jarrn03

The doctor never instructed them to have sex in the hospital. He had no idea that it had happened until he came out of the OR.

Your approach to your deliveries are about the same as mine. I totally get a kick how the familys always ask how much babe weighed, no one asks if they are breathing etc. My babies stay on their mommy as long as I can keep them there. I do eyes/thighs while babe is skin to skin. I find myself being passive aggressive to the obnoxious family members when they keep whining about how much the baby weighs. We dont have mandatory nursery time. The babe are bathed in the pp room, hearing screen can be done in the pp room also.

The doctor was unaware of it happening until the nurse told him.

Have you ever had a pt and her spouse have sex in their room "to get things going naturally"? We had a couple come in that had had intercourse that am, stimulating contractions. Her cervix was changing but then stalled out around 7 CM. The mother to be's sister was gaurding the door. Her nurse went to go in to the room because the central monitoring was showing a decel. When she approached the room the sister stopped her and told her what was going on. To make a long story short it sure enough stimulated contractions, her water broke and delivered precipidously and the nurse delivered as her doc was in the OR. In our busy unit with all our experieced and long time nurses said it was a first for them. Would love to here if you have had a similar experience;

Has anyone had a pt bring in a pic of their mucous plug on their cell phone? I've gotten 2 in 4yrs. I about died!! Thank god for cell phones!

Days-$48 Eve-$50 Noc-$52 Here in Oregon.

I can totally relate to the moms not getting to see their babies because of meds. I delivered at 28wks due to preeclampsia and was on Mag. It was pure torture. I think I finally whinned enough the nurse took me down at about 22 hrs post op. I only lasted a few minutes but that's all I needed! Pictures are not the same as touching and seeing. I had a lot of guilt. I got preg 3 yrs after having my tubes tied and hadn't come to the terms of having another child..I was done! That all change the moment I touched him. He has been a true blessing to our family!

We had the same thing happen a few months ago but we were fortunate that nothing horrible happened. I was so happy that I wasn't working that night. It went through 3 nurses and a CRNA before the night shift nurse found it. Of course it happened to one of our floor nurses daughter. The nurse that was primarily responsible kicks herself for not listening to her gut. She watched the other nurse struggle to put it in the pump.. our PCN bags are 250cc and the epidural bags are 100. Like said above it's back to nursing 101!! The 5 rights! It was definetly a lessoned learned because I think we all are guilty of cutting corners now and then. Also one time the pharmacy stocked epinephrine instead of ephedrine in our epidural box..luckily the nurse read the label!!

The longer you wait for the bath the more the skin absorbs it and less you have to wash. I don't try hard at all to get it off. Why waste a good thing! Julie

My son also had a 2 vessel cord. It was DX at my 20 wk ultrasound. I was sent for a level 2 US and nothing else was found so we elected not to have an amnio. 8 wks later I delivered due to pre-eclampsia. He spent 74 days in the NICU. After he was sent home we noticed that his "preemie" head was looking odd. His forehead was growing in a V shaped. We were sent to a craniofacial doc and he was dx with Mytopic Craniosynostosis. That lead to some genetic testing because of some other dysmorphic features. He was found to have a chromosome abnormality on # 14. It had duplicated half of it's self. So the genetist researched like crazy to find some data and they can not find anyone with the same type of abnormality or a syndrome related. So Joel has his own "syndrome". I am happy to say he his totally normal!! Developing normally with kids his age! He does have chronic ear infections because of his craniofacial deformity. They think the 2 vessel cord is related to the chromosome abnormality. Julie RN I forgot to mention he was conceived after I had had my tubes tied for 3 yrs!!

We have a policy that if they meet critieria such as late entry to care..after 20 wks, past history of use, any + screens, precip labors. Mom's have to give consent, but we don't have to have consent to screen the kiddo. If they have any of the above the kiddo gets tested also. Here in Oregon they've put all the pseudophedrine behind the counter. We have had a lull on the meth babes. "knock on wood".

My son also had a 2 vessel cord. It was DX at my 20 wk ultrasound. I was sent for a level 2 US and nothing else was found so we elected not to have an amnio. 8 wks later I delivered due to pre-eclampsia. He spent 74 days in the NICU. After he was sent home we noticed that his "preemie" head was looking odd. His forehead was growing in a V shaped. We were sent to a craniofacial doc and he was dx with Mytopic Craniosynostosis. That lead to some genetic testing because of some other dysmorphic features. He was found to have a chromosome abnormality on # 14. It had duplicated half of it's self. So the genetist researched like crazy to find some data and they can not find anyone with the same type of abnormality or a syndrome related. So Joel has his own "syndrome". I am happy to say he his totally normal!! Developing normally with kids his age! He does have chronic ear infections because of his craniofacial deformity. They think the 2 vessel cord is related to the chromosome abnormality. Julie RN I forgot to mention he was conceived after I had had my tubes tied for 3 yrs!!

