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OB, Peds, Med Surg and Geriatric Nsg
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cebuana_nurse specializes in OB, Peds, Med Surg and Geriatric Nsg.

RN from the Philippines and USRN

cebuana_nurse's Latest Activity

  1. 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.
  2. cebuana_nurse

    becoming rusty with vaginal exams

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

    The most ridiculous birth plans you've had the pleasure of reading

    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.
  4. cebuana_nurse

    Workflow of Labor & Delivery Nursing

    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
  5. cebuana_nurse

    becoming rusty with vaginal exams

    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.
  6. cebuana_nurse

    "Not allowed" to perform vaginal exams

    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.
  7. cebuana_nurse

    becoming rusty with vaginal exams

    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.
  8. cebuana_nurse

    becoming rusty with vaginal exams

    any ideas where I can enhance my knowledge with vaginal exams? training? continuing education? enroll in midwifery class?
  9. cebuana_nurse

    Sex in a LTC...is this ok?

    Hmmm.. As a nurse, provide privacy. LOL
  10. cebuana_nurse

    A Goodnight Kiss and A Bedtime Story

    Awww! You just made me cry.. You should've warned me. I could've prepared some tissues..
  11. cebuana_nurse

    charts on plain sight--HIPAA violation?

    I see. Hopefully things would get better soon. Thanks for all the positive opinions everyone!
  12. cebuana_nurse

    Would YOU accept this position?

    This is pretty common in LTC, does your facility has an on-call admin? We have one everyday and all of our RN utilizes it as a reference if something goes wrong and you don't know what to do.
  13. cebuana_nurse

    charts on plain sight--HIPAA violation?

    We don't chart on closed doors but we have a room where the charts were placed before. We utilize that room for charting as well as calling MD's and updating their families with the resident's new orders and status changes.
  14. cebuana_nurse

    New Admissions

    In my facility, the floor nurses do it all. You get lucky if the RN supervisor helps out but they only do the body assessment. The rest is for the floor nurses to do on top of their med pass, treatments and answering call lights. The unit secretary prepares the admission packet and stamps the patient's name on all of the papers.
  15. cebuana_nurse

    charts on plain sight--HIPAA violation?

    I truly believe that change can either be good or bad. But I just don't feel comfortable charting infront of the desk. Charting is one of those things that I need a good place to focus on what to write to describe the resident's condition. Being distracted or frequently interrupted with other things increases the chance of me forgetting what I should write which I already got a verbal warning for. It would be much appropriate if charts are behind walls where non-employees cannot see them. Our charts has their room number in it as well as their names in bold letters and their MDs. We already have 2 nurses that already gave their 2-weeks notice because of how things are being run by the new NHA. They hired 2 new grads to RN supervisors with no nursing experience. The old employees there are not too happy about it. We are still short of CNAs and I guess that they are trying to fix the problem by letting the nurses answer the call bells even during medpass.
  16. cebuana_nurse

    charts on plain sight--HIPAA violation?

    Just wanna vent, we just hired a new nursing home administrator (who has no previous nursing home experience)started this new idea of nurses having to answer call bells in their assigned halls. I have 2 aides in 30-bed hall who answers these call bells. I don't mind helping out to boost someone in their bed or get their water pitcher and whatever crap but this is insanely ridiculous. Nurses have already too much in their hands. On top of that, she ordered that all of the charts to be out in plain sight, where our desk is so that we could attend to our residents and families' needs. We used to do our charting in the back room of the nurses station, now the only person that is allowed to be in there is the clinical director and the unit secretary. All the nurses should be out at the desk to answer phone calls, do your change-of-shift reports, do admissions, carry out orders and etc. I don't think this is a good idea. Being interrupted or distracted increases the risk of committing mistakes especially doctor's orders. The desk in the station has so much stuff around it like paperwork so we don't have enough space to use. And when its a weekday, all members of the healthcare team gather around the desk to do their notes leaving no space for nurses to sit down and chart. Plus we don't have a fax machine in our hall so we have to run down to the other wing to fax all our orders to pharmacy. Our cordless phones are not working so when you're down the hall, you have to come up to the station and answer these phone calls. I can't believe that there are people around there that doesn't take a quick second to answer these calls because they believe that its not part of their job description. I understand that we are understaffed but it doesn't mean that the nursing department have to carry all the burden. Its sad to see that there are nursing aides that left this facility because of always being understaffed. Sorry this was long.. Now my question is, is this allowed (the charts being in plain sight)? I don't feel comfortable giving report to an incoming nurse when other people could hear it. Their medical condition is confidential and non-employees doesn't have to hear about it. If this is a violation, can I get a link for this fact?