MamaCJRN

The recommendation for a true reading is for the patient to be in a semi-fowlers or sitting position. The most important thing is to never have the patient lay flat on her back, at the very least she needs a hip roll under her left or right hip. I'm not sure as I don't know the nurse you are working with but I would want the true reading so I would know if interventions (medications, positioning, quiet environment) are working for the patient. Your hospital protocol should state how you perform BP's for these patients. Hope this was helpful.

We use the 30 units Oxytocin in 500 mls for induction, then run at 125 ml/hr after delivery. Where I used to work we ran it at 444 ml/hr after delivery, why that rate, I don't know :)

Last I heard, we were all on the same side, to do safe patient care. The nurse should have informed that tech she was out of line. I have a great deal of respect for the OR techs I work with, but they accord others respect also. She needs to remember that if their weren't any pre-op nurses, there wouldn't be any 'op' for her to worry about and she wouldn't have a job.

Sorry this happened to you, I have had docs go over my head so much I have a permanent part in my hair :)

AWHONN is Association of Women's Health, Obstetrics and Neonatal Nurses. When you say AWHONN Certification, are you referring to the Fetal Monitoring Course? If so, you can usually find a class for $150-$200. I teach this course but I'm in Oklahoma. You can take the NRP test on line then you would have to arrange to do the simulation part with an instructor. Hope this was helpful :)

Basic fetal monitoring class & NRP are a good start. The more advanced or specialty courses will require some experience in the field. Best wishes!

We have 4 LDRs, 2 docs deliver 450 babies a year. We are a Women's unit with L&D, PP (12 beds) and nursery. Our central monitor/EMR system is GE CPN, love it! I've worked with OB Tracevue and unless they've made changes it's not very user friendly. Central monitoring doesn't take the place of bedside assessment but it is an awesome tool if used correctly. If you see problems you go check on the patient or help the nurse already there doing interventions. There is also Airstrip OB that works with central monitor systems and enables the physician to see the FM strip on their smart phone. Your legal people should be behind you in this quest to get central monitoring. Best Wishes!

Does your facility use AWHONN Staffing Guidelines as a standard of care? I believe the standard is 3-4 stable mother/baby couplets and no more than 2 of these should be 1st day post op Cesareans. Standards and guidelines are for patient safety and if you facility says they go by these but don't staff accordingly, it can turn into a legal nightmare. If you have to go up the chain of command (as you did when call the DON) and can't reach someone, keep going up the chain until you find help. I can only think that your manager is experiencing major frustration and a lack of support from administration, however that is no excuse for getting angry with staff for requesting help to maintain patient safety. You can get a copy of the standards from AWHONN and find more info on www.awhonn.org

My guess it would make too much sense :) I agree, it would be much more efficient. I'm going to have to research that one to see if anyone has ever made a serious effort to create a national board.

If the area of nursing you are working in requires a certification (ACLS, PALS, NRP, etc) the hospital will normally send you to the class and pay for it. I never had to take an IV therapy course, just learned OTJ :) Hope this helps.

I have had internal staff contact me regarding job openings. I am okay with email, although some managers are more traditional and would rather have you come see them in person to introduce yourself. Best wishes!

A pregnant woman came in thought the ED in labor, dilated to 7cm. She told the doc she couldn't be more than 27 weeks because her husband had been gone on job related training for about 16 weeks prior to that. We were prepared for this sick preemie (she had not seen a doctor nor told anyone she was pregnant). Baby weighed 7 1/2 pounds and gestational age assessment put him at 39 weeks. No one knew what to say to her husband, he stood by her and acted like nothing was amiss, I really admired him for not calling her out in public. I wondered if they stayed together?

Thanks for proving once again that nurses are the most creative and adaptable people. Best wishes in your new job(s)!

The typical day (LOL does that exist for nurses :) ? ) depends on where you work. In a large facility L&D is caring for laboring patients, inductions, C/S all day, once delivered and recovered they will be transferred to the Post Partum floor. If you work in a birthing center or a facility that does LDRP, you may care for the patient from labor through discharge. I have worked in both large and small facilities. In the smaller hospital you do it all, labor, post partum, nursery and you also get med/surg patients as overflow or gyn patients. You do all the things that nurses do and the extra OB jobs. Teaching patients how to cope with pain, breast feed, care for themselves & the baby, etc. I started in OB right out of nursing school, in a rural hospital, and as a director I have hired many nurses right out of school. It might be less likely to be hired at a larger place right out of school, most employers would like you to get at least 6 months of med/surg experience before going into a specialty area. I have mixed feelings, I consider med/surg a specialty too, you have to know your stuff in lots of disease processes and like any area of nursing you have to love it. Hope this is helpful, don't hesitate to pm or post any specific questions. I love OB and know it is the right place for me.

I was working in Bakersfield, CA at Mercy Southwest. I was ending my night shift and walked into the break room to see the 1st tower burning and then the 2nd plane hit, I couldn't believe what I was seeing. Some of the travel companies were asking for nurses to volunteer to go to New York to help. The sad part is there weren't very many survivors so they didn't need us. A few years later I heard an ADON from St. Vincents in NYC speak at a conference. It was very moving to hear how staff and citizens came together to deal with this great tragedy. Now my son, who was 11 years old when 9/11/01 happened, is in Afghanistan serving in the Army. God Bless America and God Bless our troops!