maxiebelle

My ADN is from CACC. My BSN from JSU. I am currently looking for a CNM program. I have a house full of boys, which is why I love working in Women's Services!!

I received my BSN from Jacksonville State University. Learned a lot. Beautiful campus. And you can take most/all courses online, which is great if you work fulltime as an RN now.

I had all my children in the L&D unit where I work. I love epidurals. Not very fond of the vacuum extractor or forceps. Am terrified of c-sections--would not wish that on anyone. However, several girlfriends/relatives loved their scheduled c-sections--said it was the only way to give birth.

We have had standing orders for outpatients for ten years. For example, during first 30 minutes: Admit to L&D-observation. Midstream UA, EFM, vital signs, sve if no vag.bleeding, nitrazine if indicated, pre-eclampsia assessment if indicated. Then 30-60 minutes after admission: Recheck vital signs if BP>130/80, continue EFM, call MD with UA results and pt status report. 60 minutes-discharge:(check one) discharge home, admit to L&D with routine orders, admit to 3rd floor-labor precations. If any meds, IV, etc. are ordered, we write those on a separate order form,of course. And if the pts condition needs immediate attention, we call the MD before UA results (preterm labor, non reassuring strip,hemorrhage, etc). We also use a OB nurse evaluator form along with the standing orders--it breaks down different areas and assigns each answer a score. When the total score is above a certain number,the MD must come see the pt before discharge/admission. For example, someone with signs of pre-eclampsia, advanced dilation, hx precip delivery, no fetal heart tones, etc. would score much higher than someone with cervix closed, reactive strip, few risk factors. However, becoming a qualified nurse evaluator is a lot of paperwork--it must be approved by the staff physicians--it is almost like applying for staff privileges. A lot of work, but worth it. Now, if it is the middle of the night, the MD doesn't always come see the pts--they usually admit them to the antepartum unit, and will see them in the AM. Hope this helps.

i agree--there should be at least one l&d nurse in house always. i think of l&d as the er for ob patients. all er nurses would not be at home on call if there happened to be zero patients in the er for any length of time. if we offer ob services to our community, we owe it to them to have a specialty nurse in a specialty area. but i'm not the one who needs to be convinced..... thanks for your replies. i really need as many viewpoints as possible.

How is your L&D unit staffed?? I'm looking at a small hospital with one nurse in L&D each shift. Is there a L&D nurse in-house 24-7? Or, if there are no patients in L&D, is the nurse at home on-call? Thanks for any replies.