indigo

It just takes a second to aspirate and why not be safe?

Our policy is to back off on the pitocin if more than five UCs in ten minutes. We rarely use IUPCs, but I wish we did more often sometimes to get a more accurate picture of what's going on. indigo

I had a pt recently, 19 years old, difficult social situation, in labor, pit aug, but just couldn't progress. I felt at the time that it was fear holding her back, but now I'm thinking it was disgust and being grossed out also. I spent a lot of time working with her, getting her to describe her fears, talking to her about her emotional state, reassurance about the birthing process, etc. I endured her screams, "I don't care about this f-ing baby, just get it out of me!" After birth, when we went to put the little guy on her tummy, she pushed it away. It was difficult, I was pretty disgusted with her inside myself, but never let it show. She was verbally abusive even after the birth. People say, Oh, it's so wonderful to work in labor and delivery. Not always!

I so appreciate the tips on vag exams. I usually work with CNMs who are in house and do all the vag exams, plus we are so small we don't birth that many babies (150/yr). Occasionally I get to do a vag exam, and it is so stressful, but I'm grateful for the chance. I just want and need more experience, so periodically I consider going to work out of town in a bigger hospital to get better at this. indigo

I am also thinking of going PRN. I don't need the health insurance, get that thru my husband. I am a staff nurse working nights in labor and delivery/med-surg at a very small community hospital. We are usually fairly desperate for nurses, esp. labor and delivery/OB nurses. We ALWAYS have a job opening on nights for OB. I see PRN nurses coming and going at will, getting scheduled full-time plus sometimes. It would increase my salary at least $10 an hour. Because we are so small and always needing RNs, it's hard to get time off, especially in the summer. Just thought I'd add a few more thoughts into the mix. On the downside, I have my children to support (my husband doesn't support us, we just share bills and he gives me health insurance) and I do like the security. But it's hard when I see others making so much more money and having so much more freedom. I am also stuck on nights for the foreseeable future and PRN may give me more day shifts. indigo

It makes sense to do a head-to-toe always so you have your baseline. Make that your practice. The only way to know a fundus is firm is to palpate it, otherwise I guess you're just hoping it's firm. Even if it is firm, assess the amount and character of the lochia. Be sure your pt doesn't have a full bladder first!

To circ or not to circ? I am an OB nurse who assists with circs and it is SO totally barbaric-seeming. The babies scream and cry and they come out with a swollen, bloody member. For what. I am also the mother of three uncircumcised sons and none of them have ever had a problem. I am so glad I didn't have them cut on when they were so brand new to the world. I feel so glad when new parents don't want to circ. It's about 50/50 where I work.

Thank you for pursuing this and for your bravery and for being the ultimate patient advocate and woman's advocate. Please stop that monster.

During circumcision, you are number one the patient's advocate. The poor little guy has no choice but to submit to this barbaric mutilation. Get an order for EMLA cream and get it on a good hour before the doctor arrives. Try to comfort the patient as best you can while it is being done, let him suck your gloved finger, wrap him and hold him close when it is finally all over with. It is my wish that no one would EVER do this to their newborn son. Be sure to provide the family with information from the American Academy of Pediatrics before they sign the consent.

Yes, I did pass the NCLEX on the first try without taking a review course, but I did study, study, study with my Saunders review book. It is not an easy test, but if you put in some good time studying and arrive on test day confident, rested and well-fed, you should pass with no problem. Best of luck -- you'll feel so happy when you pass!

I am a new RN and have been through only one code. Even though our patient died, it was amazing to watch everyone jump into action. For the first half of the code, I was more or less a gopher, then I became recorder. It was then that I really could hone in on what was happening. I felt useful and less stressed than I had earlier. I had never seen someone die before, so it was a sentinel event. I am going to take ACLS. I know I can handle whatever is thrown at me....that helps.

Our hospital has a total no smoking anywhere on campus rule. It was instituted a few years ago. No one pays any attention to it. Patients drag themselves out and smoke right at the ER entrance. As a new RN, I refuse to take patients out to smoke. I respect patients' right to smoke, but I do not want to be an active participant and we have a strict no smoking policy in place. Most of the CNAs, however, don't seem to have a problem wheeling people out to smoke. Our hospital is short an acute care manager, so there is basically no one even paying attention to this. Now there's a new "smoke shack" being built. Right next to the NO SMOKING ANYWHERE ON CAMPUS sign. Obviously it's a difficult issue, but personally, I will not take my patients out and I explain this nicely to them and they understand. I offer to get an order for a nicotine patch. As nurses, we are responsible for promoting health and helping a sick person out to smoke is not promoting anything but illness and misery.

I am a brand new RN and I have a nose piercing. I think it is attractive and I don't see how it would offend anyone. As far as I know, our hospital doesn't have rules against it. My nursing program did (I had to use a plastic plug that made it look like a blackhead!@?!?!), but as far as I know, when I go to orientation on Monday I will have it on and don't intend to take it out. I have given presentations at the RN staff meeting, and I wore it at graduation and no one complained. It's really no big deal. I have a tattoo on my forearm that means loving-kindness, and when someone asks me what it means and I tell them, they always give me a warm, loving response. I'm a 49-year-old lady, a breast cancer survivor (just finished chemo/rads in January) and mother of three, as well as a new nurse. Can't see how I would freak anyone out!

I'm a new RN and am looking to buy a PDA with pharmacy info. software. Any advice out there? indigo

Great suggestions and replies. I am graduating too in early May. My program did a couple of units on taking care of ourselves and dealing with stress, and yes, I passed the tests, but really, it is a personal responsibility and no one can teach you to make yourself your number one priority! But I'm still trying to learn that.........