ShannonC

I did the job shadow thing once but it was for a non-nursing job, back in my old life. I got the job in question and after the fact, asked about the purpose and they told me it is largely social. In other words, they hang out with you so that they can see if you're decent to be around. So, my advice is to be friendly, easy to be with, not too serious, but not an airhead. Be yourself, for certain, but be your best self. I'd say don't worry too much about impressing them with you many many skills, be more concerned about being pleasant. Good luck! I haven't been on these boards in ages, so I don't have the benefit of knowing you, but I sure hope you get the job.

I am madly in love with this entire post! Very well said and I totally agree.

I think I have a soft spot for this Dad, because I remember being sort of in his and his wife's shoes. This is the scenario: you read the hard stats, you get all informed, but then you want to just hear from real life people... he seems like a smart enough fellow to know that the best we can offer is anecdotal info, but sometimes it's just really nice to have a "real person" behind the stats. Or maybe I'm totally wrong :) (been known to happen). But BetsRN has a point--there IS something to be said for letting go of the stats and just peacefully waiting... MUCH easier said than done though!

From my experience, what I have seen in my particular hospital,my "X" here is 34 weeks and my "Y" is 33. To me that fits the bill--33 weekers almost always turn out fine, albeit with a short stay in the NICU. Most of our 34 weekers are in the NICU for only a day or so. I had a 34 week/1 day baby last weekend who was in the NICU for all of 3 hours. And then I have my own personal experience with my own children who were 34 weekers who went home with me right away when I was discharged. Of course, I feel obliged to say, StressedDadtoBe, that (and you know this of course) we can't ever be certain until baby is out. Sadly, there are some cases where even 36 weekers(or more) have trouble. But, from my experience, we barely blink anymore at 34-35 weeks.

Though you may have to wait for a missed period, it might help to logic this out some... when did you have sex? At what point in your cycle? Are you regular with your periods? Are they often the same length? Was there a birth control method? Even if things are in perfect alignment, that doesn't mean you're pregnant, but knowing more details might help you have some relief from the crazy-going!

Blood tests can be done before the home tests, but not a huge amount sooner. These days the home tests are so good, very reliable.

I think I was the one who introduced the word barbaric to the thread... I do really apologize to anyone I offended. I'm not trying to make some huge point or change anyone's mind. That's just the way I feel, the word "barbaric" comes to me when I close my eyes and picture the procedure. Just an emotional response. As far as religion, for me, I'm less apt to argue the point when someone cites religion, but I am still bothered by it. Just because something is done in the name of religon or tradition doesn't make it okay... There are tons of examples for that.

You know, this has got me thinking, and feeling sort of "second-guess"ish about when I state my opinion. I mean, okay, it's not like I am out there campaigning for new parents to leave their boys intact. BUT, if a patient or her husband says to me about a circ "we haven't decided what to do yet. What did you do, and why?" or if they ask me "what do you think?", I respond with the honest way that I feel. I say "I didn't circ. my son based on the research showing that there was no strong medical need. That combined with years of seeing the procedure done and seeing how much pain the babies go through made the decision easy for me." Perhaps, though, I need to just leave the way *I* feel about it out if it, even if they ask. Like, maybe I need to fudge it and tell them something neutral. I don't know... it seems like a personal opinion was asked for, so I give it. But this has me wondering if I need to be adament about keeping it to myself. It's an interesting issue--sort of like names. If parents are deciding which name to name their child and they throw options at me, I hesitate to offer my opinion because it's so personal. I don't know... I guess I'm just pondering out loud!

I so totally agree with you! It's interesting what you have studied. It's too bad that this wonderful tradition of midwives got effectively extinguished... I hope it comes back full force! My hope is that everyone have a full range of choices and that women take back the power of choice when it comes to childbirth!

I am learning so much on this board! I am curious, SmilingBluEyes, if the patient doesn't push it out during pushing, when do you routinely d/c the Foley? For us, we d/c the Foley on everyone at some point during the pushing phase, and everyone, epidural or not, is escorted to the bathroom at 2-2 1/2 hours post partum (unless there are complications). So I am just wondering how long your Foleys are left in. Thanks in advance!

