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!

Congratulations! We have nurses at our facility who pump PRN, we have a nice little breastfeeding room and provide electric pumps for the staff to use. We even buy them an electric pump to use at home! Breastfeeding is your right, your employer should be accommodating. Best wishes :)

In our rural hospital, the physician draws the cord gas when getting the cord blood during lady partsl deliveries, we just have to put the blood in the lab tube. In C/S the OR circulating nurse draws the cord gases (The OB nurses receive the baby & our OR staff circulate the C/S).

Love you! Wish you were delivering at my hospital :) Birth plans are great, I don't see many and things go well anyway. Just remember we are there to help you and it's all about you (well, at least until the baby arrives, then you have to share the spotlight) Best wishes for a healthy and safe delivery!

I have never seen this problem in my 16 years, where I work, everyone wants day shift! I am like you, love nights, everyone is much more calm about things, much less drama. Isn't there someone on nights currently who wants to work days? Whatever happens, just remember, you can do anything for 3 or 4 months. Make it clear you prefer nights and do the best job for your patients, no matter what. I was silly enough to take a director position so I don't get a choice about when I work, and yes, it's mainly days. Oh well, it's worth it to make a difference :)

All school is jumping through hoops. I also have a business degree in addition to my BSN. One day you will pause in the middle of your busy nursing shift and think "That's why they taught me that!" Best wishes, you will love nursing, it's the best job in the world!

I'm so sorry for your loss, it makes it even more difficult when those around you ignore your feelings. Does your job not have funeral leave? Our hospital gives you 32 hours paid funeral leave when an immediate family member dies. Even if it was not an immediate family member, you should never be expected to find coverage or trade, it's a death in the family. I can't understand your ADON allowing you to be treated that way.

Thanks for the information Rod. That's what I was afraid of when I started looking at travel companies. I will look into a personal policy.

Congratulations! I know how excited you must be even though it's been 16 years since I walked into my orientation on OB. There are many great resources out there for labor support techniques. From breathing techniques to massage and relaxation. You can find resources on the internet. If your hospital offers childbirth classes, see if you could attend as an observer to learn what is taught or if they have videos or books you could study for ideas. One of the best things you can do is keep your patient informed. Calmly explain what will be happening during admission and the requirements that must be met prior to getting an epidural (IV fluid bolus, lab results, how far she must be dilated, etc). Best wishes and enjoy your new area of practice :)

Worked a neonate code at a term, scheduled C/S, anomalies not conducive to extrauterine life, very traumatic for the parents and staff. A few years later the parents returned and had a beautiful baby, a healing experience for all. It meant so much to know they wanted to share that joyous experience with us after the previous tragedy.

I haven't heard of any of these issues but they make my ankle hurt. I also work with two nurses who have stated the same thing :)