azzurra29

Hi there, I'm seriously considering PH nursing and I had a question for those of you already in it. If and when you check on antepartum patients do you usually see them in their homes or in clinics? If you see them in their homes do you use one of those listening devices to check the fetal HR or is there something like portable EFM monitoring that's done (I'm totally guessing on that)? What do those types of visits entail? I'm just curious about all that. Antepartum stuff would be new to me and I was hoping you might be able to share your experiences. THanks.

Hi there, Thank goodness for these specialty forums. I've had almost 3 weeks of orientation for a postpartum floor I am working on. Granted, I've learned a lot but since I'm a new grad I'm still learning how to deal with the fusion of obstetric and pediatric physiology and nursing care given. While I've been digging into my OB/PEDS textbook a lot lately, I still don't feel up to par with things. Part of me thinks that the rest will come with time and experiece but I need to be prepared for anything. SO, what would you say are the most important things to look out for in newborn care i n a nutshell? (if possible) To me, I'd say the basics are s/sx of infection, dehydration/feeding/hypgoglycemia, hyperbilirubinemia and of course the ABC's. Would you say that's about right? Oh and safety of course. I must ask however, what to look out for with newborn dehydration? Lethargy, poor tone, dry mucous membranes, elevated temp? anything else? I'm so scared that I must miss one of those signs because from what I've been learning, the important thing is measuring fluid status with the baby's output. So all the wet diapers etc. But I guess some babies will not be gettig enough despite meeting the minimum number of wet diapers? This part gets me confused. If you wouldn't mind sharing some helpful tips and expertise about this I'd so greatly appreciate it. Many thanks from a desperate new grad

I can't remember if I said thank you already but all the spanish phrases thrown in by everyone have been very helpful. Muchas gracias!

Wow, I really appreciate all the helpful posts (including the humorous ones). Thanks everyone. I've got my work cut out for me .

Hi there, Any PP nurses who know medical spanish or who are spanish-speaking, would you be able to help me out here? Or direct me to somewhere on the web... Just started out in a PP unit and I'd like to be able to get some better Spanish skills on board. Thanks. For example, how would you say (in simple yet understandable terms) things like: -are you breastfeeding or formula feeding? -have you breastfed the baby recently (within the last two hours)? -any dirty diapers? stool or urine? -anything else you might want to throw in -have you urinated? Have you had a bowel movement? -please call me when you want to go to the BR so I can assist you. -I'm going to palpate your uterus. -I'm massaging your uterus. -have you had more bleeding? -what is your pain scale 1-10 with 10 being the worst pain? Just wanted some input. Thanks so much!

Thanks shortstuff. The descriptions really helped me to visualize things a bit more. Question: when you say the pt trickled blood for awhile, what exactly do you mean? That is, what exactly are you seeing when you examine the pt? This is one thing I haven't really understood. Another question: I read somewhere that pushing too hard on the uterus can cause uterine rupture... is that true..? or what exactly do you mean when you say you pushed hard? Thanks.

I have to say I very much concur with this. Had I known how difficult the real world of nursing is I know I might have rethought my choice for this career. I'm totally a new grad as well and dealing with one of the most difficult things I've had to do in my entire life; it's almost unbelievable to me and I have never cried this much before. In fact, I get so much anxiety on my off days that sometimes I wonder if I should just quit already. Yet, that in itself is a hard decision. I just wish I could fast forward to the 6 month/1 year mark and know that I will be more comfortable and solid. I can totally relate to the trials of being a new grad. I'm glad we can share them here.

Wow, thank you both for the helpful information/answers. Actually, I know from theory that PP hemorrhage can be insidious but I wanted to hear from more seasoned nurses. Wow, I'm still processing all that--especially what this means for new nurses on the unit. The good thing is that the experienced ones can certainly help them out to spot things. Thanks.

HI there, I'm sorta new to OB nursing but I've been reading up again in my school textbook. I'd just like to ask all of you whe practice in this clinical setting about PP hemorrhage during the hospital stay (I guess that's considered EARLY pp hemorrahage then right?). I know it probably depends on what's happening like if it's internal bleeding or some hematoma formation versus bleeding out into peripads and saturating those. Is it more often than not, PP hemorrhage can be caught earlier on (VS, peripads, mental status?) or is it a mixed bag of possibilities? Does it become easier to pick up on PP hemorrhage with more exposure and time? What have your experiences been like/any tips/recommendations/suggestions? I have to ask because I'm a new grad, still very green and just thinking about PP hemorrhage sends shivers down my spine :uhoh21: (I know I'm not the only one). I may be working in a PP unit and I know that this is the reality so I'm trying to come to terms with that. It's super scary to me and I know patients everywhere in the hospital bleed BUT for some reason this really bothers me. Hmm, maybe I shouldn't be in that unit? I don't know. Thanks for any comments/feedback. I'm really grateful that these forums exist.

SmilingBluEyes--thanks for telling it like it is although it makes me more frightened now since I'm a new grad possibly entering a PP floor. Our nurse recruiter suggested this for me since I couldn't handle the stepdown floor of our large teaching hospital. I hope I can manage.

Thanks for the comment, Mirasol. What you said makes sense and yes, I'll have to investigate further the issue of expressing clots.

Hi there, I wish I could say I retained more from my OB classes/rotation in nursing school (just a year ago) but I'm a bit rusty. I might be getting a PP job soon so I've been trying to polish up some of my theory. I was rereading my OB textbook and reviewing fundal palpation and massage. I need some help understanding something here. If the fundus is boggy, they say to gently but firmly massage the fundus in a circular motion. They also say that a boggy fundus may be r/t accumulated clots which should be expressed. I was then reading that one isn't suppose to express clots until the uterus is firmly contracted. wait, what? You're supposed to help the uterus firm up but how is going to if you can't express them? I am SO CONFUSED. I am either totally reading this wrongly or the book is not articulating itself well. Oh, and another thing: I was reading that you aren't to "push" on an uncontracted uterus--aren't you somewhat "pushing" on the uterus anyway when you are palpating it and then massaging it or does this mean like blatant pushing? And if yes, is it pushing/pressing down on the fundus down towards the direction of the lady parts? I don't remember ever learning about this in nursing school. Anyhow, Can I kindly ask for some helpful comments here? I'd really really appreciate it. I've been making a concerted effort to really try to understand these things but the above just throws me off. THanks so much.

Thank you for the great explanation. What kind of nursing does one have to do to get into such a position? Do they require other types of experience as well?

Hi there, I needed some help understanding what utilization review RNs actually do, what the job is like, what's it like on the pay scale continuum, etc. Thanks so much!

I really appreciate all the comments/advice so far. rose61, I think you described a lot of what I'm feeling so far. I am indeed frightened and I think my biggest fear is not catching something when a patient starts deteriorating on me, especially with unexpected bleeding. I get nightmares over such stuff and then I really wonder if I'm cut out to be a nurse at all. I mean, that's what health/illness is all about right? Facing all kinds of situations and seeing the good, bad and ugly. However, it never really hit me until I started working in the "real world" and I sometimes wonder how I could possibly not understand that before. I tend to be hard on myself but I don't see any other way when you're a new grad, inexperienced and when liability is greater these days. My, oh my. Maybe I'm dwelling too much on the negative but I guess I'm also being realistic. I just have to believe that with all my hard work and effort I will grow more confident and really be a great nurse.