jrring1019

I take it off (during the actual procedure)and listen intermittently if it is taking a long time. I always trace mom if I leave it on and how is that helpful? You are still not getting a strip. I sometimes document "unable to maintain fhr tracing due to maternal position during epidural placement". Our anesthesia people (mostly CRNA's) are really good and have it in very fast. I will continuously monitor while she is sitting until the CRNA is ready, then as soon as the needle is out she sits up a bit while they are taping and I will dopple until I am ready to lay her back down.

I lost 2 babies at 16 weeks over a 10 month period. The first was our son, Andrew. Almost 10 months later we lost Ava, our little girl. I was overwhelmed at the strength my husband showed and how he took care of me. He was also devastated, but there were times I even did not consider that his pain could be as great as my own. Now that I am past the worst part of the grieving, I know I am blessed to have a husband who really loves our babies as much as I do. When friends and family called or helped they were more worried about me, and he did notice that. He was always asked how I was doing, but very rarely did someone ask how he was.

I tell my patients with epidurals to let me know when they get pressure that comes every couple minutes. If they already have a pressure feeling, I tell them it will increase and you will notice it coming and going. That is what I felt with my kids...comfortable and then all of a sudden, every couple minutes I would feel a pressure.

I am an OB nurse who lost 2 babies. I found the absent fetal heart tones myself, both times... There is nothing like that awful silence. When it was confirmed by the doctors, by u/s, it is absolutely indescribable to see your own baby with no heart motion. As the mother, you never forget what is said and done during those moments by the drs and nurses. Every moment of both inductions stays with me. Each time I put someone on the monitor and there is a moment when I can't find the heart tones my stomach sinks. I have never found absent fetal heart tones on a patient, but I have cared for them after. In 12 years, I have never had that experience from the nurses standpoint, but it was MORE than enough to be the mom and discover the silence myself.

if you love L&D( and you sound like you are good at it) then find a hospital with LDRP's. I have worked at both and I really love the LDRP nursing much better. Where I work now we take 1 labor with some PP's. At first it was very weird to me, but seriously you can get the PP work done and have plenty of time for labor charting and labor support. The best part is, when your pt delivers, you finish her recovery in the 2 hour time, then she remains your pt and you never move her so you can still catch up on charting etc... It can get really busy, especially with new admissions/triage but our unit is small (1100 del/year). Our moms get up when they say they are ready (usually 3 hours) and babies are brought to the nursery then for bath. It is so laid back. I really enjoy it more

I remember reading somewhere that the transition shakes and the post delivery shakes are natures way to prepare for the blood loss of delivery. The woman vasoconstricts and sends blood to the vital organs to protect in case of PPH,,,makes sense.

Yes, I chart those accels as accels present. Accels , even with contractions are a sign of fetal well being.

The question is "what would you think of this?" I would think that the doctors recommendations are appropriate based on the findings of low amniotic fluid and high (at least borderline) BP's. The tests are non-invasive, and may reassure both you and the doc. Personally, I can't imagine not having the tests done IMHO.

I had a 16 week loss of my little boy in October. I was just trying to doppler the heartbeat at work when I found out that he was gone. Horrible. I did not think I could handle going back to work, but it was really OK after the first night back. I was emotional about going in the room where I found out he was gone, but taking care of the patients and their babies was not bad at that time . Lots of girls at work are also pregnant, and it is a little sad to see them getting bigger and planning for their babies. Now that I am closer to my due date and women are coming in who are due when I was...this is difficult. I find myself wondering how their baby survived and mine did not. I will not work on my due date, that would really be too much. Overall going back to work is not as bad as you think, I did cry the first night but who wouldn't? You know how it is when someone asks you how you are doing when you are on the edge of tears anyhow? But the docs and nurses I work with are so great and understanding. They still will not let me take a pt with a loss, but I think I am OK now to do that. It is harder to take care of someone who is 34+ weeks (where I would be) especially if they do not take care of themselves or the pregnancy and still get a baby at the end. Take all the time you need before going back. You will be OK , but not on the first day back. If you can, work a shorter shift...I worked 4 hours and it was really the best thing. I am so sorry for your loss. Please take care of yourself.

