Pixie Dust

One of the best L&D nurses on our unit is a man. He says he treats his patients with respect and shows professionalism and they generally don't question it. I (a female) happened to be put out of a postpartum room by a husband while his wife was nursing, then our male nurse came on next shift to take over my assignment, and I thought, this husband may object, then found out he was their labor nurse the night before and delivered them. So it doesn't always matter what your sex.

To me it's one of those things. You have to be on your own in order to think for yourself and start being more independent. Hopefully the other nurses will be understanding and know to help when you need it and won't be put off by questions and need for checking with someone else. Two minds are always better than one. Truthfully, I think this is the best time to take some high risk patients also so you can ask questions. My experience has been if I put that off, before you know it more experienced people have quit and your the one with the most experience on shift. That's scary! Remember to give yourself a pat on the back once in awhile too for what you have learned.

Marie LPN I love that one. The one that really irks me is when patients come into our triage area for one thing or another (90% of which should not have come into the hospital in the first place) and here you are trying to be pleasant, get the information and paperwork done and they ask in a derogatory manner, "how long is this going to take." In those cases I have to admit, I take my sweet time.

I personally love working with the midwives and patients that are more involved in their labors. I work at a hospital that is high risk and most of the OBs are very interventionist minded. I do find it difficult to work with though when a midwife will choose not to follow the hospital protocol, putting the hospital and the nurse in the position of the bad guy. Example: we have one midwife that will call light meconium clear fluid so he doesn't have to call in NICU and Neonatology since this is our protocol. Or telling a patient that they don't have to have an IV and then when they get to the hospital they find out from the nurse they are GBS +. We all know the protocols and things that have to be followed in the hospital environment even if we don't agree with them. I think there are some you can work around and some you have to abide by. While writing this I am realizing that this trait is not exclusive to midwives. Though the midwife patients are generally looking for a more natural birth so I feel like I come across it a little more.

The website is pocketdilationguide.com It's a great tool to have in your pocket for reference if you just want to check after yourself and also a great tool to bring out of your pocket to show those primes in very early labor just how much progress they've made when they're discouraged. I can't tell you how many I've sent home a little more reassured about they're progress when they can see it visually. And in my experience Murphy's law applies to those dilation charts. When you're not looking for one they're right on the desk. When you're looking for one you can't find them anywhere.

The only time I have ever seen a request granted for an elective c/s was for a prime who's reasoning was that her mother had bladder problems after giving birth. I was absolutely shocked that the insurance company would pay for that. After reading this forum I'm getting the impression it's not that uncommon. As for the elective induction rise I'm surprised insurance companies (and those of us who pay for insurance) are paying for a higher cost to delivery considering the cost that is involved in putting a woman into labor. I must admit though with the way staffing is being cut at my hospital it is to the nurses benefit to have labor by appoinment. At least we get staffed for that. The new trends are a shame.

Since you are a visual person, go to pocketdilationguide.com and check this out. This is a guide you can get and use at home (with your eyes closed) before you ever start doing exams. You'll at least know what you are supposed to be feeling when you get there and have a little more confidence. It also has an effacement measurment on the back in centimeters. It gives just a little sense of security when first learning to do exams and it's something you can keep with you at all times while working. Believe me, since it is a blind exam and we as nurses want to do things well, we all question what we are feeling from time to time. Thank goodness most patients keep on moving forward with their dilation so we don't have to question our exams often.

There is a helpful little guide out there called the Pocket Dilation Guide (pocketdilationguide.com) that was developed by an L&D nurse. It's great. You can keep it right in your pocket so its there when you need it and you can place your fingers inside the centimeter circles so it feels very similar to the real thing. It also has effacement measurments on the back of it. Check it out. I've been doing L&D for 10 years and I still use it. Remember, we were all new at this once, it just takes time.