obenfermera1

Patient walks up to triage desk accompanied by her twelve family members, three suitcases and five pillows...... Patient: Hi! I'm having my baby, my doctor said he'd be here waiting on me, my contractions were every 20 minutes this morning, but they stopped while we were in the car. When can I have my Epidural? One of my doctors said I didn't have to feel any pain if I get the Epidural. Patient's Mother: She's going to need a C-Section, I had to have one when I had her 30 years ago because I never dilated, so she probably won't dilate either, where's the doctor? My all-time favorite scenario! And it usually happens between 2 and 4 in the morning.... :heartbeat

Aaccck! I just typed out a post and it disappeared into the ether....dang. Short version....I agree with all the stuff xtxrn said, you go sister!

Way back when there were actually techs/aides/CNAs on the floor every shift for real I remember these things - baths, oral care, linen changes- were done in a much more consistent manner.....I miss ya'll!! Now, I am more likely to come into a laboring patient's room and find her (1) soaking wet from shoulder blades to knees (2) Foley bag close to exploding and (3) hasn't been turned/repositioned since the epidural was placed 5 or 6 hours ago! Arrgghhh!!! And don't even get me started on the lack of care with Antepartum patients..... I agree that there's been a HUGE shift in focusing only on the infamous "she's pink and breathing she's OK" philosophy. You can't manage labor from the desk people!! Ahhh, I feel better too OP, thanks!!

Just saw your response post about having already worked at this facility for a while.....In this case, you're GOLDEN! Relax and enjoy your pregnancy!

Absolutely positively what MassED said!! Pregnancy is supposed to be treated like any other medical issue, which means you have every right to keep it to yourself. Although the flip side is that SOMETIMES it can be nice for your co-workers/charge nurse to know b/c they will often take your condition into consideration when making assignments....for instance, on our floor the pregnant nurses get a free pass on fetal demises for the length of their pregnancy. Of course this consideration isn't required of them (co-workers/charge nurses) but when you're pregnant every little bit of compassion helps, especially early on when you might have your head in a trash can at any moment! I have no idea what kind of L&D unit you're joining, and of course they are all different in some ways, but just steel yourself ahead of time for possible behind the back eye rolling when you share the news. Not trying to drag you down, just a warning to be realistic like you said: "the new nurse is preggers, it figures!" does get said and we all know it. On a short staffed L&D unit the RN's see orientees as "thank God, a new person to help us out!" and often the more burned out/cynical and outspoken ones will be less than thrilled to hear you'll be out on maternity leave as soon as you get through orientation. My facility is one of the more short staffed/cutthroat type of L&D units and we see this all the time....The poster that mentioned checking into the FMLA requirement was 100% on target too. There's a 12 month employment requirement to qualify for FMLA at my hospital, I think this is pretty standard. Of course this is discretionary, so our manager uses it to weed out the newbies that get pregnant or have other medical issues early on. If you go through orientation and do well and are well liked you get that "discretionary" maternity leave if you've been there less than a year. If you don't do well in orientation or make enough people mad for whatever reason it's "oh congrats on being pregnant, too bad you haven't been here for a year, sorry to see you go!". I hope you find your L&D unit to be alot more family friendly, but it always pays to be prepared for the worst. This is one of the basic tenets of L&D to begin with, right? Hope for the best but be prepared for the worst! Whatever happens, remember....family comes first and babies are blessings! Good Luck!

Nope, no DEEP guilt, but I do feel bad for my co-workers as you mentioned. I'm also one of those pesky Part Time nurses that have the gall to choose NOT to work full-time and am very rarely able to work extra because of child care issues. I have to occasionally remind a snarky or resentful co-worker that I also get the part-time benefits (none) to go with that title including signing up for our schedule after the full-time folks, having to work the SAME number of weekends and holidays as full-time, and missing out on all the little quirks and perks of full-time employees...that's an easy thing to forget! I find the concept that just b/c I work less hours a week I'm supposed to feel more obligated to come in when the floor is short hilarious. I could be full-time and work OT to boot and the floor would STILL be short- that's poor management, not poor planning on my part!

Hmmm, Do RNs in the other specialties get as jaded and cynical as us L&D nurses? I've often wondered this....I was a pretty skeptical person even before nursing school, but in 16 years I have turned into one of the most unimpressed and unsympathetic individuals I know~ other than my L&D comrades of course! Not knowing you're pregnant falls in line with my general policy of "15% legit/85% B.S." Harsh I know. :smackingf But having said that, I also have to say that I've noticed an alarming trend of patients (women in my case of course) have ZERO awareness of their bodies. The younger, the more clueless! Whatever the reason, our young folk are not being taught about keeping up with what's going on "in there"! Sad but frustrating too...

Yes, my facility repeatedly hires new grads into L&D and repeatedly beats them into the ground until they quit, have a nervous breakdown or somehow manage to struggle through the trenches despite it all. Usually 4-6 get hired every year, maybe one, two MAX get through orientation. A great many of those wind up leaving within a year. I don't have a stance AGAINST new grads coming to L&D as I was one 16 years ago- NOT at my current hospital though ~shudder~ It's just that they are so often treated unfairly with unreasonable expectations and sometimes put in dangerous situations. We typically have 90 days for new grad orientation and more if they don't pass snuff after that, but it's very fractured and inconsistent. It's a hospital-by-hospital call, but once you've figured out you're in a new grad meat grinder it's too late! So sad that we still have managers that just see warm bodies versus seeing an opportunity to invest in a human being. What you put into them is definitely what you get out!