Currently our facility uses stadol. We are looking into using Fentanyl. For those of you that use it can you tell me what you like and don't like about it. What are the usual dosages? Thanks for your help. Julie

What they were doing is called amnioinfusion. This is done for different reasons. One is when the amniotic sac has broke and water has came out, the cord loses some cushion. If the baby is laying on the cord or it is being compressed in anyway it will cause the heart rate to go down with each contraction. So we replace the amniotic fluid with normal saline to provide a cushion. We also use it to dilute amnioitic fluid when there is meconium present. Does that make sense? It is very useful! It's done very easy through an intrauterine pressure catheder. It's threaded through the lady parts into the uterus. Julie RN

I tell my pts "Natural" is coming out the magic door. Doesn't matter how you get there, just as long as it comes out the magic door. Everyone has a choice. C-sections are not natural so we do everything we can to make it happen "natural".

We use stadol. I've only had to give Narcan once because of mulitple doses. I generally tend not to give it after 8 cm unless the doc okays it. I have seen Morphine given a few times. Some of our docs use a Demerol/Phenegran cocktail for a long prodromal labor just to give the mom a rest and hopefully help her rest some. Mostly we use Epidurals though. I think our epidural rate is above 85%. Happy New year!

We have a new nurse on our unit who came from a large hospital that did a lot of midwifery deliveries. We are a small rural hospital that does about 30 deliveries a month. Anyhow the other night we had a primp that went very quickly, 4 to complete in 1 hr. Anyhow the nurse was actively encouraging the pt to push without the doc being there..the baby was crowning 5-6 cm. The only thing that held it back was the primp perineum. We do not do this when there is no doc in the house..she was on her way. We don't try to deliver these babies on our own..because of the risk of a shoulder, cord etc.. When I questioned this nurse she was offended and didn't understand why I wouldn't let my patient push..I would encourage her not too, but we all know that mother nature has it's way. This pt was totally coachable. What do you think?

This drives me nuts..when I admit patients and start EFM I explain the US and Toco. I explain the Toco can tell me how often and how long the contractions are BUT not how strong. That the number means nothing as long as we are using it externally. So when I come back in the dad or family members are saying WOW did you see how big that contraction was, it went all the way up to 60. So again I explain why the number is what it is only to come back in later to the same thing. DRIVES ME NUTS!!!! The other question is when do you think the baby will come..on and early primip that's being induced. Have a great day!

I work with a female doc that does this quite often. If she has a mulitip mom who's kind of stuck and has a mushy cervix she will have them push with a contraction. I've seen a woman go from 5 to delivery in 10 minutes with her doing this. I've seen her do it in emergant situations, prolonged decel and it has avoided a sections but I've also seen her do it when not warrented. It really irritates me when she does it and I am not set up!! I feel she's going to rip a cervix or worse some day! What do you think?

I am a Labor and Delivery Nurse in a small rural hospital. I am curious to how you do your consents. Do you expect the labor and delivery nurse to have them signed before you get there? Do you do a full PAR? We have a few CRNA's and Docs that do absolutley NO PAR!! Basically it's sit up and bend over and hold still. I feel completely guilty having them sign a consent then. What do you think?

The patient came in at 300am and delivered at 330am. There was barely time to turn on a warmer. As for the parents not given a choice, they were told your baby is only 23 wks and is not viable by the doc. The nearest NICU is 45 min away via ambulance, they do not have a heli. I was looking at out laryngo-blade..it wouldn't have fit in his mouth. I think it would have been more torcher to try to save him. He died peacefully in his parents arms.

Thank you! I've only been an OB nurse 18 mo and that was my first and I know not my last. I look at it as a learning experience and I know I was blessed to been able to be there for the parents. You don't forget the ones that were there with you during a time like that. They were very grateful and apprecitive.

Thank you so much for all your replies. I do feel much better. I am a mom of a 28 wker so I have a little experiece with a healthy preemie. What bothered me the most was the doc was 30 min away. Spoke to the pt by phone and wasn't really given a choice of resusitation. Basically told you are only 23 wks and the baby is nonviable. I know this..what bothered me was the little noises he made when he first delivered was exactly the same noise I heard my son make. The parents were very grateful for our care and were so relieved they did come in because she could have easily delivered at home. Again thanks for your replies! 2 nights later we delivered a 27 1/2 wk mom for severe pre-eclampsia, unstable to transport. The NICU team was there for delivery and it went great! The kiddo was only 60 gms bigger than the 23 wker. Definatley IUGR. His head was much larger, they intubated without any trouble. It was awesome to watch.

Did you do Cappa before? What didn't you like about them if so? I am just checking into it. Thanks

I work in a small rural hospital. 300 births a yr. We had a 23 1/7 wk mom walk in at 0250, complaining of mild cramping since having intercourse around 1700. States she is feeling better. Rates pain 4, compares to mild period cramp. It had been a night from hell on our floor..anyhow. Hooked her up to EFM, showing 20-40 sec crampettes. Most she wasn't feeling. Got orders from doc to check her at 0320..bulging bag and complete. Doc gave orders not to resusitate, being the kiddo is only 23 wks. Anyhow baby delivered at 0330 with a HR of 100, no respirtory effort..agonal type breaths. ER doc came down who trained at a childrens hosp and was wanting to resusitate. Baby weighed 597 gm (1# 5oz). This was my first experience with pre-term delivery(this early). My senior nurse was adamant we doing nothing per pt doc orders. What does your NICU consider non viable and what is your criteria. We don't have surfactant and our closest NICU is 45 min away. I'd appreciate your input.