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CNM 26.2

CNM 26.2

L&D/Postpartum/Newborn, Home Health

Content by CNM 26.2

  1. 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.
  2. CNM 26.2

    Breast lump in pregnancy

    I've seen a few CNM's floating around here from time to time.
  3. 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.
  4. 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!
  5. 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.
  6. I have been an RN in L&D for many years, I recently graduated from CNM school. My question is-have any of you made the transition to CNM praciticing in the facility where you worked as an RN? Most of the nurses are fabulous and I work very well with them but there are some that I am struggling with. I feel like there is a lack of respect for my credentials because I used to be "one of them" and although there are very few that have been in L&D as long as I have, there are a fair number that have been in L&D for close to as long as I have-these are the ones that I am having problems with. In some cases they are passive agressive by making little digs at how I practice, others are I think trying to be nice and saying things like "you've done this for so long school was probably a breeze for you." When I was in school I always heard "you already know this stuff, why do you even need to go to school?" Although they were meant to be compliments, do they think that because they've been L&D nurses for a long time and haven't gone to school they have the same level of education that I do because "they have been doing it so long they already know it all?" Does anyone have suggestions to deal with these situations?
  7. 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.
  8. 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.
  9. 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.
  10. 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!
  11. 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!!!!!
  12. 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!
  13. 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.
  14. 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!!!!!!!
  15. CNM 26.2

    Seminar In Vegas

    Have fun! Vegas is a great place!!!!
  16. 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!!!!
  17. CNM 26.2

    Bloody patients

    I beg your pardon. I took the fact that the OP said "Patients" (plural) "Please realize the following" that maybe he/she had issues with most or all patients; in which case a career change may be in order.
  18. CNM 26.2

    Transition from RN to CNM within the same facility??

    Haha!! I like your thinking!!!!!! That's what I try to do-I just hope they get over their passive agressiveness soon!!!
  19. CNM 26.2

    Bloody patients

    Maybe you need a new job....or a new career.
  20. CNM 26.2

    Stupid things said by your non-nurse significant other

    I have several..haha!! One night when I was on c-section call and there was a mom attempting a VBAC so I was required to be within 5 minutes of the hospital while she was laboring. My husband and I went to dinner at a restaurant about amile away from the hospital. As we finished dinner I was debating whether I should call in and see how the patient was doing so I knew if I would be able to head home soon or if I should just go to the hospital. My husband said "they'll probably tell you she's six and multi-tipped" HAHAHA! I must say, I was impressed that he was at least trying to use the "lingo" When I was about 28 weeks pregnant with my third child, I got a wild urge to rearrange my furniture. As I was moving things around my daughter, who was 8 at the time, and my son, who was 5, were concerned. They kept telling me I should stop. I reassured them that I was fine but they weren't convinced, my daughter said "but, mom, please stop if you start having those one things.." my son rolled his eyes and replied "duh, they are called C-SECTIONS." I think "contractions" is more what she had in mind.... And finally, a few years ago I took my daughters to the zoo, they were 8 and 7 at the time-they were playing on some toys in the petting zoo-one was a large nest, one was a cracked egg that was big enough for a couple of kids to get inside. My youngest daughter was in the egg, her big sister was in the nest on the other side of the playground-the daughter in the egg yelled out "look mom, I hatched out of an egg" the daughter in the nest yelled across the playground to her "no you didn't, you grew in moms uterus and came out of her vagina." Yeah, maybe being open about the reproductive process is not always the best idea!!! (haha)
  21. CNM 26.2

    personal cell phone and the internet and impact on staff moral

    This is also one of my huge pet peeves!!! The hospital finally blocked some sites but it didn't seem to help much. What really gets to me is that the offending nurses got upset because they felt entitled to be able to get on the internet and felt that it was "babysitting" when those sites were blocked. Well...um....YEAH, apparently some people needed babysitting! Cell phones are my other huge pet peeves and they have been "banned" as well but unfortunately, my hospital is not notorious for enforcing rules. We have nurses that refuse to leave their cell phones in their lockers because "my family needs to be able to get ahold of me in case of emergency." I have suggested that they have the family call the nurses station but I've been told that they are concerned they may not get the message and it takes too much time to come hunt them down. Yet in the same breath they say that they never answer their phone in a patient's room, which is also incorrect-I have seen many nurses answer calls and texts in patient's rooms.
  22. CNM 26.2

    HTC Incredible

    Yes, the battery life is quite short, but, I talked to one of the reps at the store and she told me that if you have apps like FaceBook on your phone it will run the battery down very fast because it updates constantly. I took the FaceBook app off and I found that it does make a big difference in the battery life. Also, if I am away from home, I turn the phone part off...aka "airplane mode" because it also uses the battery like crazy searching for a signal. I just turn the phone back on to make calls. When I haven't done that, the battery only lasts a couple of hours As far as turning itself off-it's not just going into "sleep" mode, it's turnin the phone completely off-for some reason it tends to happen more at night-and somtimes it will turn itself back on too-it's rather annoying in the middle of the night because it buzzes when it comes back on. I think I'm going to switch to BlackBerry and see if it's any better.
  23. CNM 26.2

    Can I still work?

    Check with your board of nursing. Some states allow you to get a temporary license and work as a "graduate nurse" until you get your official license. Unless things have recently changed the scores go to your state BON then they issue the license-that can take a few weeks.
  24. CNM 26.2

    What is it like to be a nurse in a prison?

    When I read the title at first I thought it said "What's it like to be a nurse in prison." hahahahahahaha!!! Carry on!
  25. CNM 26.2

    Should I keep my LPN license active?

    I agree, I really see now point in having both an LPN and an RN license-you are held to the standard of the highest license you have anyway-which would be the RN.