breastfeedingRN

we play brahms lullably when the mom is leaving L&D on her way to postpartum, so that she can hear it. it only plays in the main hospital halls/public areas, not on the units/rooms, so the mom never got to hear "her" baby's song (we used to play it when a baby was born). it plays when they are passing thru the double doors of L&D. this also saves patients there who suffered a loss, etc, from hearing it in the rooms, which might be a way to compromise for places that have complaints.

lurk away! have your tried hypnosis for your fear of vomit? could be worth a shot!

Exactly. I had only seen one VBAC in the year I have worked postpartum. I read the VBAC consent form and it actually said several times how the risks of VBAC were less than the risks of C/S and that was surprising to me how honest they were. I wonder how honest they are when it comes to just a C/S?? We have so many that are cut happy. You can even tell when certain docs are on-call because we have soo many sections that night. Argh... I do think that it is our sue happy world though that has a lot to do with it since I don't think that actual safety has the biggest part in the reason docs don't want to do VBACs, though I am sure the new restrictions hinder their schedules, a lot is probably to do with fear of being sued. That is our country, things don't go right, sue.

when i was home postpartum after a 2nd degree lac, i would put water in a newborn size disposable diaper, then freeze it and presto! i also suggest this for engorgement to my patients.

That makes complete sense. on another board where I post, some of the mom's who have lost their babies have posted pictures. I don't think anyone has said anything but how beautiful they were. I even think the pics of babies in utero are beautiful as it is human life. I am sure your babies were beautiful and thanks for sharing your experience. it is much like the feelings expressed by the moms on our loss board and I am sure your post will help someone here as well to be supportive to someone who has lost a baby. Hugs to all those who have lost babies.

my friend lost a baby at 17 weeks and it was very hard. hopefully they have a good bereavement program and they made a memory album for them. some parents choose to hold their baby, others don't. my friend didn't and then wished she had later, but she was thankful for the memory book they made for her. here are some websites for you. https://www.miscarriageassociation.org.uk/ I think the fact that you want to be sensitive and are searching out how is great. She is lucky to have a friend like you. Here is what an online friend wrote about what to do and not do... Do - Call the baby by name (if it was named) - this validates the parents and the love that they have for their child. - Send a card, flowers or a note of support - Call the couple and ask how they're feeling - Bring up the baby - you won't cause them to be sad, they're already sad and need to talk about it. Don't - Say they have an angel in heaven - many parents wanted that angel here on earth - Say it was 'God's will'. Even if the person is deeply spiritual, this can leave them feeling angry or questioning. - Tell them the can just have another or at least they can get pregnant - comments like this really hurt! Even if they do have another baby, they wanted THIS baby and have the right to be sad and mourn the loss.

i tested out of them back in 2001. i worked as a medical assistant for 7 years before that, so i thought they were very easy. i think if you have a medical background, then they should be easy to pass out of. good luck.

just wondered if you have thought about looking around for another NP that wants to work part-time and see if you can find somewhere that will let you guys "share" a full time position. 2 pediatricians that i worked for actually did that. both worked 2.5 days a week so they could still be at home with their kids. worked out well.

I was an MA for many years and never referred to myself as a nurse. When I worked in a peds office for several years, one of the docs would call me her "nursie-poo" to her patient's, but I always corrected her. I always assume that an office staff member who says they are a nurse is an MA until I see her badge with LPN or RN on it. I actually had an awesome instructor in MA school that told us in the first semester that we were to never refer to ourselves as nurses. She told us that if we did and gave medical advice and that patient believed we were a nurse and sued because of wrong info or whatever, that we would be held to the standards of a nurse in trial. Not sure if that is true, but never wanted to find out! I wish all schools would tell their students that. I also think that it is the doctors that hold a big responsibility in making sure their staff MAs don't refer to themselves as nurses and that the docs themselves don't. I always identified myself as Dr. So and So's medical assistant when I called a patient. In peds we actually had a staff nurse that did triage and whenever she was out, the MAs had to return calls. I always made sure they knew that the nurse was out and that I was an MA.

i love couplet care! some nights can be a little "boring", but there are many a night that aren't. breastfeeding issues, postpartum hemorrhages, people with pre-existing issues, etc. i do love all the teaching and getting to work with the mother/baby pair. we also get GYNs occasionally, so you still get some med-surg in there. i have no interest in L&D, the medicalization of the birth process drives me nuts and i would go crazy in L&D, but i love helping new parents, breastfeeding challenges, etc. i had a patient on remote tele this weekend, several on IV anbiotics and breastfeeding issues galore. it was definitely not a "boring" weekend for me. i say if it sounds interesting, to go for it!

