cebuana_nurse

I had one patient who happened to be a nursing student (not sure how far she is in the nursing program). She was already fully dilated and she fairly did well for being a primip. I went over the couple regarding pushing and the delivery of the baby which both parents were receptive to teaching. So, as she was pushing, she was asking the doctor if the baby is moving down at all so our OB suggested that she reached her hand in there to feel the baby's head which the patient did. The OB jokingly said, "Oops! I think you just pushed him back." The patient was like, "Oh my! I did? Now, I have to push more to bring him down further". We had to tell her that it was a joke and she still looked at us that we are just being nice to say that.

I checked those lady parts in a box and the cheapest I could find is $425!!! Maybe I could ask for it this coming Christmas. Lol

I've had instances that patients come in with lengthy birth plans, I go over them with the couple to see which are applicable and not as well as emphasizing that as long as the baby is breathing and transitioning well to extrauterine life, I'm more open to skin to skin contact as well as breastfeeding immediately after birth. Setting priorities and limits are possible and so far I've not encountered any problem with this. Unfortunately, only 1 out of 10 that had their birthing plan actually happen, the others ended up being sections due to non-reassuring tracings, arrest of labor, failure to progress and patients actually requesting it due to not tolerating labor itself.

To: shadow This is pretty much the same scenario at my current hospital. They ended up doing on-call schedules for nurses and we have a calendar full of requests for vacations so that our manager could fairly approve such vacations or reject them due to staffing. We have a 2-RN policy per shift but due to being a small community hospital, such thing doesn't happen due to low patient census. The staff that has the most seniority has a choice to stay in OB or float to other departments and the 2nd RN be on-call at home granting they only like 30 minutes away. Being on-call, you are guaranteed $50 per 8hr shift. Same thing applies to OB-GYNs. We don't have an in-house OB M-F as well as weekends. I totally understand the whole no inductions or scheduled sections before 39 weeks. It's a bummer

I work at a small community hospital that only averages less than 100 births per year, so practice with limited patients is really hard. I was looking for like dummies or study materials to know more about this but so far no luck.

I agree with Fyreflie. Ask your co-workers if there's any written policy regarding this. I think that as a nurse working in L&D, you should be ready for anything. Labor and Delivery is known to be very unexpected. God forbid if you get a patient that is screaming in agony and dropping F bombs in the room and who happens to be a multip and the doctor is not around and you don't check them, and they start pushing without a table, then your screwed. This would also limit paging doctors for unneccessary things. I've learned this the hard way when one of our new OB-GYNs just came out of residency from NY and she likes to do all exams on her own. Needless to say, I was able to prepare for a table and anticipate a delivery. When the doc came in, all she needed to do is gown up and put her boots and goggles. I work at a small community hospital that only averages 100 births per year and our OB-GYN's are not in house but on-call living 30 minutes away.

I currently have my Bachelor's so enrolling for master's won't be a problem since it's in my plan anyways in the future and my hospital reimburses for it as continuing education as long as I keep my full time status. However, I don't think it'll be happening anytime soon. I am able to know how dilated the patient is but don't have a clue regarding effacement as well as station. Any tips on what I should feel for? I don't know what it feels when a patient has an anterior lip or if the cervix is posterior. I feel useless at times during labor and I kinda noticed that our OB-GYNs prefer the older staff working instead of me which doesn't help boost my confidence with my chosen field.

any ideas where I can enhance my knowledge with lady partsl exams? training? continuing education? enroll in midwifery class?

My department gives out a lot of free goodies just to boost our census. So far, we only average up to 100 births per year which is really sad. We give out a diaper bag from Gerber (only given to WIC moms) and is already pre-packaged whether they are breast feeding moms or formula feeding moms. We also have Similac for other moms that prefers to use it. We also give out a free diapers courtesy of Huggies. I think there are 10 diapers in a box with coupons in it too. Since we don't have that much deliveries per month, we give 2 boxes per mom. They also get a fleece blanket with our hospital's name in it saying, "I was born at ...". We also give out a framed artwork with their baby's footprints in it and lastly, we give out complimentary gourmet meal good for 2 people prior to discharge.

I agree with NurseNora. In addition to that, most babies would either get a small laceration due to to electrode placement but very minimal. We usually treat it with Polysporin ointment application.

I have never heard of Demerol can be used for shivering. Good thing I bumped into this topic. Most of my post C-sec patients gets IV Toradol x 6 doses. They either get Demerol or Morphine in the PACU. Once on the floor, they don't use those. I think it also depends per physician too.

UPDATE: Its been almost a year since I got a job at the OB dept and I love it! I think this is where I definitely belong. I'm also picking overtime and my co-workers are amazing and definitely took me under their wings. They're very helpful and nurturing. There are days that we are closed and I get to be crosstrained in areas like Med Surg, ICU and ER. Hopefully, I'll have more happy years in this job.

I agree with above posts. It's not easy to be in nursing school here in the US. Being a foreign grad, sitting in the NCLEX was nerve wracking as well as the processing took forever. If you go to the Philippines, there's no question of you getting into nursing school, but they have to transcribe all your credentials to match the Philippine curriculum and the colleges there could care less about your grades. All they need is you able to afford it. If you stay here in the US, and try to get into an LPN program, it would be easier and at the same time give you an ample time to rehash your skills and get better grades. My opinion, stay here in the US. It's easier and hassle-free. All you need are good grades, so strive harder. Good Luck! =D

It does happen and I agree to take it as a compliment. Smile, be professional and walk away. With FB, thank God, I don't have friend requests from patient's families. I usually ignore them. I had a post surgical pt where his brother was visiting him. When I came in the room, he was like, "Bro, I feel like I'm getting sick seeing how lucky you are to have this beautiful nurse." I smiled. He was asking my name saying if he could request me as a nurse. Too bad, I'm an OB nurse just floating at the med-surgical floors.

@rninwch: I live literally half a mile from the hospital I worked and it doesn't matter for them. They need an RN to staff a department even if it's closed. So I am being used as a number of the staffing enough needed to be in the hospital per department. My understanding is, if the hospital is being benefitted by staffing an RN in a department that they should be paid hourly and if the department itself doesn't have patients that they should be pulled to other departments whether they're gonna be overstaffed or not. If they are very anal about the patient satisfaction survey then they should allow overstaffing other departments too. It doesn't happen quite often. I guess that only exist in the ideal world. Such a shame...