knufflebunny

I used to be an L&D nurse for 10 years. I left that job for 2 reasons. One, I was burned out. Two, there was a bully of a doctor that I made it miserable. I left bedside nursing and couldn't get myself to go back. I tried to take a travel position but I think I literally have PTSD. I found this opportunity to start my own mobile IV hydration business and I am loving what I do again! And the cherry on top is that I am making more than I was at the hospital and work a fraction of the time. If you have been thinking about starting your own nursing business. Don't be afraid to take that leap!!

Thanks everyone for the reply! I actually went to my managers with research because the best way to practice is through evidence base. They actually told me there were several other nurses who brought it to their attention. They put a reminder in our staff huddle to turn off IV infusions if patients are taking it PO. :) A few people have mentioned about asking the doctor who put in the order to clarify. I did talk to one of our Anasthesiologist and he agreed with me about stopping fluids when tolerating PO. The order is actually part of an order set. So after a patient delivers, they check boxes with whatever orders they want, so this order is standard for all patients after delivery.

I know this post is old but I got an interview for the RN transition program! I'm super nervous. What type of questions did they ask?

I wish we had male nurses on my postpartum floor! With our entire patient population being female and staff being female, there is way too much estrogen on the floor. Having a male nurse would be a nice change.

I actually did. My nurse friend (different hospital), her husband is the anesthesiologist at my hospital. I asked her the same question and she ran it by her husband. And they both agreed with me. I guess I needed more validation. LOL :)

Yes, I did interpret the IV access as "keep the IV in and patent!" not "keep the fluids running"! I'm curious if other postpartum floors are running IV fluids as long as these nurses are. The night shift nurses give me such appalled looks when I tell them I saline locked them. It makes me feel like I'm doing something wrong!

I am new to the hospital I am working at and they seem to run IV fluids for 24 hrs regardless how the pt is tolerating fluids. When I get a fresh C/S, the pt is on slow pit and IV fluids. If the pt is tolerating fluids well, not nauseated or throwing up, great bowel sounds, doing exceptionally well, I cut off the fluids about mid-day and continue with liquids to full liquids...etc. When I give report to the night nurse, they seem absolutely appalled. I explain to them that they are taking fluids PO and tolerating very well ...give them the whole above scenario but I can tell they are not happy or don't agree with what I did. Finally I asked one day shift nurse and she said that it is anasthesia's order to continue IV fluids for 24 hours. We look at the orders and I point out the part that says "discontinue IV if tolerating PO". She then points to another section that says, "keep IV access for 24 hrs" and says, "see that means keep fluids for 24 hrs." I do not agree with her translation of that order. What is the rational for keeping fluids going for 24 hrs if they are drinking fluids fine and output if fine...perfect scenerio basically. The entire unit practices like this so it makes me second guess what I am doing. 20 nurses vs 1. Advice/opinions please! Thanks!

Thank you!! Your response not only answered my question but was very educational! Are you a CRNA?

About a third of all my patients that get epidurals fail at the end. Why? In the beginning, the epidurals work beautifully, and then when it gets close to 8, 9, 10cm, it fails completely like they don't have an epidural at all. I call anasthesia back to try to fix it, but no matter how much they bolus, it doesn't work. Sometimes we try to replace the epidural but most of the time it's too late and they just deliver. Why does this happen?

I would recommend going straight into an RN program. Does she mean go from CNA, to LVN, then RN? In my opinion, it would be a waste of time to "go up the ladder". Especially in L&D, the majority of the job we do, only RN's can perform. I'm in a small rural hospital so we don't have LVN's or CNA's on our floor. I think in large hospitals, CNA's might be utilized, but I don't think LVN's. Either way, to learn L&D, you need to be an RN.

Hospice might be a good choice. I had a relative on hospice and I definitely appreciated the staff that helped our family through the difficult time. As for postpartum, I'm still considering it. I just don't feel the same connection I do with postpartum pt's than I do my labor pt's. But it's not totally off the table.

I'm happy to report that I got insurance today and covered to the max amount!

UGH! I can't believe I haven't gotten it yet! I literally asked everyone I knew about insurance because I was so nervous about being in such a litigious area of nursing. Not ONE said to get it. I will get coverage immediately! Does that mean the first 2 years I've been in L&D I won't be covered now. Well I guess better that I got it now than never! Thank you so much for this advice! I guess this has been the best advice on here yet rather than just figuring out my path in nursing!! Thank you!!

Yes I have considered being an IBCLC Lactation Consultant. It is definitely a route I can consider. I have also thought about working at an infertility clinic. I guess there are options for me . I wanted to see if there was some other area of nursing that I haven't considered yet. Some magical, wonderful, non-litigious area of nursing that I didn't know about :)

I am a new nurse but I have been in L&D long enough to know it's not right for me (almost 2 years now). I've talked to my fellow co-workers, my cousin who is a doctor, and some other specialty nurses, and ALL of them said not to get my own coverage because I am covered through the hospital. Do nurses typically carry a separate malpractice insurance policy?