Hi! I started as a new grad on PP about 11 months ago. Every place is different I am sure, but here is how my night typically goes. I usually have 4 couplets assigned to me. Get report and am introduced to my patients from offgoing nurse. After getting report I get my charts and check for any new orders or orders that haven't been done yet. I go through my clipboards and see what the patient will need that night, are they going home tomorrow, is all their teaching done, does baby need tests done before the AM so they can go home, etc. By 8pm or so I start assessing my moms and make a quick assessment of baby as well. I go over the plan for the night, answer any questions and then move on the the next mom. After that I start charting on my moms, unless I was lucky enough to chart between moms. By 10pm, I am done with assessments and am starting on charting. Around midnight we do our baby assessments, we take them from the room to another room with a scale and good lighting and do a full assessment and weight. We figure out how much weight they have lost, if it is WNL and if not what we will do about it (usually with breastfeeding moms, though sometimes bottlefeeding moms are underfeeding). When I am done with baby assessments, usually by 2am, I chart some more and then go to lunch. When I get back, I finish charting, do the chart checks and also sign off the next days MARs. Around 5 or 6am, depending on how many babes need to be done, I start taking the babies to do their Newborn Screens and Bilichek (for jaundice). I also update the feeding sheets for babes at this time and then they go back to their moms. That usually ends up getting me until 7am which is time to give report and then go home! Of course, that is only when things go as planned. There are always nights with babies that have problems breastfeeding, pain issues, or starting the night with only 2 or 3 couplets and then getting 1 or 2 new admits. Meds are given as well, IV antibiotics hung, postpartum hemorrhages, moms on mag sulfate, etc. I really love postpartum. It can be hectic some nights and other nights things just go smoothly and I actually get finished with everything on schedule. As for things to bring. Maybe the normal parameters for moms and babies, what you are assessing when you do your assessment, etc. I am imagining you will be following a preceptor for awhile? Hopefully you will be able to learn a lot from them and maybe even get to precept with a few people and see how their routines differ. I liked having a good Maternal/Child nursing reference with me, just in case. Good luck to you! Postpartum can be a very fun and rewarding place!

i am totally paying out of pocket for my homebirth and prenatal care because my insurance at work doesn't cover lay midwives or homebirths. actually, i am going to try to fight them for some reimbursement, but am not holding my breath. i read the policy and nothing says they don't cover them and under their out of network providers, it says any provider licensed by a state or federal agency and she is. not that i mind paying for her services, it is worth it for us. our medicaid here covers homebirths and my midwife is a provider, i guess i could quit my job. LOL! i have tried scoping out OBs at my hospital and there are none. i won't see a man for prenatal care because of being sexually abused as a child and the women haven't inspired much confidence in me, they seem more cut and epis happy then the guys. i think in a transfer situation i wouldn't care who was "catching" the baby, be it man or woman, but not for PNC.

Definitely! I am pregnant with #2 right now and have a CPM and am planning for a home waterbirth. I had DD in the hospital, after planning on a birth center birth with a CNM. I had high blood pressures, but no signs of pre-e, so I am hoping this time I have no blood pressure problems. It wasn't bad, but being stapped into the bed made my previously easy labor much harder, luckily I made it through with no interventions and had a pretty okay hospital birth. As much as I like my old CNM, her practice is way too busy and it is practically like seeing a physician. They are just too busy to spend the time with you. My CPM comes to my house, spends at least an hour here talking to me about proper nutrition, etc. I know that she really knows me and I trust her completely. I know there are some risks to homebirth, but I also know the risks of delivering with an OB or even just in a hospital setting. I choose my set of risks as well as the benefits to the care of a homebirth midwife and delivery at home. Klone, good luck deciding what to do! I hope you find a decision that you are at peace with!!

Awesome post! I plan on having my baby with the care of a CPM at home this time. I couldn't have said it better, so I won't even try!

thanks everyone. i am liking the tshirt with a vest or jacket over it. maybe i could get a few button up scrubs in my size and wear them over a tshirt with some drawstring scrubs. congrats andrea!