dwetherelt

As a manager, I have written policy in two hospitals forbidding nurses to hold legs, just due to nurse injury -- I know several nurses who have had either shoulder or back surgery from this practice. Families can hold legs, or the leg rests (don't use the word "stirrups" ) can be used, but nurses can NOT hold them. In one place I had some push back so used the hospital's Risk Manager to help push the policy through, along with the Employee Health Manager, who wanted the practice stopped due to the high cost of Workman's Comp injuries. When docs object I tell them of the risk for nursing injuries and ask them to hold the patient's legs for awhile - it usually ends there.

I managed a unit several years ago; when the BON said it did fall within the scope of RNs to perform amniotomy we initiated an education program and then let the RNs perform the amniotomy (we also inserted IUPCs and applied FSE's). BUT, I told the staff there would be no excuse accepted if there was ever a cord prolapse when they did the amniotomy. Long story short, staff sometimes refused to do the AROM, insisting the docs do it the presenting part wasn't well applied or was too high and in the ten years I was there we had 2 cord prolapses with AROM. . . BOTH when an MD did the AROM. Other posters are correct, you need to know what your BON allows, then ensure you have adequate training for safe performance.

. . . depending on your locale, quite a ways! I've been an RN for 28 years and for various reasons (none of them being lack of desire) I still have "only" my ADN. What I DO have is a wealth of experience and a good measure of common sense . . . I've come up thru the ranks (in four hospitals, not counting the contracts I worked when I owned my own Travel Agency) from staff nurse, to Preceptor, to Unit Manager and now am the Director of Women's & Children's Services. I've looked at a BSN several times, but have now decided that a BS-MS in Healthcare Administration will serve my personal needs best. Can you go quite a ways? Yes, indeed . . . but I do recommend deciding what track you want your career to take and then getting your advanced degrees in the area(s) that will best serve you along the way. Good Luck!

The national c/s rate is close to 30%, but not 50% (yet). Section on demand is being touted as a woman's "right" ~ the last couple conferences I've been to have essentially said if a prime (or anyone else) requests a section and the OB refuses, and ANYTHING goes wrong at delivery you're dead in the water in the courtroom. I think we'll see a continuing rise in the section rate (have at every place I've been in the last five years) until, as will inevitably will happen, we begin to see maternal mortality ~ which will happen. The risks of surgery are RARE, but real . . . increase the number of sections and the chance of that rare complication happening also increases.

While hospitals are looking to decrease the poundage of disposal of red-bags (because it is VERY expensive) no one is looking to increase infection. Check with your Infection Control people, one IC defined contamination is when something has more than 20ml biohazardous material on it ~ then it would be more likely to "drip" and cause a contamination. I agree with Fiona, tie it up in the trash bag ~

I'd like to thank everyone who has taken the time to write in response to my question. The upshot is that there are no easily available statistics available (darn!). We are doing community focus groups to see what (if anything) the moms have to say (I suspect they will!). The savings in salary dollars are significant (for us, $350-525,000 every year!) so that will also factor in. Again, thanks for taking the time to respond!

we are in the planning phase for a new ob unit; the staff really wants to go to ldrps, but we are meeting wide-spread resistance among the ob providers. the perinatologist has stated "ldrps were "in" in the 80's but are on the way out, everyone is reverting back to ldrs". i'd like to have actual statistics to refute (or, hopefully not!) verify this statement . . . anyone have any ideas where i could look for statistics? what are you doing at your place if you are plannig a new unit? thanks for the help. deb