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babyktchr BSN, RN

Nurse Manager, Labor and Delivery
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babyktchr is a BSN, RN and specializes in Nurse Manager, Labor and Delivery.

babyktchr's Latest Activity

  1. babyktchr

    EFM C

    Professional Education Center has a review course for this exam and then you took to exam on site. You should have a solid EFM background to take the exam. The review course is helpful.
  2. babyktchr

    Week 11 of orientation... Lack of confidence :(

    Unfortunately, you are not alone. It makes me sad that your clinical management/educators came at you like they did. Perhaps the better question would have been HOW CAN WE HELP YOU SUCCEED?? It's very hard to be a preceptor. It's hard not to jump in and just do and lets face it, its faster to just do it. Somehow, though, we have to pull it together and teach. We need to find the correct balance of nuture and butt kicking to get the job done. It seems you may have been cheated out of some of both. There is one great truth in OB. Feeling comfortable will take some time. What you feel is quite normal. You have to allow time. One day you will have that Ah Ha moment and things will fall right into place...until the next time. After 20 years in OB I will come across a cervix that had no possible dilation, a doctor who has an out of body experience or a patient that has a bad outcome and all will shake me to the core. Always learn. It is my greatest advice. You will find your groove. Ultimately you need to decide something. Is this what I want and are you willing to do what it takes to get it. Celebrate little things. Breathe. Find a wingman you trust. Keep open lines with your manager. Give yourself a break. Childbirth is magic. Don't forget to enjoy!!!! Wishing the best for you in your journey
  3. babyktchr

    Laboring Morbidly Obese Women

    unfortunately this is going to be a norm or us and will continue to be problematic as ACOG stacks more and more "guidelines for induction" onto the already monsterous list. most morbidly obese women have co-morbidities attached (HTN, GD, IUGR) and are brought in for induction sooner rather than later. intermittent monitoring is not going to cut it for these babies. we just recently dropped some money on the MONIKA monitor which is designed to assist with monitoring the obese patient. it works simiiarly to a tens unit as far as uterine activity goes and ECG monitoring for FHR. it consists of electrodes being placed strategically after a vigorous prep of the skin. while this piece of technology has merit and will be on the forefront of monitoring technology of ANY patient in the future, i fear that it misses the mark for this situation. too many positional parameters have to be met, such as the uterus always has to be center to the patient, even if the pt is on her side? HUH? although FDA approved, a lot of the studies came from european use where a BMI of 30 was used as as a reference. sigh. really? 30? this topic needs be be addressed sooner than later in the world of those with power. staff nurses are put to the test when monitoring these patients, and outcomes are going to be scrutinized because of the multiple risk factors. C/S is not the answer. with technology as it is now, i find it hard to believe that other avenues have not been explored. anyone else have experience with MONIKA??
  4. Wow. There was no intention on my part in implying that you were naive. I was just giving you and opinion based on my managment style. When looking at a resume of an experienced nurse, a list of certifications is always welcomed. A new grad, not so much. I look at experience in an acute care setting. How long have you worked in direct patient care? Its more important to ME that you have your feet wet in day to day goings on than how many tests you took. Honestly, unless you use your newly achieved certiications, you will forget them. And as I said, unless you have worked OB, how do you know you will like it. It may have been a strength in school, but the real world is so much different. I was just trying to give you another view of how to get out there after graduation. I am sorry you felt demeaned in some way. Good luck to you.
  5. here's the thing about certifications and such for a newbie. as a hiring manager, i wouldn't hire you over someone else if you had all that stuff if i didn't believe you could do the job. i would have no expectation you would have any of these things (ok, maybe ACLS because its marketable anywhere in a facility). in my honest and humble opinion, i think the best way to get hired on an OB floor is to be a tech, or a CNA or extern on a unit. that way i see how you work, see how you learn, and hear from others what they think your potential is. a LOT of people think OB is their dream and never set foot on a unit besides their nursing rotation. let me tell you, there is so much more. you may hate it once you start. your job in an interview is to convince me you are worth training. it costs a lot of money to train someone new, especially from scratch. convince me you are gonna let me mold you, teach you, make you a long term labor nurse. make me believe it. a basic monitoring course would be good for you, only to get your feet wet in terminology. until you really work with it, you will only see squiggles. i feel for everyone who wants to get their foot in the door. its a tough hiring world. good luck to you.
  6. babyktchr

    On-line advanced EFM course & test?

    awhonn has online competency assessments. there is no online intermediate or advanced classes.
  7. babyktchr

    Certification before applying for L&D?

    I would not expect you to have any kind of certifications if I were interviewing you.. I am looking for someone who can think and act on the fly, stay calm when all you want to do is run and realize that labor land is not just about birthing babies. Home care is a different animal than acute care. I would wonder why the change? You have patient care skills, and 'gadget' skills. All a plus. Are you a critical thinker? Can you anticipate issues? How are you with provider interactions? Show me why I need to take a chance on you. Its really going to come down to the right place at the right time. So many units are looking for experience only then poof, they open up the floor to train newbies. Just keep applying. Good luck to you.
  8. babyktchr

    Ob call requirements

    I said that because I have 12 LDR beds and have 200+ deliveries a month. Seems to me that your core goal is a good thing. You need to hire to meet that instead of all that overtime. Thats a budget buster right there. The just in case is always going to be there, no matter what you do or have. You just have to cross your fingers some days. I know that isn't what you want to hear, but its what happens. EVERYWHERE.
  9. babyktchr