Here in L&D there's no push (or even mention of) CLC yet, thank god! RNC on the other hand is aggressively pushed, much to my dismay......yes, sadly I'm in the mid life crisis/burned out L&D nurse category....anywho, at my hospital we get a bright shiny quarter per hour more in pay with our RNC titles. The purpose of such a certification is bragging rights for the hospital (X percentage of OUR nurses are CERTIFIED, oooohlala!) and most nurses themselves seem pretty proud of it too, so there's and added bonus of the pride of being "certified" in your specialty plus being able to sign that RNC after your name..... Have I fully conveyed my disdain for the concept? Sorry guys, my cynical nature reigns supreme

# 1..Yeah, what cherrybreeze said.... why would you stress yourself out if you don't have to? You're talking about finding out definite answers in September! Safe sex only until September isn't really "putting off having a family" is it? Just makes sense IMHO... #2..FYI, I'm in Georgia and I also have never had to wait for insurance to kick in..granted I've only worked at 3 hospitals and 1 agency in the last 16 years, but for all of those the health benefits were immediate, as were my husbands who does not work in the healthcare industry. Based on all the posts, this seems to vary widely, so you really do need to know this from your potential new employer before you make a decision though. #3..Another FYI...You're not protected under the Family Medical Leave Act until you've been employed for a year, so you also need to know if your potential new employer is going to feel flexible about you taking maternity leave before the 12 month waiting period is up or if you'll be terminated and have to reapply for your job when your maternity leave is over. Job security baby!! Oh, and if you're part-time you actually only get protection under FMLA if you worked 1250 hours minimum in the previous 12 months on the job prior to your leave (hence the 12 month rule) this is approx 24 hours per week btw. #4..If income is an issue for maternity leave, a short term disability policy would help alot, but they typically won't cover pregnancy if you're pregnant when you sign up, so you've got to get a policy in place prior to pregnancy. My last policy had a one year elimination period, which sucked *ss! I hope something out of here will help a little... All of this I had to learn the hard way and via a very uncooperative employer in the past, so just know that the more you know the easier the whole thing will be! Good luck and congratulations in advance! :heartbeat

At my hospital (and the one I worked at previously 10 years ago) the L&D nurses do it all from pre-op until transfer to postpartum. This includes pre medication, shaving, pre-op checklist, dealing with patient and family, getting consents, calling everyone (EVERYONE!), transporting to OR, helping anesthesia, setting up warmer for baby, circulating case, recovery and transfer. Oh and somewhere in there we have to chart on all that, it's INSANE!! Heaven forbid you have to do some extra task such as pushing up a head or irrigating a bladder! At the previous hospital we even had to care for baby once the initial "ok it's breathing and HR is good" assessment was over. At least at the current hospital there's a NICU team that comes and cares for baby, all we have to do is note the vitals and weight on the delivery record. I'm pretty sure the previous hospital is STILL requiring one circulator be responsible for Mom and baby.....I can't believe I did that!! Ignorance is bliss.....

Our hospital also uses the 12 hour rule for a covered setup. IDK for uncovered as we just never uncover until the provider is ready to gown up/delivery is imminent. Our techs say 2 hours for an OR to be "open" but IDK if this is a standard or something they conjured up on their own.

Instead of the "kudos", (or in addition to if you prefer!) we need some smiley icons that match each one of these poster types so we can chime in and vote on a type for each poster....now THAT would probably put me under the crap stirrer category, but it's all good! LOVE IT!

I'm not 100% sure, but I think this very issue is one of the current Joint Commission identified patient safety thingamajiggys. Their position on the matter is something like there should be an opportunity for the receiving nurse to receive report and have a chance to ask questions at the same time. We were told this was their way of forcing the "face to face" report issue, as we had implemented a verbal/phone report process for transferring our delivered patients to post partum. At the time, our (L&D) argument was, post partum knows the patient is coming when our secretary calls to request a room, so why do we have to track down the receiving nurse on the gigantic floor to give a face to face report when we've already called ahead and given report to receiving nurse on the phone? The answer was b/c our phone report process had created a potentially looong lag time between our call to say patient is otw and her receiving RN presenting to the room to assess the patient, and it was unclear who was responsible for patient if report wasn't given face to face and care officially handed over at a precise time. I know this doesn't really answer your question, but just wanted to say this is an issue across the board. The Joint Commission wants us to have that precise magical *moment* of handoff to make it simpler to identify the responsible party in case of an issue. But then life interrupts the perfect plan........You're not alone! :redpinkhe

Been doing mainly L&D for 16 years.....nope, no excitement. You're not crazy! The first job I had out of nursing school was in L&D in a big teaching hospital here where the staff is mostly older L&D "lifers" and the residents do most of the work. In that environment, it's almost a recognized sport to be as passive as possible with pit/inductions/augmentation, etc so you could get through your shift WITHOUT delivering....After 8 years there I left and went to a private hospital and was SHOCKED to see that nurses were running "active pit" and having up to 4 or 5 deliveries in 12 hours, how RUDE!! I'm still doing it and I love the job as a whole, but you're right, the actual deliveries are WORK and there's just no getting around that fact.