I had the exact same job you do when I started nursing. I loved cardiac, but I went to OB after 2 years and have done OB for 10 years now. Go for it! If it is not a good fit, you can always go back. I stayed prn on my cardiac unit just in case and only went back for 1 shift.

After reading my original post I have to add that not all my care was bad. My labor nurses were great. My delivery nurse did a lot of pictures. We all know that the pictures never look all that great, and I have found this great service for stillborns or neonatal losses that do BEAUTIFUL photos. It is available in many places , it can be seen on the web site: Now I lay me down to sleep. The pictures are amazing, better than we can do and it is free. Also, I have never heard anyone discuss the emotional side with a pt, and had this WONDERFUL doc talk to me and then took my husband aside to also let him know what we would be going through at home emotionally. That was so important.

I have been an RN 12 + yrs (OB fro 10), I experienced a fetal demise at 16 weeks and and I can't believe what a new perspective I have. I cannot even begin to remember all of the pts I have cared for over the years who have experienced loss, but I hope that I did the best I could for them. None of us are perfect, and I think we could all learn something from a patients perspective. Things not to say to pt: 1.)At least it wasn't your first. ( this wisdom was bestowed upon me by a stupid/young resident). I quickly told him that I had lost my "first" to an early m/c. And just because it was my 4th child DOES NOT make it easier. 2.) "At least it happened now" (as opposed to later or having a sick baby). I totally get that, but it does not need to be said. The pt/SO know this on some level. This does not ease anyones pain. 3.) "At least you have kids at home" Once again, I get that . Yes, I am very lucky/blessed but this also was my child. Until you experience this, it is hard to see "it" as someones baby. But the parents very often view this as a very real part of the family already and it is a loss of that dream. 4.) "God has a reason" I guess you have to know the pt pretty well before this is a safe thing to say, but trust me I am religious and I HATED hearing this. After you lose the baby you hear EVERY SINGLE STORY on the news about every abuse in the world and it makes you think..these people get to have healthy babies? Where is God in all of that? The words that meant the most to me were "I am so sorry for your loss". Other things that helped were "I can't imagine what you are going through but I am thinking of you", "I will keep you in my prayers" Someone even asked if it was OK to pray for me, which actually was nice because you never know how a patient feels about people praying for them. I could go on and on. Also, it is OK to assess the pt as you normally would. My PP nurses avoided me like the plague and DID NOT EVER assess me and checked my VS 18 HOURS after my recovery (at the time of discharge). WHAT!!??!! I had to stay b/c of a hemorrhage and meds I received which required lab work q 6 h. The lab actually was closer to me than ANY one of my nurses. I did not deliver where I work because if insurance. Also, the parents should have a say in disposition even under 20 weeks, it is not a specimen to them!

Can you imagine the pregnancy? I was VERY uncomfortable with my 8 and 9 lb babies, I felt so heavy out front , back pain, etc... I cannot even imagine getting out of bed with a 17 lb baby in there!

I think that most L&D nurses support natural childbirth and are supportive of pts choices. If a pt is going natural I always give encouragment, tell her how strong she is and I am always so impressed by these pts. The time I think my pt is a pain is when they come in the door with a chip on their shoulder and you know that they do not trust you or believe in anything you are doing. If a pt thinks everything I am doing is not necessary and won't even discuss things with me then it makes the whole experience awkward. When the pt is suspicious of the hospital then the partners are not very friendly. I am sure almost every L&D nurse knows what I am talking about. There are some pts who bring their doulas and ask them for advice for every intervention, never really listening to the medical professionals. Those pts can be a pain. We recently had one as an example who refused PCN for +GBS...she was informed of risks, baby will need blood work etc..she still refused with doula at bedside supporting her. BTW, when this pt took some Nubain, the doula LEFT!!! Think about it, if a pt came to the ER and refused all kinds of basic care, you would be annoyed. About hypnobirthing...one of our L&D nurses did it and did great!! you couln't even tell she was in labor and only looked uncomfortable while pushing.

I can understand this from the confused, but I have never understood why a woman would rip off her clothes in labor and remain naked until delivery. Many who are going natural do, I figure its because they are hot and irritated. Honestly, I had one who was naked and walking in the room. It didn't get annoying until she started to squat ANYWHERE she was when the urge struck and push. I had to follow her around and put a chux under her to catch *things* whenever she pushed. Eventually, even her husband began to look perplexed.