obnursesteff

We have LNA's in the Birthing Center (LDRP) that I work in. They do such things as baby care, baby sitting in the nsy. Other tasky things such as phones, filing, stocking, doors (security), car seat education, charts, vital signs, setting people up for showers, changing linens.... We are a small operation (4 rooms with 2 overflow rooms on the M/S unit)we have 2 RNs on all shifts and an LNA on Days Mon-Fri, and prn on Eves or Nocs. We could never do it without them. We do not, however, hire LPNs.

As far as I have found, AWHONN has a policy/standard that says only clean female, non-infectious women can be cared for in the ob/gyn setting, but I can not seem to find anything about the reverse situation. I would assume that keeping those particular rooms on M/S empty except for clean, non-infectious patients would make those rooms safer for moms and babes. It is amazing at what situations a lack of common sense can get you into!

It was definately an oops by the clinical coordinators and many people were not happy when discovered. There is obviously plans to avoid this at all costs, but unfortunately not everybody thinks like OB/NSY nurses when it comes to these things and they do not always think before they act. This is why I posted this question, because at current time there is no guidline or policy for the clinical supervisors to use. If I make one and put it through the right channels, at least there will be something in writing for the supervisors to use in making their decisions (hopefully).

I have seen many issues regarding clean female non-infectious pts overflow to Birthing Center units, but how about.... We have 3 LDRP rooms and often need to use Med-Surg for OUR overflow. There have been issues with our pts sharing bathrooms with c-diff pts, RSV pts, MRSA pts.....Are there anyother RNs out there that are dealing with this? Any guidelines or policies out there that any of you are using? I can easily make one from "Common Sence", but would like to show evidence to back it up. Any ideas? Thank you in advance....

We are a low risk, small rural hospital birthing center. The local pedi is instituting a drastic change in our vital sign checks to q15min x4, q30min x2, q1hx2 then q4h. What do other birthing centers do??

Has Anyone Out There Seen What They Believe Is A Neonate With Adverse Reactions From Mom Taking Ambien? Please Answer....we Have Had A Babe With It In Meconium And Have Had A Fetal Death And Mom Is Convinced It Is From Taking Ambien?

Just as a side. If you want to take a course with Michelle Murray (she is awesome!!) Just did her seminar on advanced fetal monitoring in Hartford last week. Michelle is going to be taking time off due to a latex type 1 allergy. BUMMER!!! If you can get a chance to see her, do it, you will learn so much. I learn lots every time I see her. You could say I'm a groupie of hers.

Due to staffing issues, it has been brought up that we might have to transfer an active labor pt to a different facility. Does anyone have thoughts or legal information on this? :angryfire

Does anyone work in a hospital where they remove foleys and IVs from cesarean section pts in PACU, before the pt is sent to the floor? I know that after my own c-section, I arrived in my post partum room without any IV or foley. I now work in OB and our sections come with IVF, morphine PCAs, (despite receiving intrathecal morphine and even if they are tolerating regular diets), and foleys, all of which stay in 12 - 24 hours. I'm curious as to whether we are behind the times with this.

I work at Copley Hospital in Morrisville, Vermont. Our L&d unit is looking for 2 FT noc RNs at this time. My nurse manager is Cheryl Bourbon. Give us a call!!!! By the way, what is a PM? I'm guessing it is "personal message". How do you do it? Steff

We do do car seat challenges on all NBs Guidelines/routine: 1) baseline color, HR, RR and O2 sat recorded prior to placing NB into car seat 2) place NB into car seat, with cardio resp monitor and O2 monitor on and place car seat at 45 degree angle 3) record HR Discontinue for: 1) HR 2) apnea > 20 secs 3) central cyanosis 4) O2 sat 20secs Document any interventions needed to resolve any of the above Car seat challenge should be done 30-60 mins after last feeding If our car seat tech is out, or this is needed over the weekend, RN's can do. All hospitals should do this. Car seat safety is a priority. Hope this helps.

I was almost in tears after reading your note. We have a small LDRP unit (3 rooms, about 250 deliveries/year). We always have at least one RN on the unit, even if we are closed, a 2nd is always on call. Our orientation is scheduled for 1 year. 8-9 months on day shift, following preceptor's schedule, then 3 months on shift hired for. This coupled with weekly meetings with nurse manager to keep her updated with orientation goals and competencies. This is how I was precepted, I have been at the same place for 9 years. I LOVE IT. Do not settle for a place that makes you hate your job. It is too great of a profession for one place to turn you off. Get out and find a good place to work, that will treat you like the professional that you are.

We have a doc here that says it is not hyperstim, unless there is fetal distress to go along with the all too frequent ctxs!!! Not in my book. He's been upset with me several times. S***s to be him.

AMEN!!!

We have monitors (telemetry and underwater) for those pts on pitocin. They have the flexability to walk, shower or get into the tub. This provides great relief for out pts. without using meds. Our anestheisologists have been doing such good intracthecals that everyone is itching and can't pee afterwards. Any suggestions for that?