JenDenRN

The hospital I am at we do the pre-op, circulate & PACU. We have either a scrub tech or OR to scrub. I wish they would train us to scrub, however. It is always a little stressful when our scrub tech calls in sick & we have to rely on the main OR scrub who's on call to arrive.

It is always so hard to deal with a bad outcome. In 14yrs I still remember the one where I felt the same as the other two nurses. My 3rd year as an L&D nurse. "Am I qualified to do this? Did I miss something that could have prevented this?" I also wasn't sure if I wanted to have the responsibility of women & their unborn children's lives in my hands. I almost gave up. Then I was in another very serious situation a few months later that was handled very well. Afterwards, both the md & the patient thanked me for my knowledge & "getting them through it safely." I then realized that we are human. We are not perfect. I do my best & still enjoy my job. Talk to who will be supportive; it may not be the administrators of your department. Try not to be too hard on yourself.

Wow!! That "miso-bullet" sounds great. It is so time consuming to open each little 100mcg tablet container & then make sure that all 8-10 get inserted. Especially when time is of the essence. I agree that the horrible GI side effects of hemabate should make it the last resort. We always prepare ourselves for a "code brown" when we have to give it.

The first hospital I worked at in L&D would use 1,000mcg cytotec rectally only as a last resort. It would go pitocin, methergine hemabate, then cytotec. The hospital I'm at now seems to use the cytotec even less. Until this new MD arrived. It seems to work so much better w/ much less side effects than the methergine & hemabate. Thanks for the feedback!

We have a MD that is fairly new to our area that routinely will insert 800mcg of cytotec rectally post delivery. he will do this both after delivery of a pt with either a "boggy" uterus not firmed up with pitocin or methergine or a pt that has increased risk of postpartum haemorrhage due to prolonged pitocin induction, magnesium sulfate therapy or grand multips. He claims it works much better than hemabate; which has horrible side effects!! Code brown anyone?? It seems to work very well with little side effects to the pt. anyone else out there doing this routinely?

The Perinatologists we work with now only use MgSo4 for neuro protection. In cases of severe PIH, it is for the Mother's neuro protection. In cases of imminent deliveries of babies below 34wks, they will infuse the MgSo4 for only 24hrs for the fetal neuro protection. As far as antepartum "care", each MD is different. Some order strict bed rest, foley, NPO in every case. Others take it patient by patient.