Littlewonder

Hello from Zanzibar... from a nurse working with a humanitarian aide organization that does many different projects, I see often the educational side of things is more important than actual "nursing" actions over here. Example, the organization I am with has an orphanage in Kenya - they have had three babies die this last year from issues that even the "greenest" new grad could have prevented with some basic health education to the workers. (And this orphanage has been begging for a nurse to come for a month and help teach the workers for a long time now with no takers... anyone interested PM me!?) I find that the bulk of what I do here in Zanzibar is teaching people about their chronic illnesses and ways to take care of themselves. The doctors here mainly tell them, "don't drink ice water." Yup, when my asthma gets really bad, I find that avoiding ice water is the way to go... WHAT!? No kidding, education can save so many lives - and you don't even have to go with a specific medical missions group to do it.

I have been at several facilities where nursing is not allowed to do sterile spec exams and the physicians are not in house. We would simply do a SVE (without goo, ouch) and then brush the gloved fingers over the slide. We had great ferning results when ROM with this technique and no huge spec to try to get to go anywhere semi dry.

I think one thing that has not been mentioned here that should is the cost to the infant of early formula feeding. I never make mom's feel guilty for using formula if that is their choice (and have times recommended it for large weight losses, etc.) but I do think they need to be made aware of all the things that happen when their breastfed infant has a "dose" of formula. With the introduction of even one bottle of formula, the larger cows milk proteins can cause allergic type reactions to the infant's small intestine. The small intestine is very "leaky" in the first few days and before the colostrum has had time to seal off the bowel is not a good time to expose the infant to the allergens in cows milk. Also, the newborn stomach is barely the size of a marble. A half ounce feeding is enough to stretch the stomach enough to cause at the very least a good bellyache, and at most a insatiable appetite that colostrum is not going to fill - leading for a need for repeated supplemental feedings until the mother's mature milk comes in. Also, in families like mine where there is a very high allergy risk, one early bottle would expose my child to a much greater risk for following dad's celiac disease and my own multiple food allergies. One bottle also can increase the risk of asthma and other heredical problems - I am not saying every baby will have such severe consequences - in fact very few will... but why increase a child's risk if not medically needed on a baby that may be excusively breastfed if encouraged by nursing staff? Anyway, just my pet peeve here - nursery staff saying, "just one bottle to let mom sleep won't hurt anything!"

I don't work critical care, but OB (labor, delivery, postpartum, and level one newborn nursery.) I have found that different areas of the country do many things differently. Some area's have nurses rupturing membranes of laboring patients and putting in scalp leads and IUPC's while others won't even let a nurse give translady partsl cytotec for inductions - they require the physician come in to insert it. :monkeydance: Does not bother me, I just go with the flow in that state - although for liability reasons I do not rupture membranes or place IUPC's - too much risk for me! Also, policy and proceedures vary so much I have to look them up in every hospital during my first week as a traveler... Sigh. I really dislike those books...

Littlewon's dh here. I was an orderly in OR and saw some great practical jokes. I think the classic was when the circ. cut off the scrubs pants while he was scubbed in. We also sterilized a rubber duck to place one one Dr's table. My favorite with a student though was when he was working with an oncologist who didn't speak english very well, I had to laugh when the scrub who was working with the student informed him that when the doctor say's "you suck" not to take it personal, he just wants suction. I imagine that doctor offended many a tech.

Littlewon's dh here, I used to be an orderly in OR and one day I was sent to pick up a patient from ER who had caught a circular saw, when I got there he was still fully dressed (including winter coat) so I told the nurse, "I can't take him anywhere, he's still dressed".

As long as your due date is after graduation - not so bad. I ended up pregnant and delivered in the middle of my last semester. I took a year off to enjoy baby (but we really went into debt to do it.) I finished my last semester when baby was 8 mo old.

Now, working in an LDRP where we never get anyone before they are twenty weeks along, I have a hard time with this! Every once in a while we are called down to ER to find FHT on girls between 12 and 20 weeks. I don't have any problems with sixteen weeks and up, but does anyone have any tips on finding FHT with a doppler below sixteen weeks? I would appriciate any tips possible! Thanks...

