes!!! You get breaks!!! N- Necessary. This pain is necessary for you to meet your baby. There is a BABY at the end of all of this! I have seen women who denied all pain (those were hypnobirthing moms) and women who wailed throughout labor but still refused pain meds because wailing was part of their coping. Labor pain is a subjective experience, no one else can assume that you need pain relief. For me, I did feel pain but it was a completely manageable pain. It was not terrible. My second labor was much easier than my first simply because I had my bag of water intact for that whole labor. My bag was AROM'ed at 2cm with my first labor and that made the experience much more difficult, but still manageable.

I am kind of surprised that you will be working in OBT right away. I am at a county hospital too and I was hired as a GN under the OBT cost center, but didn't actually work in triage for well over a year. Most hospitals only put the most experienced nurses in OBT since it is a pretty high acuity environment. BTW, I am in TX too. If you want to PM me we can talk about which hospital you might be at.

I loved this book. This diary was actually one of the things that spurred me to go to nursing school and now to grad school for midwifery. What is even cooler (for me!) is that I am relocating and just got a job at the hospital that Peggy Vincent wrote about... I am just so excited!

I am moving to CA from TX and I would like to get my certification in Public Health Nursing. I have been trying to call the CaBON for several days and I keep getting that the lines are too busy to take my call! I have a BSN, but I understand that I need a 7 hour CA child abuse recognition and prevention course. I am trying to find a course that fits that requirement online, but after hours of searching I am coming up empty handed. I would prefer to have an online course, but if I have to travel to CA to take it I can manage. Anyone know of courses out there? Thanks in advance... :)

It is impossible to know until she is in labor. The pelvis of a primip has a miraculous ability to expand when the labor hormones get going. I honestly think that most women can deliver a 10lber lady partslly without surgical assistance if they have freedom of movement. It is harder to deliver bigger babies on your back with your coccyx immobilized in comparison to an upright or hands and knees position. Most Obs don't really use positional changes in mothers whereas most midwives know those tricks.

I was a doula and childbirth educator before I was a L&D RN and let me tell you- there is a huge difference. Have you ever attended an out-of-hospital birth? Without that experience, you really can't compare. Nearly everything that we do to women in the hospital disrupts "normal birth". Heck, just being in the hospital can slow down labor, affect her fear level, and cause complications. Starving women, denying them liquids, denying them freedom of movement, starting IVs, continuous EFM, et are all considered to be "normal" in the hospital (ie- not an intervention) but all of these things ARE interventions and do affect the course of the labor. Let alone the actual interventions that we do! AROM, internal monitoring, hanging pit, pain meds, epidurals, et (some have their place) but all immediately increase the risk of the labor. Lets talk about pushing... In the 50 or so out-of-hospital births that I have attended I have NEVER seen a woman choose to deliver on her back. Yet, that is the only way that I have ever seen an OB deliver a pt in the hospital. I did see a CNM deliver in side-lying once though. How many dystocias happen because of maternal positioning during the 2nd stage? A LOT IMO. Now, lets talk about expectant vs active management of the 3rd stage. There is some new research that makes this inconclusive, but what I will say is that at my hospital they routinely cut the cord right away which leads to a lot of pale babies. I never saw a baby born so white until I started working as a LAD RN. I HATE having to call NICU to do an IV bolus on a baby- if that OB had just waited for the cord to stop pulsating, it wouldn't of been needed. Sorry to rant there. I'm a little frustrated with my job right now, but I am very happy to be starting grad school this Spring! Normal birth is out there, but it is rarely seen in the hospital setting.

6 years now! I love it! I am looking at sitting for the IBLCE next July.

I have been looking at the excel worksheet instead of the book, but I am having a hard time figuring out how to protect the information that is entered from being changed and still allow new information to be entered on the next line. How do you manage that or does only one person input information vs a variety of secretaries? Of course the birth book is double charting- everything is already in our central monitoring program (OB Tracevue) and we still write it all down!

I have even used a bed pan upside down covered with a towel under a mom's hips to help raise her up. The best advice I ever had on finding a cervix on a G1 in early labor came from an attending. She said to follow the posterior wall of the lady parts as high as you can go and then turn your fingers around- the cervix should be right there.

Klone! Me too! To the OP, I was actually a doula and a childbirth educator before entering nursing school. I went to nursing school to become a LAD nurse and eventually a CNM. I can tell you that I did NOT tell my nurse manager that I was a homebirther when she hired me, but I did tell her that I was a doula, childbirth educator, and LLL leader. I think that really helped me to get hired. Some nurses that I work with are not receptive to doulas, but others are. It really just depends on how much the doula helps the nurse.

I am trying to move my hospital away from the big paper Birth Book to log births. I do the statistics for our OBT and it seems that both the triage book and the Birth Book in LAD can be moved to an online format as long as HIPPAA is not violated and all of the information is secured. Am I crazy here? Writing everything down on paper seems so archaic and prone to error. Does anyone have an electronic program at their hospital or even just use Excel for this? We use OBTracevue for our central monitoring, but it doesn't have a Birth Book feature where you can just print out all of your births for the month with all of the pertinent information.

redbeads- I know that an online school is the way to go for me. I need to be able to study at 3am if necessary! Plus, I live in the country and Baylor is far far away... I am NOT making that drive. Have you started at Frontier? If so, what do you think of it?

