ShannonB25

your unit does this??? I'm wondering because the last hospital I worked for routinely gave abx at the 12 hr mark if a patient was ruptured, but the unit I work for now doesn't give anything UNTIL Mom is showing signs of infection (febrile, etc)... The pt I had tonight had been ruptured over 27 hrs and was still not on abx, thus prompting my question. Oh, and her temp was slowly creeping up btw! Just curious..... Thanks :) Shannon

Hi all, I was wondering if anyone here has participated in (or has opinions regarding) Walden University's online MSN Education program? I would really appreciate learning any pro's/cons or otherwise. In doing my own research, I was told repeatedly that they are accredited for the maximum amount of years, which was impressive to me. ANY information regarding Walden would be so appreciated! Thank you in advance, and feel free to email me as well if you're more comfortable speaking about it in private :) Warmest regards, Shannon

Hi, just wanted to add that I agree with what has been posted thus far. I too have seen this type of strip far too often (twice this week so far- ugh!) and unfortunately both babies ended up with c/s. Those cord strips are the worst. I literally stayed at my pt's side for a full four hours, flipping her back and forth, repositioning, bolusing and basically having mini heart attacks with each UC a few days ago. It was a relief when they called a code actually. Turned out there was a tight nuchal cord and baby had 9-9 apgars so go figure. But those strips are hard to watch for sure. Another nurse had a pt. like the one you're describing on my last shift and they crash sectioned her after attempting an amnioinfusion (I didn't see that mentioned, but it was sort of a "last resort" before cutting her) to see if they could float the cord, etc. Anyway, I feel your stress in those types of situations. You're not alone, trust me! Good luck!!!

What she wrote!!

Best of luck to you! Can't wait to hear what happens! I'll keep my fingers and toes crossed for ya. :)

I also feel that this is far too many pts, particularly for a new grad. It's just not worth risking your license over. I'd advise you to give it careful thought before going into this. There are soo many opportunities for nurses now, and I for one will agree with what the above posters said about really *needing* that support/backup from coworkers during your first year or so of nursing (and even after that really!) GOod luck with whatever you decide but it seems that they are being very risky by putting a brand new grad into a position to care for so many pts. Keep us updated, ok? :)

Oh, that's horrible! I hope the poor dear is okay, and doesn't suffer any lasting effects from her behavior. Poor thing.

I Love this thread...of course, I am also sitting here with my cheeks that are wet with tears, but I adore these stories, nonetheless. So..for mine. One of the first times I *knew* I'd made a difference to a patient was during nursing school. I was doing my ICU rotation and felt pretty overwhelmed. My patient was an ARDS pt that was being extubated that day. She was in restraints and was fighting the tube so badly- they'd stopped medicating her as well for sedation. Being the cautious nursing student that I was, I stayed by her bedside the entire shift, watching her vitals and all, but more for the support. After consulting for about the fifth time with my instructor and the nurse I was orienting with, only to be assured that yes, the pt was fine- she was simply bucking the vent and would be extubated as soon as RT came around, I stood helplessly next to the bed as my pt thrashed about. My patient was an elderly black woman and I noticed she had a Bible next to her bed, no doubt brought in by her kind daughter. I took her hand at that point and said, "Ma'am do you pray?" and she nodded yes, then continued to move about, wild-eyed. I did the only thing I felt moved to do, and I held her hand, closed my eyes, and started to pray out loud for her. It was almost instantly that she began to calm down and when the time came shortly thereafter for her to be extubated, I continued to hold her hand. I'll never forget though that first thing she said, in her raspy, dry voice after they pulled the tube out- She looked straight at me and said "thank you". I knew exactly what she meant. I drove home happy that day. Stressed but certain that I had done exactly what was needed for that patient. You guys are right you know- it's about *all* of the patients needs, not just the numbers that we get so adept at interpreting.

Well, I went back to work after an over 2 year hiatus. It can be done- lol. I returned to Labor and Delivery, as that's all I've ever worked. While it's challenging as well, there's not another place I'd rather work. I highly recommend the area. Several of the nurses that I work with have ICU backgrounds and feel that it's served them well in Labor and Delivery. My very first preceptor was a former SICU nurse and I'll never forget her telling me about her experience as an ICU nurse vs. a labor nurse- she said, ICU was tough, but labor and delivery is tougher! lol Whatever you choose, I wish you the best of luck with it! This is a great forum for any questions you might have too. As I said, I had a gap in service and am doing quite well now (and I've been back for about 6 wks now!) Good luck!!!

Sorry to hear about your situation..I truly hope things are better for you soon. Hang in there!!!

Thanks for the advice, ladies, and for listening. I'm going to chalk this up to experience I suppose and try not to lose heart over it. I love my job and I won't let this stand in my way. Thanks again for the support. And I've committed your advice to memory as well as possible scenarios. Hugs to you all!!!