Wow... interesting thread. For me (have been an L&D nurse in Southern California for 7 years), I see the doctor as part of the patients' team. I am an important part, and so is the OB. I have caught some babies, but I always prefer it when the doctor is there. What if something goes wrong that I am not qualified to handle? What if she bleeds and I can't stop it? What if there is some unforeseen complication that only presents itself at delivery? Rare, I know, but if it happens, I want someone with an M and a D after their name present. That said, I totally agree that there are many patients don't take the responsibility to get themselves educated. They blindly follow their doctor and don't understand what is happening to them. Some don't care. Last weekend we had 4 (or was it 5?) inductions scheduled in a 12 hour period for the same doctor. I asked my patient why she was being induced and she said "Oh, Dr. D has a conference to go to and she wants me delivered before she goes". This was perfectly okay with my patient. I think for some people, from what I see in my fairly affulent patient population, there is this idea of the doctor as the person they have "hired" to "take care" of the delivery, much like you'd hire a caterer for a party. They just want to turn all the decision making over to the doctor and leave it at that. And if that is what they want, so be it. It sits funny with me on some level, but another way to look at it is that it is the other extreme of letting someone have the kind of birth she wants. If a patient wants to not think about anything, not have to decide, wants to leave all the choices to someone else and have a completely medical birth, that is her choice here in 2005. Like I said, it's not the way I would do it, but I gotta respect her wish. What a great topic. I wonder how the OBs would feel if they knew we dicussed their relative usefulness. LOL! :) -Shannon

Well, shoot. I totally messed up my reply just now. I tried to quote and reply to different sections, but ended up just making it all messed up. My responses are in italics, making it look like they were part of the original quote. Then I tried to go fix it but wasn't able to... Sorry for the mess!

Agreed, 100%, like I said above. But if my patients ASK ME, I'll tell them how I feel. It's why they asked. Also, play nice, please. :)

Yay!! Things sound really good for you guys. I myself had my twins at 34 weeks and 3 days... and they came home from the hospital with me. They weighed 4-5 and 4-8. No o2 needed, no IVs, no big problems. Just some difficulty getting them to suck vigourously, but other than that, perfectly healthy little babies! And now, at almost 5 years old, I can't imagine them being more perfect. I am so happy and touched that you are coming back to give these updates. I only get to come on here periodically but when I get a chance to read your updates, I am so happy. Keep up the good work! -Shannon

I vividly remember freaking out about test scores during nursing school. But, and fellow RNs back me up on this, my grades never had anything at all to do with one MINUTE of my nursing career. It is far more important to have the knack for it. And if the nurses on the floor were complimenting you, well, I'd take that information far more to heart than the test score. You're going to be fine, just keep believing! Memories of school... :::shudder:::

I've never seen a botched circ, per se, but I've seen many "regular" ones done, and I always think the same thing--it seems barbaric to me. That's just me, though. When my patients tell me they want a circ, naturally, I don't give my opinion. They have already made up their minds and it's not my business. But, sometimes they ASK and then I get to say how I really feel, which is fun for me. I am encouraged by how the procedure is getting less and less common. I find it kind of amusing that fathers want their little boys to look like them, in the member department. Seems a bit of an invasion of the kids' privacy? I dunno... seems weird. I don't go around saying "wow, I sure hope my daughter's boobs look just like mine!!" There aren't too many things that get me riled up. Circs are one of them, though.

When I was a new nurse, one of the people training me said that it takes 100 VE's until you "get it", and she was totally right. It just simply takes time. Maybe not 100 exactly of course :) but the idea is right--the more you do it, the better you'll be. That said, I agree with the tips give so far. I ALWAYS have the patient put the soles of her feet together and knees wide apart, and she's always basically flat in bed. I find with this positon, I pretty much never need the bed pan or hands under hips. I always go very VERY slowly (the warm hands is a great tip--I'll start adding that), and I try to go down first, like the others have been saying. The bottom of the lady parts is much more "spongy" and has more give, so I find I have more room to sort of manuever (sp??) that way. I hope this makes sense.

