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cherokeesummer

cherokeesummer

OBGYN, Neonatal
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cherokeesummer specializes in OBGYN, Neonatal.

Mommy, Wife, Friend and Nurse

cherokeesummer's Latest Activity

  1. cherokeesummer

    Breastfeeding support by HCPs

    PS and I do not give formula unless mom asks me to. I have gone in a room in the middle of the night to make sure its what they wanted if they sent the baby to the nursery for the night but have been otherwise breastfeeding. I will ask if its an out on demand infant (feeding in the room when hungry) or if we are to feed in the nursery and many moms choose to feed formula at night.
  2. cherokeesummer

    Breastfeeding support by HCPs

    We support it at our facility BUT often are over worked and understaffed and do not have the time we would like to devote to it. BUT when someone asks me to help latch a baby I do it, even if it takes time that I don't have at that moment I do it b/c its important and even if it is someone who really doesn't want to do it but is feeling pressured. I've had a patient ask nurses to tell her spouse she was unable to nurse b/c of a breast surgery b/c she didn't want to nurse and didn't want to just tell him that. Frustrating. It is frustrating when I tell ppl over and over again that colostrum is small in quantity and huge in quality and that its important to try to latch if they want to breastfeed and then they give up immediately b/c the baby is crying. I try to explain that it does take work, dedication and its a personal choice, i will support them either way. On the flip side I get frustrated when I have a baby that has a HUGE decrease in weight and increase in bilirubin and the parents will not budge on giving a supplement and only try to nurse the baby when its awake and only for a few mins. I suggest at that point finger feeding/syringe feeding pumped milk and formula. I want to support moms but at the same time, I want their babies to be able to go home with them so I try to get them to breastfeed successfully and offer alternatives to supplementation that do not involve a bottle. If they want a bottle I will give it to them without lecture and I explain that it is still possible to switch from breast to bottle, it may take more work but it can be done. I was one who tried, could not get it right, my son had a bottle from the start b/c of hypoglycemia and when I tried to latch I couldn't and I gave up too quick and didn't seek help. I pumped and gave that to him for a bit. I still feel bad about that 4 years later and try to help my patients so they can work harder at it if they want to. I wish I had worked harder at it but I know that he is happy and healthy and thats what counts. But no I do not think that HCP are against breastfeeding, but there are those who will be hardcore one way or the other as well.
  3. cherokeesummer

    Newborn evacuation plans

    Do you guys have an evacuation plan in place for newborns and what is it? I am working on updating (hopefully) or at least clarifying our policy/plan and was looking to see what other options are out there. Thanks in advance!
  4. cherokeesummer

    Animosity between L/D & Postpartum

    We have the same issues and for the same reasons. It sucks for both sides that sometimes the other side doesn't get what the other needs, but yes we have the same problems and same underlying causes.
  5. cherokeesummer

    Could I like OB even if I'm an "all natural" kind of girl?

    100% all the way agree with this!
  6. cherokeesummer

    pre-delivery "grooming" issue?

    Yeah I was thinking about that too. I really have no problem with those who want to be bald and can see that men would appreciate it and like it or even prefer it. The only thing I have issue with is a man telling a woman she must do it. LOL, I just don't like being told what to do lol!!!!!!!!! :) I can not imagine the pain of waxing but hey its probably more effective than the old razor deal! :)
  7. cherokeesummer

    pre-delivery "grooming" issue?

    LOL yeah! I asked my hubby about it once, lmao and he was not for it LOL, but hey I'd support him even if he wanted to color it rainbow colors lmao! But I'd still have to laugh a smidgen! :):)
  8. cherokeesummer

    pre-delivery "grooming" issue?

    LOl I love this thread, cuz I've seen all kinds of things at work LOL. I must say, my husband cares not either way - hair or no hair. There is no "reward" he does what he does b/c he loves me :) He also fixes things and eats a lot of steak lmao! And my thought is if you want the woman to be bald then the guy parts need to be bald too. Which in itself sounds like it would be pretty funny looking lol. :)
  9. cherokeesummer

    Was I Inappropriate

    Idk about phone calls but often if I'm off two nights and come back and a patient that I had two shifts ago was there still I will go in and say hi to them, check on them etc. If I pass them in the hall, same thing.
  10. cherokeesummer

    How long in bed for post C/S mothers?