Hi, I need some advice please...I usually consider myself very confident in SVEs as I've over 2 yrs experience but had a bad experience when I worked a few days ago. In short, I checked a pt who had previously been 5 cms, to find that she was 9 with a contraction, 8 without. Ran around getting everything set up, etc. Rechecked her a couple hrs later (she was a SROMd prime with an epidural) when she c/o increased pain to find that she now felt no more than 7-8 with a UC. Her block wasn't effective at this point and I felt puzzled by my exam, and presenting part of the head felt different as well. I got the MD who was on and had her check. She said she was only 5-6 still. So I had to inform the family of this, all of whom are looking at me like I'm an idiot. The MD looked at me like I was an idiot. I'd have bet my life on the fact that this pt was a hair away from complete with my initial exam..so my question is- just what happened there??? I feel so out of sorts after this experience. AND it was my first shift sans preceptor following orientation. Just NOT a great first day solo whatsoever. I feel so dismantled inside over it, I've had nightmares the last couple of nights. I just feel awful... Any thoughts as to what may have happened? Anyone ever experience anything like this before? Just wondering if I'm the only one... One Bummed Out Labor Nurse

I'm so sorry you had to go through that truly i am. *big hugs*

Very cool!! And kudos to you for the good work you obviously did with that patient, too. It's always nice to be recognized :)

((gentle hugs)) I read your post and teared up right away. I'm sooo sorry that this is happening. Please know you're in my thoughts and prayers. Many are thinking of you both now, I'm sure. ~Shannon

Just wanted to give you a big hug and tell you that I really think that you did the right thing by leaving that position. I don't know what the future holds for you but I'm sure that it has got to be better than what you had at that job. Big hugs and best of wishes to you in your recovery and with your future job search. I'm sure you'll do grand!!! Good luck to you! Shannon

YES!!!! Food is most appreciated by this nurse as well as those on my unit!!! I think your nurses will be most grateful that you've thought of them in this way. It's very thoughtful of you indeed. Happy holidays!

Just wanted to state my stance real quickly on this, which is basically that it's not my job to decide what any decision is for a mom. Be it whether to nurse or bottle-feed, to have an epidural or labor without analgesia, my job (and I feel the only appropriate thing to do) is to relay the options- ALL the options- to the mom, and then support her in whatever she decides. I'm not there to judge. I will help provide teaching regarding BF in as unbiased a manner as possible simply to clear up any misconceptions for mom, but it's merely because I feel teaching is part of my role as a nurse, thus it's the right thing to do for my patients. I am wholeheartedly in support of BF as I nursed both my boys and plan to nurse future babies, so if a woman chooses to BF I'll all but applaud her and do all I can to help in her attempts. By the same token though, if I have a mom who doesn't choose that route I don't change my attitude towards her, I just gear my teaching that way and away we go! Just my two cents...

Just wanted to add that I agree completely with what you all are saying on this topic. Dayray, I think you hit the nail on the head with regards to being able to successfully explain further and refine teaching if need be, rather than merely regurgitating info by a CNA..we're not just tape recorders after all!!! I'm so glad I work with such a smart group of people, sincerely!!!

You know, I have a problem with the CNA doing the discharge teaching as well. That is the nurse's scope of practice, definitely! I mean, come on. I've moved out of state as I now live in Cali but graduated nursing school in a southern college. One of the nurses I graduated with works in one of the tiny, rural hospitals like you referenced and said that basically the same thing happened there. She said that a CNA works in the nursery and there may be one actual RN on the floor doing the L & D/PP area, but she's also the person that "puts her RN sig on the nursery assessment". My friend said that it's not unusual for the CNAs to have up to 7 or so babies in the nursery, and that this is considered normal there. I have a problem with this (and I won't go into a long diatribe because I"m tired and I don't frankly want to go there too much BUT...) as you all know there can be a touch and go time in transition for babies that CNAs are just not trained to watch out for. IMO, that puts those babies at risk and I for one would not want my baby to be looked after only by a CNA for hours at a time as a transitional newborn. Like I said, I could go on and on, but I'll spare you...Just had to put in a small bit as this really irks me.

Hi! Just wanted to add real briefly that as someone who's being precepted presently, be sure to get a good baseline assessment of your preceptee's skills level initially so you're not wasting any time going over things that she may already know. ALso, be sure to jump in and get your hands dirty right alongside the person you're precepting- it's reassuring, trust me. By no means would I encourage doing everything for the person, but when you're new to an area and you're feeling overwhelmed, sometimes just having your preceptor say kindly "here, I'll go get that for you" is such a relief! I'm tired and those are the first things that popped in my mind, so hope they help a bit! I"m sure you'll get great advice here though- I know I always do! Good luck!!!!

Thanks for the advice and the suggestions guys. I really appreciate it. I feel like I'm just starting to branch out and challenge myself, first with my new job and then the RNC. In the near future I plan to start working on my master's degree, but I'll cross one bridge at a time :) Thanks again!!!

for taking the RNC exam. I'm planning to take it in ~3 months and would like to prepare as thoroughly as possible. Any links or books you could recommend would be great. Also, does anyone know offhand what the pass/fail rates are for the exam? I've been looking online trying to find some numbers but I'm just not having any luck yet. Then again I did work last night and my eyes are dry and blurry- lol! So any help would be greatly appreciated! Thanks in advance!!! Shannon

LOL..yeah, I guess it would! That's cool. I just started a new job- maybe this will be the lucky place that will change my pattern :)

I'm giving a small gift basket to my nurse manager, along with a card. We're doing a potluck dinner at work for Christmas night so I'm making a pumpkin roll to bring along to that, and probably some candy as well. FTR, I've not worked for a place yet that buys their employees gifts of any kind on christmas- have ya'll???