I love this question! No doubt, the best thing, and the reason I got into this job, is that moment when the baby is first born. The parents are exhausted but exhilarated, and it is just amazing. I've always felt that it's an incredible honor to be invited into such an intimate and important moment, when a family welcomes its newest member. It might sound like a cliche, but I mean it when I say that I am truly humbled, moved and honored to be there for that moment. I love telling a patient that she's fully dilated and it's time to start pushing... or I love breaking the happy news that she IS indeed in labor and we're admitting her... basically I am just a sucker for those BIG moments!

I get most frustrated with having poor managers--people who don't come from L&D, people who don't get it that you can't staff the unit based on what the board says at 5pm. People that don't understand how a busload of pregnant women can be dropped off at the hospital at any hour. "But you only have 1 patient on the board--why do you need three nurses? Of COURSE I cancelled your third nurse!". Drives me batty. Oh, and just my two cents... I LOVE computer charting. Once I got over the extreme hatred in the beginning, that is. It's hard to get used to something new but, once I got used to it, man, has it been wonderful. It's cut a good hour out of my total time spent charting. I love it.

I think I share pretty much everyone's else view... I think being CF by choice is a perfectly understandable and certainly acceptable way to live life!! Not everyone wants kids! Why is that so hard to get? But back to the original question of how to handle the pushy questions--I can relate some of my own experience (though it's not EXACTLY the same). My husband and I have 4 year old twins. EVERYONE at work, many of my patients, my extended family, the whole world it seems, wants to know when we are having more kids. We don't want anymore! Two is plenty. When I explain that we always set out to have two kids, and we got them in one shot, people inevitably say something about "don't you want to be pregnant again?" or "well, now that you have two, don't you want more?". One comment that is nice, but still can bother me is "but you made such nice babies, you should make more!" I just tell people that we're happy (that and a shrug usually stops most people), or if they push, I go on to say that our family, as it is, feels very complete and that I don't have the urge to have more and that it would be pretty silly to have more kids if I don't have that urge. I do think people are looking for that "you've been there" thing when they ask if you're a parent. For myself, I found that I was a better L&D nurse after giving birth. But that's totally just me. Some of the best nurses I know of haven't had kids. It doesn't limit you at all. My main nurse when I had my twins was amazing--I couldn't imagine someone better--and she wasn't a parent. And on the flip side, the biggest nightmare nurse I ever worked with had given birth 4 times. Interesting topic!!

I think when we support each other, we all benefit. I really learned something from this, and in the future, it's going to benefit my patients as well as myself... I'll always push Amp no matter how soon that baby is coming out! On a related note... Do you guys ever fudge and give the 2nd dose early (say at a 3 hours interval) when it seems like baby is going to come before the 4 hours are up? I've occasionally given a 2nd dose at like, 3 1/4 hours. Anyone else? Incidentally, I've been a L&D nurse for 7 years, too! But, with 2 years off in the middle to have my twins : ) Thanks again!

Something that strikes me as a contradiction (though it might make perfect sense to someone else, I don't know) is the uber-Bradley anti-intervention couple that go on to request a circ on their son. Huh???

We monitor all through prep time, and then for a few minutes IN the OR, too. Though, depending on the situation (ie which anesthesia doc is there, and whether it's just a routine/elective section) we forgo the OR monitoring.

Oh, that sounds like a very NOT fun delivery. I admit it--I get nervous when I hear I have a Bradley patient. Not because of anything wrong with Bradley necessarily, but I just never know when I am going to accidentally offend someone. You know? I really like for people to have the kind of delivery they want to have, honestly, I do. It's not my birth, it's theirs. BUT, I do have some liability on the line when it comes to my license. I guess I don't understand why more Bradley patients don't deliver at home. Here's how I see it: they come to the hospital for a service, and that service is called labor and delivery. Please, give me your INPUT (ie I'd like low lights, no IV, put the baby on my chest right away), but on't tell me to change policies or do things that feeel unsafe. Okay, when I go to Burger King, I ask for no lettuce on my chicken sandwich, but do I insist they let me bring in my own cooking vat, tables and chairs, and that the cook ignore safety standards while doing his job? If I am THAT picky about the "product" I need to eat at home! Vent over.

Wow! Thank you so much. What a nice thing to say...