As much as I love L&D, I do not feel it is right for me. I do not like the fact that it is such a highly litigious area of nursing, potentially critically or permanently hurting a baby, and the stress of a crash/emergency c-sections, etc. But I love bonding with my labor pts, getting cards and thank you's from all the pt's that I worked so hard to deliver lady partslly or being there for the scared pt that wasn't expecting a c-section. That is what I love! The bond you create with your patients and the job satisfaction you get from making a real difference in someone's life. I'm trying to find an area of nursing that will fulfill the love that I have for nursing without the high stress level of an L&D nurse. Any other areas in the hospital do not interest me...med/surg, ICU, ER, telemetry, ortho, oncology, nicu, etc. I've thought of just doing postpartum (I do that in my position as well, I work in LDRP.) But to be frank, I think I would get bored. Any suggestions?

As much as I love L&D, I do not feel it is right for me. I do not like the fact that it is such a highly litigious area of nursing, potentially critically or permanently hurting a baby, and the stress of a crash/emergency c-sections, etc. But I love bonding with my labor pts, getting cards and thank you's from all the pt's that I worked so hard to deliver lady partslly or being there for the scared pt that wasn't expecting a c-section. That is what I love! The bond you create with your patients and the job satisfaction you get from making a real difference in someone's life. I'm trying to find an area of nursing that will fulfill the love that I have for nursing without the high stress level of an L&D nurse. Any other areas in the hospital do not interest me...med/surg, ICU, ER, telemetry, ortho, oncology, nicu, etc. I've thought of just doing postpartum (I do that in my position as well, I work in LDRP.) But to be frank, I think I would get bored. Any suggestions?

I would definitely leave out the "dream job" comment. I think a great OB nurse is one that is able to quickly think on their feet, can handle any situation under pressure, and able communicate effectively. I feel like L&D is the most commonly misperceived area in nursing. Generally it is the "happier" place in the hospital (that's why I love it) but things can turn south VERY quickly and you have to be able to handle those situations effectively. I would definitely mention any stressful or high pressure situations you may have had clinically or other jobs and how you handled it.

It is more obvious when the pt's cervix is thick. When you go to check, you feel the outer os first and it might feel like 2 cm, then when you tunnel your fingers through, you notice the internal os only fingertip.

I live in Los Angeles area and found a job 2 1/2 hours away in a very rural area in L&D. Got hired as a new grad. It is hard to find a hospital that will train a new grad. But doesn't hurt to try and apply. You definitely won't get hired if you don't submit a resume. Consider relocating and try to apply everywhere. I've actually seen some postings that said new grads will be considered, but they are far and few between. You just have to be persistent.

I am a new nurse at a facility that does not do high risk labors. So I do not get much experience after a pt gets a dx of anything high risk. They are sent to another hospital to delivery. Today, my pt received dx of preeclampsia and was on bedrest refusing to be induced. She agreed to stay in the hospital to watch have her B/P watched. We managed it with Labetolol if it got too high. Her B/P would flucuate between 140-160/90-100. But when I left the unit, her B/P was 170/110. I was wondering at what level could a pt seize/abrupt. Why didn't the physician order mag sulfate? Any advice would be appreciated! Thanks!

1. CA (rural area, far from any city!) 2. $30/hr 3. Started as new grad 4. Labor & Delivery

I'm interested in picking up a per diem shift every week and have been curious about registry nursing. There are so many companies out there. Are they pretty nice all the same? What should I look for in a good company? Is it more beneficial to apply directly to a hospital as a per diem nurse. What are the pros & cons to both. Thanks !!

Calinurse 4 - I can't believe time has past so fast, I wrote that post a year ago! I am now 1 year and 3 months into my job and..... I am starting to love it!!! I can't believe I am saying this! I was SO freaked out for over 6 months! My anxiety and stress level was almost unmanageable...but I just kept chugging on, knowing that most new grad nurses feel like this and the stress level WILL eventually go away. I can now say that the stress HAS gone down. In L&D, you are going to be doing the same thing over and over and over again. Granted, EVERY delivery and situation is different, but, essentially you are providing the same level of care to the patients. You are going to run Pit after every delivery (unless pt refuses), you are going to do fundal massages after every delivery, you are going to prep pt's the same way for every C/S, etc. After you learn all the basics, it does get easier. I still worry about OB emergencies, but I know my experienced nurses are there to back me up! And with any scary situation, you learn from it, and the next time it comes, you will know how to react. After my anxiety level went down, and started understanding what a good labor nurse does, I now find my job SO rewarding. I love it when I work my butt off to get a pt to dilate (after being stalled for hours) and save her from a C/S or being able to calm a pt down from so much pain and have her concentrate on pushing. The cards, thank you's, and hugs make it so worth it!! I love being there for my pt's and being their advocates. I NEVER thought this day would come. I wanted to quit everyday...but I'm not a quitter. And I'm so thankful that I didn't. I was TOTALLY where you are at now so I know what you are going through. Just hang in there and I promise it will get better!

The day I found the cervix, I never had a hard time finding it again. At first I felt warm squishy mush too. But when my preceptor was checking the cervix, I noticed the mom was about to jump out of bed. But when I checked her, she comfortably laid there. I realized I was not reaching for enough. It true that the cervix can move forward as the baby descends...but for the most part, don't feel bad or uncomfortable to reach a little further. And it's definitely easier to check on patiens with an epidural. Then you won't feel so bad taking a little longer and not causing so much discomfort. Good luck!