redbeads

Yes, I was accepted to Class 79 and start the end of September. Good luck to you, Frontier is like no other school on earth and the best place to get your CNM degree!

I have a job. With benefits. And Dental insurance. Been a nurse for 16 years and took a pay cut in '97 with a pay freeze for 3 years. No regrets for me. When I started, I made 12.50/hr, now I make 31.00/hr. I'm in it for the long haul. Where else could I do what I love and get paid for it? Four years of college was well worth it.

I think you just have to let it go... As you said, you felt comfortable taking this assignment, you took good care of the patient and that's what matters. If, in the future, you find a certain pattern with this particular charge nurse, perhaps it should be addressed, but I don't think you need to question this charge nurses' judgement based on one experience. It is always hard to be the "new" person and it is normal to compare new places/practices to more familiar places/practices. That being said, I certainly understand being protective of demise patients since they do require extra sensitive care.

My facility does around 8,000 deliveries/year. On labor and delivery we use OBTV tracevue. This system does not interface with Cerner, the system that the rest of the hospital uses. We use Cerner for some things on L&D, but we also chart a few things on paper.....if this sounds confusing that's because it is! I like OBTV over-all b/c there is much individualizing that can be done, but information is all over the place and things don't necessarily "flow" well. I would love ONE system that EVERYTHING could be charted on by EVERYBODY.

Your questions are somewhat confusing as I do not see how they are related to "post emergency c-section information". And what kind of packet are you referring to? Something to help educate patients or a packet that you as a student need to present or find answers for? Sometimes the phrasing of your questions makes all the difference in the answers you get.

Except for the 500.00 bonus part, this is exactly what my institution has. I did it, had mixed feelings about it b/c I really don't think I was any smarter or a better nurse after I took the exam than I was before taking it...just now I can sign "nurse smith, RNC". Maybe other people think I'm smarter now;)....little do they know. My patients really have no idea what the title means unless I explain it to them, which I am not in the habit of doing. Some days I just think it's some made up thing that the NCC promotes just to make money..... but now I'm rambling. But hey, if your institution is promoting it and paying for it like mine is, there is nothing to lose (maybe alot to gain) for passing the exam.

I don't believe that we have a policy ....just depends. Sometimes the nurses place it, sometimes the docs do. I've done it plenty, but usually just ask what the docs preference is. I can tell you that one advantage of the nurse being able to place it is that it gets placed a whole lot quicker! I work at a fairly large teaching hospital in Michigan.

For me, a brick and mortar institution was not an option. I am not a graduate, in fact, I am just beginning my journey, but I have chosen Frontier. I know many nurse-midwives in my area who are graduates of this program and they are all quite successful and well respected. I believe that you need to reach your goal however you can....don't worry about what will happen in the end. You are your own best advertisement and people will hire you for who YOU are. Best luck to you.

Yes, she said that she gets good results with spec exams and simply doesn't feel that amnisure is often, if ever, necessary to r/o rupture. Although she didn't mention the cost factor, others have. Another reason was exactly what has been discussed here....when nothing else shows rupture of membranes, but someone does the amnisure and gets a positive result, then you have to proceed as if membranes are indeed ruptured. She felt that, similar to fetal fibronectin, amnisure results can have many false positives.

I spoke with one of our practitioners who works in our triage unit where we do many r/o ruptures every day. She said that she rarely uses the amnisure, but when she does, she treats any positive test like the pt. is ruptured. I'm thinking that sending someone home who has had a positive amnisure might not stand up well in a court of law if there was a bad outcome r/t this later on.

My gut reaction is don't use a test that you're not going to trust....but, I will talk to the practitioners that use this on our floor and get back to you. I know that it is quite expensive and we usually first do spec exams, then if that is questionable and the patient has a convincing story, we go to the amnisure kit.

http://www.awhonn.org/awhonn/binary.content.do?name=Resources/Documents/pdf/5_Epidural.pdf This is the link to the AWHONN position of management of an epidural in laboring women

Good luck to you!

I know this is not a response to your question, but...... have you shadowed at the hospital you are applying for? You say that you like the hospital you are at right now which is a HUGE bonus...perhaps worth more than a few more dollars/hour. I would hate for you to go to a new place only to find out that the grass is not greener.

Your post makes me think of this paraphrased quote: "You're either part of the problem or you're part of the solution." I say, bring on your "all natural kind of girl" attitude and help solve the problem! Go change things, one delivery at a time.

I commend you for wanting to prepare yourself ahead of time for your upcoming clinical rotation....I wish every student nurse would do this. These are things I tell student nurses that follow me: learn the basic terminology used in the labor and delivery setting, the basics of fetal monitoring, like what a decel and an accel is and what different types of decels might indicate and responses to these decels, how to determine the baseline fetal heart rate, how to measure how often contractions are occuring, know the mechanism of labor, the stages of labor, and how to help women during these different stages of labor. I know this may sound like a lot, but it really is not. Most of this info should be in your textbook. I believe that the more prepared you are for your rotation, the more you will get out of it! Also, don't be afraid to cry when you see your first delivery:)

I have been a labor and delivery nurse for 15 years and have run across every kind of birth plan imaginable.....I think they are great!!! Even with the so-called unreasonable ones, at least I know that the patient and her partner have put some thought into what might happen when they get to the hospital. I always make a point of sitting down with the patient and s.o. and going over the birth plan line by line. If there are things that may be unreasonable I explain why this is and usually the patient is okay with this. Above all, I AM MY PATIENT'S ADVOCATE! And not all birthplan patients end up with cesarean deliveries.

Absolutely! I feel your pain....sounds like Frontier is losing out on this one. Have you spoken to the head of the department directly? Just a thought.

Good to know...point taken

I believe a reason for giving the rubella vaccine right before the mom leaves the hospital is b/c it has a small amount of live virus in it....so this decreases exposure for others in the hospital.

It actually would be alot easier to do this the other way around. That is, become a CNM, then get certified as a WHNP after that. Frontier School of Midwifery and Family Nursing has this program. After finishing the CNM path, you would just need to complete some more clinicals, and take the certification exam to get your WHNP. From a previous poster, it sounds like UCSF has something similar.

Eventually the light bulb moment will happen, trust me. In the meantime, don't sweat it! If you are really concerned about it, or absolutely need to have an accurate effacement for whatever reason, have someone more experienced check behind you. As far as the pinch test goes, I really don't think it would be accurate b/c you want to determine the effacement as is, not as pinched....similar to a truly accurate dilation, you don't stretch the cervix to as far as you can and call it that number, you call the dilation what it is when the cervix is not stretched. As I read over this, I realize it is probably more confusing than I meant it to be. Take home message is you WILL get it eventually.

A variable, by definition, HAS to drop down by at least 15 beats or more (abrubtly,

Hi- all of this information is on Frontier's website, midwives.org. I believe that total cost runs between 24,000-30,000 depending on the degree and full or part-time status. I am also pretty sure that Frontier's policy regarding clinicals is that you cannot do them on the floor (maybe even hospital, though I'm not sure) that you work on. There are 2 times that you have to go to Kentucky, in the beginning before you start, and before you start clinicals, 3 times if you choose the Bridge option; otherwise everything is online. Check out the website....good luck to you!