AprilAZRN

Can someone link the article? I'd like to read it.

I answered in the other thread, I'm curious about other hospitals too. If ruptured and a good strip (with no pitocin running, of course) and a head well applied, I will let her ambulate. In the case of the PPROM'er, I'd check heart tones first, if the strip the FHR looked fine, then no, I wouldn't do a SVE, in they tones were down... then SVE, push the head up and the call button if I found a cord. And I'd be going for a ride on the bed to the OR. Hope that helps a bit. I'll check today if we actually have a policy, I don't think so, I think it's a judgement call.

if head is well applied and FHT is reassuring for an hour or so I'd let the SROM'd pt w/ no other risk factors ambulate. The PPROM'er, I'd have gotten heart tones first. You really want to minimize SVE's.

I sounds like you are moving along in the right direction, learning some important lessons on the way. Absolutely find out if you are assuming care or helping with call lights and fetal distress. It's a common miscommunication, and that simple clarification is so important (and it's asked often, so no one should look at you like you're off your rocker). I'm sure in another 6 months you'll be feeling a lot more comfortable. There is ALWAYS more to learn and we have all been new at one time. Hang in there and have fun. Hang in there!

We use if often post c/s. I've also seen an increase in use for PTL pts that present in triage less than 28 weeks. It works very well.

We used to, I was one! At that time they hired 4-6 a yr and we did group educational stuff, time on the floor, etc... I also had to sign an agreement I'd work full-time nights for 18 months. But we don't do it anymore. I think it's been 3 or 4 yrs. We do take new to L and D RN's, and they get around 3-6 months with a preceptor to learn the specialty.

You know in your heart what you want, I really hope it works out. I'm willing to bet the M/S unit would take you back if the switch isn't a good fit for you.

A visitor policy? wow.. that would be nice. Something to bring up at the next staff meeting for sure! I think we're about as busy as your hospital, around 250/month? It's not locked, there are no time frames, the nurses and secretaries informally stand guard (inevitably someone thinks they know where their friend is and tries to walk into the wrong room, or the labor room they were in the day before), there is a security guard available if we need one. No policy on how many people can attend the birth either. So each nurse sets limits as the situation presents itself. I set pretty clear boundaries on the space I need, and let them know if the FHT are ever non-reassuring we need to back down to 3 visitors, if I need to change mom's position quickly I may push someone out of my way. I'm not trying to be rude, just trying to keep everyone safe. When this is established at the start of my assumption of care, I have never had a problem. I really try inform everyone in the room what I will need to do and where I need them to stand to make the situation work before it happens so there's no misunderstandings. I also do not allow people to come in and out during pushing or repairs. Post c/s in recovery is 1 person, no switching, for the entire recovery period. That is a policy :-)

Im in AZ, but we don't use LPN's at our hospital for anything. I was an LPN in WA state and worked mother/ baby (but this was a long time ago, (93-98).

Heather.. for some reason I can't reply to your message. Yes, I did find the CCPR ?s helpful. Are you the only one taking the exam? It lets you print it after you answer all the ?s, so you could go in on the cost of it with some co-workers and share. I had a hand me down mother baby exam from CCPR too, from a couplet care RNC who took the exam, that was helpful too. I haven't heard of anyone that hasn't passed at my work place. When are you scheduled? I'm still so relieved to have it behind me.

I was hired as a new RN Graduate directly to L and D almost 8 yrs ago. Those first 6 months are a blur! Ask ?s and be yourself. I hope it goes well! Congratulations!!

It hasn't really changed how I feel about the size of my family. I have 2 children and my husband and I knew that was enough for us. My work environment hasn't effected that. Some labors touch my heart more than others, and I can get a little nostalgic, but after 7yrs in L and D, we're still a family of 4. :-)

the link for ProEd Center is in my previous post. Apparently the instructor takes the exam herself as often as she can, then does a 2 day review. They have now added the option to test right after the 2 day review ( on location) which seems like a good idea. I wish I had done it right at 2 yrs experience, instead of waiting 7 :-) Good luck.

How did you get a crushed tablet into to posterior fornix? We have a few drs that like the 25mcg lady partslly, most are 50mcg PO. And never ever with pit running at the same time. Sounds like a crash waiting to happen.. yikes!

Our policy is get a reactive NST, oral cytotec, 3 hours continuous monitoring, off monitors x1 hour for ambulation etc... then repeat if needed. We'd hold it for the same reasons NPinWHC stated. I really like it for primips with a closed cervix.