Thank you for the Now I Lay Me Down to Sleep information! I just contacted them for my hospital. We have some local nursing homes who have residents that crochet/ knit blankets and hats for us. We also go through the Mary Madeline Project for free burial gowns for our babies. http://marymadelineproject.org/ My hospital serves an at-risk population that is fairly low income. It is a big deal to be able to offer them burial garments. Let alone how difficult it is for most families to go out shopping for burial garments when they are in the middle of their grief.

Well, I am in the exact same boat, but I have been working as an L&D nurse for a year. I am finally starting the process to apply to grad school. I was a homebirther/ doula long before nursing school. There are a lot of things that I have done to make this year a good one. First off, not everyone WANTS the midwifery experience. A lot of people are terrified of pain and want to not feel anything during labor. My job as a doula was to give women the birth that THEY wanted, not the birth that I wanted them to have. Also, once you are outside of your preceptorship, you can decide what kind of nursing practice you want. You don't have to do things like everyone else on the unit! You can advocate for you patients, you can ask for ambulation orders, for intermittent monitoring orders, for food and liquid orders. You can go to the docs with research in hand! AWHONN has a great book for about $35 that I have highlighted and dog eared. I show it to docs all the time to get the orders that I prefer. If you pick a busy hospital, you will see things that you might not get to see in 10yrs of homebirth practice. I KNOW what PIH looks like, I KNOW what an abruption pattern looks like, I KNOW how to resuscitate a baby, how to manage a seizure, how to deliver a demise, and how to do tons of things that I would of never learned in years of practice. I might secretly know that the nurse 4 doors down unintentionally caused her pt to end up in the OR because she was pushing her on her back for 3 hours, but it isn't my place to fix her pt. I manage my own pts and I get them delivered while giving them a sense of empowerment and that they were well cared for. I encourage them to wait for the pain medicine. I rub backs, make hot packs, and sit them on birth balls. I use my skills as a doula everyday in my job. Is it ideal? No. I would rather of spent the last year at a birth center, but I knew it was necessary to get into grad school.

What a long road it has been to get to this point! I am one of those homebirthers turned doula turned RN now looking forward to grad school in midwifery. I need your help though in figuring out all of these online programs. The three programs that I have found are Frontier, U of Cincinnati, and Stonybrook. All seem to be comparable as far as tuition goes. All seem to offer the same type of programs. I want a combined CNM and FNP program because I would like to treat the whole family one day. I am in the Dallas/Fort Worth area and here Baylor's DNP midwifery program dominates. I had a CNM that I work with tell me that employers around here prefer grads of the Baylor program (most instructors were Parkland instructors back in the day) and that they may turn their nose up to an online program. Particularly Frontier as it is clearly known as an online program. Ridiculous if you ask me considering Frontier was ranked 6th on the US News and World Reports list of graduate midwifery programs. Was Baylor on this list? Not that I saw. . I don't plan on staying in this area- I would like to move back to N. California after graduation or possibly in the middle of the program (thus the need for an online program!). I have to admit that I really like Frontier, but I don't know much about the other schools. Is there a strong natural childbirth focus at UofC and Stonybrook? Is it mostly a hospital model? I want to learn how to start a homebirth practice or a birth center. I genuinely trust birth and believe that most births are very normal. It is just the stuff that we (as providers) do that messes things up. I do not want to spend the next 2-3 years rolling my eyes during lecture! Now to the questions! Is there a program that I have missed? What are the students feelings about the programs? Do you feel prepared to be a midwife in a homebirth/ birth center setting? What are the job prospects after graduating from these online programs? Is it harder to find a job than someone who went to a brick and mortar school locally? Thanks!

I am in Texas now, but miss California terribly! I just finished nursing school (BSN) and am working in L&D at a great county hospital where I am learning tons, but I need to start planning on moving back. I want to get a year under my belt and move back next summer. Will a year of experience in L&D be enough to ensure a job when I move back? I have a 2 year contract, but there is a small buyout to leave early. Heck, if I thought that I could get a job I would put my house on the market today and move back as soon as it sells, but I am pretty sure that a year of experience will be necessary if I want a job. I know that nurses in CA make quite a bit more than we do here in TX, so I think that I should be okay financially as long as I can get a job! I am a single mom and my kiddos are 7 and 4, I want to make the move back home before they are too old and it is really traumatic. All of my support systems are there and I need the support! Is there work in CA now? All of the hospitals web sites look barren of jobs and I am worried. I can always do agency work for a while if needed.

The thing is that MVUs are really only truly calculable if the mom has an IUPC in. You can have a skinny mama with mild ctx that look booming on the strip and a fluffy mama with little itty bitty ctx on the strip which are in actuality really strong. Without an IUPC I think the best way of determining ctx strength is through palpation.

I just wanted to let you all know that this trick worked for me! I passed! I got the pop up 2 hours after taking the test and only having 75 questions. I have checked that pop up at least 2 dozen times over the last 24 hours and I just got my results from Pearson Vue that I passed!!!