    I wanted to add too, one of the biggest issues is getting them on board, even repeat sections can give me a hard time about getting up b/c they are not wanting any pain and I manage the pain before hand but also try to remind them that it is surgery and that pain may be involved but will be worse if they stay in bed. Also it is clear liquids til ambulation most of the time, so my patients tend to be more agreeable to trying to ambulate if they can eat. (I do sometimes give crackers tho if they have good bowel sounds). I had a section with my son, delivered at 1152am and was in the nicu via wheelchair by 5pm.
  11. cherokeesummer

    How long in bed for post C/S mothers?

    Our protocol/orders say 2 hours post op, I however don't usually have a patient with legs at that point if they still have a pain pump. So generally speaking I come in at 7pm and will get them up anywhere between 9pm and 5am, depending on when they delivered. I prefer to get them up after several hours to rest/get feeling back, etc. I will try them out just to the bedside chair first if its still kinda early.
  12. cherokeesummer

    Toradol? Do you give it to breastfeeding moms?

    Previously we did as it was always a selected order by anesthesia who controls the pain meds in c-section cases. However then they started to not give it to known breastfeeding moms. Generally it was 30mg IV (sometimes 15mg) q6 hours x 10 doses and then switch to prn 800mg motrin after the 10 doses. But it really depended on the anesthesiologist that was on as to whether it was given or not. It works well so I wish more would give it. And if my patient is having problems and its not ordered I do call to ask for it.
  13. cherokeesummer

    staffing issues...any suggestions?

    Wow that is scary! We do not have ldrp, we have ld and then a seperate mother/baby unit. On post partum we do not have any ancillary staff so we are required to do everything for the patients (vitals, trays, discharge teaching, bed linens, etc. etc.) and we start the shift generally with 4 couplets (8 patients) or a mix of couplets and gyn surgical patients. There are times when we've had no choice and been up to 6 or rare occasions 7 couplets. But that is a rarity. Generally 5 couplets, or a combination of couplets/gyns to equal about 10 patients that we do everything for is the norm. (not saying I agree with it but its what generally occurs). I can't imagine having to divide up with laboring patients as well, that is just so intense, I can only imagine how stressed you would be.
  14. cherokeesummer

    Pain medication in Postpartum

    Wow compared to some of the responses here our unit provides a lot more meds, sometimes I wonder if that is the problem with our patients not wanting to get up. CS come over with epidural in place and keep it 1-2 days there have been rare ppl who had it on day 3. I encourage removal as soon as they can tolerate it b/c I really don't see how it helps them a lot, some ppl yes but most of them seem to be ready to be done with it sooner rather than later. CS also have toradol q 6 for about 2 days. They can have percocet in between for breakthrough pain. Vaginal deliveries can have motrin 800 or percocet or both. I try to start out slow, if my patient is complaining of cramping (vaginal) I try a motrin and then if that doesn't help or if they ask for somethign stronger I will try one percocet (we are allowed to do 1 or 2 q 4 hours prn). But I strongly encourage ambulation, especially for cs patients, they really need to get that gas out. Personal experience, having had a cs as well as a few other surgeries, pca pain management is not good for me, I do better with po meds. I think toradol is good iv though for many pains and I think if I have another child and its a cs delivery I will try to find an alternate route, or have the epi pulled asap. I just don't find the benefit in it and always did better with other methods of pain management. And walking as soon as I could was always helpful! I am just shocked sometimes at how much time post partum patients spend in bed, I think it really helps to be moving and doing things even if its just within one's room.
  15. cherokeesummer

    VBAC: new insights

    Thank you for sharing this! I'm always interested in learning about VBAC issues not only b/c of work but because I have wavered on whether I would attempt a vbac if I were to have another child.
  16. cherokeesummer

    Recovery for vaginal delivery

    Elvish I'm with you, I would be totally shocked if all my patients came over tucked into bed and already showered LOL! No way, most of the time they are still partially numb, or at least a little shellshocked and we are expected to do all of their care, orientation, plus recovery (once we get them we recover them with vs and fudal checks q30 mins x 4 ad q 1hour x 2, then q 4 hrs x 24 hrs and the q shift unless there are problems), plus our other couplets (average for us is 5 most days) and do other work (vital signs, i's ad o's, pass meal trays, change linens, empty foleys on surgery patients, assist with circumcisions, etc.).