    Ob call requirements

    Hmmm. You have a lot of space for your deliveries/month. Why is that? Are your labor nurses and M/B nurses crosstrained to both units and can flip flop as needed? Do you have call for a just in case kind of scenario? Are your call days above and beyond your regular shifts? Is your core staff of 2 just for labor and delivery or all of your units? We pay call time and time and a half when called in.
  10. babyktchr

    Terbutaline protocol

    we don't use it. the MFM gods took it away.
  11. Congratulations. I am not a by the book interviewer, so I don't know if my advice will be helpful or not. EVERYONE comes in and says OB is their dream job. Unless you have worked OB before, or have been a CNA, or intern, or extern, or volunteered on an OB floor, you really don't know that OB is your dream. Having a baby before, while fabulous, does not count in the experience column. With that said, I want to know why I need to take a chance on making you the best OB nurse ever. Why do I need to spend time training and molding you? OB is a think and react on the fly kinda place. What experiences do you have that you can share that will convince me you are up to the challenge? What was your worst day in nursing school? What was your best? How do you handle criticism? In an interview, I look for authenticity. I don't want fluff. I don't want you to give me the canned responses you have been taught in school. Think about this really...why is OB what you want to do. Not just birthing babies, but what difference can you make to a paitient. OB isn't all rainbows and sunshine, or sitting around rocking babies. I will tell you this much, and other managers can certainly say yay or nay to this, but once I hear "I want to help people" or "I have always wanted to be an OB nurse", I turn right off. I will give you that, "oh nice" repsonse then I am drawing smiley faces on your resume. I want you to tell me why I should hire you. I hope things go well for you....best wishes in your interview.
  12. babyktchr

    Please tell me they are not all like this...

    oh, I forgot. The OB or CNM is the provider. Its their job to do vaginal exams. In the absence of the provider, the nurse CAN examine the patient. Certainly nursing doesn't 'let' them do the exams. In most teaching facilites, everyone but the nurse gets to examine the patient. Too many exams if you ask me. Ok, I am done. I think.
  13. babyktchr

    Please tell me they are not all like this...

    I am sitting here struggling to collect my thoughts enough to repsond to this rationally and intelligently. Ok. So, here goes... What you describe is probably every "born to be a labor nurse" nurse dreams of OB being. There are some places that actually allow natural birth, spontaneous labor. There are happy, drama free patients who actually know who the father their baby is AND want to be proactive and beat the I AM WOMAN drum. There are places that are untouched by the spoils of modern technology, where childbirth can be celebrated and cherished and not a ridiculous spectator sport where cheetos and mountain dew are involved. Thanks to the Joint Commission, CMS, ACOG, Magnet, the Baby Friendly Initiative,the Meaningful Use Act, and any staff memeber of the law offices of Dewey, Cheetam and Howe (and oodles more too numerous to mention) nurses now have the incredibe opportunity to bond with a computer for 8 our the 12 hours they work, making sure every box is checked, every bubble is bubbled, there is a growth chart charted on a 19year old laboring patient, every medicine ever taken is documented and what diseases the paternal great great great great grand grandfather may have had and what year they died. Instead of making sure bonding happens when that baby comes out, we are scrambling to document FHT's q5 mins during second stage (which can be a long long time), making sure we document skin to skin in 5 different places to appease the baby friendly gods AND be crowd control over the gazillion family members all ignoring the poor mommy who just pushed a bowling ball out of her body, trying to get facebook coverage of a resuscitation. Labor is now a circus of medical intervention because women are just unhealthy these days. Complications lash them to a bed, to a monitor. with IV this and that. And by golly, someone out there told someone and they told someone, and they told someone else that labor is supposed to be PAINFREE, so not only do we have epidurals, we need to have complete and total numbness because our makeup may run if we sweat a little. Um...whoops. I do digress.... Please don't generalize your observations. Not all units are like what you have experienced, but I am sure there are far more than we care to admit. Nursing has changed and I am not sure it is for the better. Study after study shows that actual bedside time for the nurse is less than 2 hours total. How sad is that? I know that I didn't become a labor nurse to sit at a desk. But honestly, with the amount of documentation that is now attached to every patient, when is there time to actually care for the patient? This goes for any specialty. I cannot even begin to imagine having an assignment of 6 patients and having to chart these days. Yowza. Nursing, medicine for that fact, has become CYA driven thanks to the litigious society we live in. THis is not an excuse for poor care. Maybe not even a reason. But it is a reality. The minority are the patients who want no intervention. Who really want to do the natural thing. I am sure depending on geography, you may see this more, but I am sure there are more that live in city and suburbia who will tell you that patients arrrive in full makeup demanding and epidural upon admission or a csection more than they see a woman show up and say please I don't want anything. There are days I can honestly be proud of the care I gave. That I made a difference. That I will be a memory in the birth of someone's child. There are also days I cannot remember giving this or that, or did I chart that or man, what happened here? My real world version of childbirth would be so much different than what it is 50% of the time, and that is being generous. For now, I have to find contentment in doing my best, trying to navigate rules and policy and giving my patient the best experience possible. Its always frustrating knowing I can't. I know this probably doesn't hit the mark for your post, but I guess what I wanted to say ultimately is that appearances aren't always what they seem, and make assumptions that this is how it is all over, and please don't give up on 'the dream'.
  14. what preciptatied this? was there an incident?
  15. babyktchr

    EEK what would you do?

    i find it interesting that she sought you out despite the fact you had nothing to do with her care. why you? direct her to hospital compliance, or administration, or joint commission.
  16. babyktchr

    Studing for Perienatal certification exam

    it seems to me this question is asked A LOT. i don't remember or not if there is/was a sticky for a quickie resource or not for answers. you could probably do a search of the topic and find OODLES of answers.

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