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CNM 26.2

CNM 26.2

L&D/Postpartum/Newborn, Home Health

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  1. CNM 26.2

    Breast lump in pregnancy

    I've seen a few CNM's floating around here from time to time.
  2. CNM 26.2

    Need an advice

    Actually, CNM's can provide the same services as WHNP with the addition of attending births. CNMs do women's health care and primary care as well.
  3. CNM 26.2

    2nd shifter possibly moving to 3rd shift

    I worked nights for many years and for various reasons. I never realized how little sleep I actually got until I stopped working nights-I was amazed at how great I felt! Having said that-I did like the atmosphere of night shift much better so it was a trade off. We did self scheduling and I found I actually did better if I never scheduled more than one night in a row-unless it was the weekend in which case I had to work both Fri and Sat night, plus my husband was home so I didn't have to worry about childcare and I could sleep. I know some people hate breaking up the nights but when I had little kids I KNEW I would get NO sleep during the day so knowing that I could at least sleep the next night was a relief. Best of luck to you!
  4. CNM 26.2

    Comfort Measures...

    klone just about covered it all! :) The only other thing I would add is-if for any reason the patient has to be (or wants to be) in bed and lying on her back-have her bend her knees with feet flat on the bed, place your hands just under her knees and apply pressure-almost as if you're trying to push her femur farther into her hips (OK, don't really do that, just imagine that's what your doing-just far less pressure) ; ) Also, for back labor, sterile water papules. I have used these many times and have never had an unsuccessful experience-every woman has had significant relief for about two hours. While mama is in the tub, get a graduated cylinder or some other container and fill it with warm water from the tub and pour slowly in a clockwise motion over her tummy during contractions. Just to name a few.
  5. CNM 26.2

    Breast lump in pregnancy

    I'm just wondering how you all manage concerning breast lumps in pregnancy. I have seen two patients this week with concerning lumps-both around the 28 week mark. I ordered an ultrasound and plan for mammogram postpartum-but I kinda felt like I was shooting in the dark. I asked my back up MDs and they mostly just said "yeah, that's fine." But I'm just wondering if there's a better way to manage this.
  6. CNM 26.2

    preterm inductions

    ACOG states that elective inductions should not be done until at least 39 weeks so measures to prevent inductions under 38 weeks are still not adequate. Even though this doc brings a lot of $$ to the hospital-one law suit could cost the hospital millions. I would bring it up to your nursing director. In my institution the ob commitee polices each other-any induction under 39 weeks is reviewed by the QCI committee for true medical need. There have been some cases of induction for "PIH" with nothing to support the diagnosis so the docs have all been warned that they are being watched-the inductions have become much more appropriate since then. Like I said before, even though he brings in a lot of money for the hospital, he still needs to practice according to accepted guidelines or he could be putting the hospital at risk.
  7. CNM 26.2

    how to keep track of dr orders

    I would suggest to ask other nurses on your unit how they do it. I suggest this because each unit is unique in how they do things-maybe there is already a process in place that you don't know about. Even if there isn't, some of the other nurses may be able to give you some suggestions based on the "flow" of your unit.
  8. CNM 26.2

    Transition from RN to CNM within the same facility??

    Unfortunately, that's not an option unless I move my family somewhere else-and I'm pretty stubborn, I refuse to uproot my family and my life because one or two nurses are having a hard time with me being a CNM. Midwife228-thanks for your comments, they are enouraging. I'm sure things will get better over time.
  9. CNM 26.2

    Accidental Diversion - Need help!

    Yep, for sure a lesson learned!!! You really should have called and/or returned to the hosptial immediately instead of waiting over the weekend to see if someone called you about it. BUT, you'll remember next time for sure. I wish you the best!
  10. CNM 26.2

    Things that should be banned in acute care.

    Diane~ I hope you got written up for not following doctors orders. PS, I'm just kidding!!!!!
  11. CNM 26.2

    online vs classroom

    I just finished online grad school-and it is harder than classroom-at least for me. I think it really depends on your learning style. In a traditional classroom you can read the material then have it reinforced in the lecture-with online learning you miss the lecture portion so sometimes it takes reading things a few times or asking a lot of questions of your professors or other students. HOWEVER, the convenience of being able to do classes on your time is nice too. I would suggest to check into the online program you are considering and see what kind of support they offer. Some of the classes I took the professors recorded podcast lectures and that was very helpful-if this is offered it helps a lot!
  12. CNM 26.2

    Have you ever had to nurse through a water shutdown?

    I have only been through very short water outages (a couple of hours or less) for construction. We also used bottled water for drinking and we filled the bathtubs with water before the shut down so we could use a bucket to pour that water into the toilets to flush them if needed. We told the patients of the water outage and had them all take their showers before and maybe use the bathroom right before as well so chances were they wouldn't need to go again until we had water again. We also made sure that all patients had their water mugs filled just prior to the water being shut off as well-although we did have bottled water if they needed it. The patients were very understanding and it has always gone off without a hitch.
  13. This thread reminds me of one particularly CRAZY shift I had. We had one patient after another walking in-all of them of course in labor. We had every room full-we were short a nurse-we did two back to back c-sections (and it's a small hospital with only 1 c-section OR) we did three back to back deliveries and even had to transport a patient out-crazy,crazy busy!! Babies were crying, no one could get their work done.....finally it slowed down a little but babies were still crying and all the mamas wanted to sleep and wanted them in the nursery. I offered to help the nursery nurse out and hold one of them-I sat down at the nurses station (FINALLY!) to get some charting done-I had the baby in my arms as I was charting. A well-meaning grandmother walked up to the station to find out which room her daughter and new grandson were in-I gave her the room number and then she said "I would love to have your job-you just get to sit around and hold babies all day." That sweet little grandmother is lucky I didn't rip her face right off!!!!!!!
  14. CNM 26.2

    Seminar In Vegas

    Have fun! Vegas is a great place!!!!
  15. CNM 26.2

    I passed my Boards!!!!

    CONGRATS!!!!!! Let's all do a happy dance!!! :dancgrp: HEHE! I've just been WAITING to use this smiley...haa!!!!