I have dealt with this issue as I have worked LDRP for several years now and have miscarried three times while working LDRP. It really hurts in the middle of a miscarriage or when seeing someone who does not want or really is not caring for her baby. Otherwise I can fairly easily set aside the personal and focus on my patient and the joy they have with the birth of their miracle. As far as being a guy? Does not matter. I can not deal with ICU (tried for a year, could not handle all the death.) Whether you can enjoy OB will be a personal thing that you won't know until you have experienced it. As for the patients, some will be be great, some will be hesitant, but almost all will just be glad for competent and compassionate nursing care. I would not mind male nurses in OB caring for me. I do really hate seeing the male and female OB's do not hesitate to cut a huge epis for no reason - totally depends on practice, not gender...

Yes...:icon_cry: :icon_roll and I have my husband and children with me, just not the same as being home...

Hey, don't feel so bad - it CAN happen. Maybe not officially, but I have definately had it happen to me (verified by repeat exams by the nurse midwife who felt the same thing!) There are several possible senario's: she could have had some swelling going on, she could have had an undiagnosed latex allergy (have had happen, her cervix would close more with each exam due to swelling,) she could have had less pressure of the presenting part on the cervix - thus causing a reduction in dialation. One thing that would be interesting to see would be to try some position changes to see if more pressure on the presenting part would return the cervix to its prior dialation. I do think a change in head position could possibly affect things too, due to change in pressure, etc. I don't know the official take - but I do know it happens. I am sorry you had such a hard and frustrating experience. Too many people fault the nurse if things don't go the way they think they should. We can not make the cervix do anything - we just report what happens. And there is also some human error factor and difference between people too. Maybe with the last exam the MD's response was 5-6 when actually she was a good 7. How many times have each of us had a MD do a totally different vag exam and then we compare with the chart (or experience) and know that their fingers are blind!!! :argue: Hugs, go in and have a great day next shift - don't let this keep you down.:icon_hug:

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At risk of getting flamed here;) , I really think we need to take all of our supposed "guidelines" (AAP and all the others...) and use our own critical thinking when we are looking at a parenting issue and not a health issue. For me, co-sleeping was much safer for my children. I am a VERY HEAVY SLEEPER! Now, you say, "how can a heavy sleeper say it is safer for her to sleep with her children?" I can answer that! I fall asleep anywhere when I am tired, including rocking chairs - especially when I am breastfeeding. I HAVE dropped a child to the floor while nursing in a rocker! I have NEVER dropped a baby from a safely positioned bed and I have certainly never rolled on my babies. I do sleep soundly, but I always wake in the same position WHEN MY CHILDREN ARE NEXT TO ME. Not when they are not. I have back problems and frequently change positions in my sleep when my babies are not with me in bed. When they are, however, I wake up in extreme pain from being in one position for two or three hours. So, although I truthfully do not really "enjoy" co-sleeping (due to the pain issues) for my children it is much safer in bed with me when I am tired instead of up in a rocking chair! I do always keep my babies between me and the wall, because my husband moves a lot in his sleep regardless of the presence of a baby. Anyway, I have issues with using the banket "guidelines" of any medical recommendation board over critical thinking and individual situations. Look at all the times the recommendations have changed through the years!!!

I ran into this problem a lot because I never used a blanket when I was nursing in public. My babies got hot and would pull blankets off - that left me much more exposed than if I just discreetly put them on and let my shirt cover everything up to their faces and bellies - which covered the rest. I finally found a great sling that I could put my second baby in to nurse that was just great! It gaped open at the top so it did not feel like I was smothering my baby, but no one could see in unless they were looking from directly over the top. Also great because I could now nurse on the go! Yup, talk about multi-tasking. I have nursed my son in the checkout of the grocery store and no one was the wiser. People just think you are cuddling your sleeping baby!!! Works for me!

I don't doubt Rob's story at all. Nurses take a lot of nasty stuff without even flinching - and expect it. Because of a long history of nurses not standing up for themselves, there is quite a history of abuses of the system that may or may not go on in other work areas but are definatly illegal. I remember the attitude of my nursing school - the student nurse was always wrong if an instructor disagreed!