All Content by Suebee6
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Safe nurse to patient ratio? How do they do it at your hospital?
We always do 1:1 with all active labor or section patients. We circulate and recover our section patients, but they are our only patient at the time. We have 2 or 3 at the most "watcher " patients in L and D..PTL or Mag..etc. No PCAs in L and D. Usually one secretary for the unit. We do about 300 deliveries a month, core staff is 3 RNs and 1 scrub tech at all times. On our perinatal floor, we have 4 patients each at the very most, some days we also have 1 PCA to the floor (12 patients) and 1 secretary..but not always. We can get pulled up to perinatal for staffing if they have over 4 patients each. (that is the only floor where we get pulled)
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Fetoscope, doppler, EFM?
I have SEEN a fetascope...but never had to use one!! We do intermittant monitoring at times but it consists of hooking them up to the EFM for a 20 minute strip. We do still have one on one nursing care though :monkeydance:
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First day on the job as L & D nurse.
:cheers: Congrats!! Sounds like you were broken in well today!
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Out patient Cytotec
I agree!! We don't even use cytotech for a viable pregnancy induction at the hospital where I work, so I cannot even imagine this ever happening.
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What can LPN's not do in Alabama in regards to nursing job responsibilities??
hmmm.. I think so...??? We only have RNs on our floor, but we used to have an LPN and I can't remember her not being able to start an IV, we do IVs every day...
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Help
ooops sorry!!! I just saw this..cleaned out space !!!
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Something all OB nurses should know.
Never thought about a photo...great idea. No, I would not tell them the baby had died. Even when I was telling my friend that our other friend lost her baby at 10 weeks in utero, I said that the baby no longer had a heartbeat. I just imagine the poor mom hearing those words over and over for the rest of her life...
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Something all OB nurses should know.
I am a L and D nurse and I do not have any personal experience with loss. I appreciate you all sharing and letting us know what helps you all in your times of need. I think at times I don't know what to say, and I feel inadequate because I cannot imagine there is anything I can do or say to help...if that makes sense. I do not avoid, I try to be there and I do take pictures, allow parents to hold the baby, bathe and dress the baby and most everything that is listed above. We have memory boxes and do the lock of hair too. We have a check list that we follow to make sure we dont forget anything. But I feel lost when I don't know what to say.."I am sorry" seems inadequate...I feel like I am invading their space when family in there and I ma in the room..if that makes any sense, like it is a private time and I am an outsider...?? If they come in for decreased fetal movement and I dont see FHTs on US, and have to call in a doc to confirm...what do I say..I say "I don't see a heartbeat...." I dont want to say the baby has died..what if I am wrong, what if the doc finds it..I second guess. It is a difficult time for the family and they are waiting a horrible eternity for the doctor to get there...what can I do to help???
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Double Standard BS
I have actually had a patient once tell me half jokingly but I think she was serious..that she wanted a different nurse when she found out I had six kids! I really think she thought I was going to have a "been there done that" attitude and not "feel sorry" for her when she was hurting..even though she had only known me for all of 5 secs when I introduced myself and she bombarded me with questions! She was a bit of a princess, very nice girl but she was afraid I was going to be mean and not get her an epidural as fast as she wanted one. We ended up having a great day together. ANYWAY...my point is you never know what a patient is going to "want" or not want...they just need a competant and caring nurse whether or not she has been there done that or not!
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Ephedrine IV push
We have standing orders for it for the first time, if we need a second dose the order reads to call anesthesia (although they just say to give another dose usually)..the third time they will come LOL..
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huntsville: school choice help, please!
Wish I could help...I don't know anything about these schools...sorry! Good luck though!
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Help
yeah...they do tend to kill off any brain cells you have. I tell everyone my children must be geniouses cause they sucked all the "smarts" right out of me!
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Pitocin titration
We mix up 30 units in 500cc LR, start at 1mu and increase by 2 q15 until we gt ctx q 2 to 3 minutes. THAT is what the order reads. NO max written. Our docs dont really have a max, they all have different preferences. We usually just ask what theri limit is. Some docs say start at 4, go up 2 every 10. If I have an IUPC in, I am comfotable with however high it needs to be, as long as I have my MVUs in front of me. Of course it never has to go very high LOL...well not often anyway. Now without one...I am ok up to about 35 or so, as long as I am not hyperstimmed, FHTs reassuring of course, after that if doc wants higher I will put an IUPC in their hand first. Our docs will usually let us have our way LOL. It sounds like we are pretty aggressive compared to most..hmmmm
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bedside ultrasounds-nursing restrictions
Just an aside, but our policy states our doc must be in the hospital in order to start pit on a patient anyway...is that not a standard in most hospitals? Just curious... I was wondering the same thing about US too...they ask us to do them before a section to comfirm breech LOL..but they will come down to do them if we arent comfortable. We have a nurse who used to be a US tech so I always have her or the charge nurse document, or make the doc do it.
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Age when you had your first child?
LOL...knew you had southern blood in ya! I am from Mississippi too..Biloxi, and went to Ole Miss. Ended up here in Alabama though!
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Age when you had your first child?
Are you from the south?
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Age when you had your first child?
#1 24 #2 25 #3 33 #4 34 #5 36 #6 37 Now I am 40 and I think I am done..although God may have another little surprise out there somewhere LOL.. Best age....tough question. Physically or mentally? Physically I would say younger for sure, pregnancy was harder on my body later, although I seemed to get more fertile with age! Mentally I had more patience, but maybe that is because I had "been there done that" with kids...so it was easier to handle things. I guess over all I would say that late 20s to early 30s seems ideal to me, I think you know more of who YOU are as a person and maybe that would help you more as a parent???
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New Nurses in L&D
We do hire new grads in our dept as well, and have a wonderful orientation period. If it is where you want to work and you know it, then why be miserable somewhere else first..IMO..??? I did peds orthopedics first just because I worked there while is school and stayed on for a few years, then went right over to L and D. Never did or have any intention of doing med surg LOL..
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HELLP syndrome patient today
I can't answer that one, because we bring our moms over ASAP to see the babies. Our NICU is across the hall...so it is very easy to go over. (well easy as can be with multiple IVACs and IV poles and IV lines ..etc LOL) Even my very sick mom from above was allowed time with her baby. The moms are very unstable...maybe that is why? But seeing her baby helps.. IMO...
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HELLP syndrome patient today
Depends on the severity. We expect them to deliver early so we try to manage with steroids, Mag if needed for pressures..etc. Very close monitoring of proteinurea, (24 hour proteins done) frequent labs for liver function and CBC, of course BPs. Obviously we would rather keep baby inside as long as possible, but when things start to go bad we do what we have to do!
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Teen dies from Med Error in Labor
Our epidural meds are in glass bottles, not bags at all, no way to mistake them. Plus they are on the other side of the bed by themselves to keep them separate. We do not hang them anyway, the doc does. How tragic...
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Dermoid cyst
ew. Freaky looking things arent they!
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OB Interview tommorow. Looking for tips pls!
yikes..havent interviewed in so long, and I dont think I do very well either! Hopefully others will have some good tips. Just be relaxed, be yourself, let them know how motivated you are to really learn and pull your weight!
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HELLP syndrome patient today
yeah..my coworkers kid me it was all my fault for being relief charge today, for some reason me on charge on Sunday always spells some sort of crazy day..