BENNETTRN

Oh I am so sorry for your loss, you and your family are in my prayers! Dont hold back your tears, emotions, or sorrow. And as many others have suggested seek support from others who have experienced this. We have a wonderful perinatal bereavment team, and they express that one of the parents biggest fears is that their baby will be forgotten, and with their support groups and education they make sure that this doesnt happen. They hold a candle light ceremony every spring, and the parents say their babys name and a moment of silence and release a ballon in the babies memory, among many other support meetings and get togethers year round. I know right now this is probaby not what you are thinking about, but just know that months down the road, there are resources out there to help with your loss and make sure that your sweet baby boy is never forgotten! I know I will forever remember this post. My heart goes out to you and your family!

Be very scared, I have never heard of doing this and cant believe that the possiblity of a anaphylactic reaction is taken so lightly there. We had a all out anaphylactic reaction on our unit back in Feburary this year. Mom was GBS+ and the nurse hung the first dose of Amp., and all you know what broke loose, (this lady came in with NKDA), it took all of us on the unit, approx 10 nurses, anesth x2, the OB, and our manager to run this emergency. She swelled up so fast and the redness quickly crept down her body like a wave, anesth could barely get a airway d/t the severe edema, and heart tones went down like a cliff dive. Mom was in ICU after, and baby in NICU. Maybe you can start talking to some of the nurses in a effort to band together and get this practice changed, or at least a protocol. Good Luck to you, and I hope you dont have to deal with a anaphylactic reaction ever!

We use it for DIU's only at our hospital.

THE FREQUENT FLYERS- PTS THAT COME IN FOR R/O LABOR STATING THEY HAVE BEEN CTX'ING, THEY ARE INTENSE AND FREQUENT, PUT THE TOCO ON, NO CTX'S, STILL NONE AFTER 10 MIN'S, 30 MIN'S..........YOU ARE SITTING AT BEDSIDE PALPATING FOR CTX'S IN CASE MONITOR NOT PLACED RIGHT, BUT STILL NOTHING. PT SAYS "THIS ALWAYS HAPPENS EVERYTIME YOU GUYS PUT THE MONITOR ON THE CTX'S STOP, I DONT KNOW WHY" AND SOMEONE ELSE SAID AND ITS MY OTHER FAVORITE, SO WHEN WILL THE BABY BE BORN, I NEED TO KNOW WHEN TO TELL SO AND SO TO BE HERE. OKAY I WILL PULL OUT MY CRYSTAL BALL AND GET BACK TO YOU, LOL

ME TOOO, my fingers hurt now!

Thanx everyone, you guys gave some great tips!!!1

Exactly- instead of reading her the riot act for eating so much of Sally's birthday cake, I will accept her for who she is, and all the wonderful qualities she posesses as a person, and should she decide the try and loose some weight I will be there when she is a little on edge because she is being forced to stomach rice cakes, just like I would hope she would be there for me when I was on the edge, chewing the end off of every pen in sight or eating 3/4's of Sallys cake because I was trying to quit smoking, LOL :) !!!!!!!

Thanks for the motivation, and the stat, wow I didnt know the average was 8 times before actually quitting. I will give it my all, so many of you have done, and I need to join the ranks. It must feel great to say I was able to quit.

Sounds like you have quite a brave doc, trying to do so called convience deliveries, but he or she has flipped their lid, doing this at 35 wks. He or she is sure to get burned some point for this practice. That is RIDICULOUS!!!!!! Im sure you cringe everytime you flip the Pit switch!

I LOVE IT, THANKS SO MUCH FOR SHARING, I TOO WILL BE PRINTING IT AND TAKING IT TO HANG ON THE BOARD! EVERYONE WILL GET A GOOD LAUGHT AT IT!

Minerva and Gompers- I think you took the birth plan to seriously, I dont think she wanted to say "Hi my name is such and such and, then immediatley flop out her back side with anesth armed and ready. As for the part about the family being present, who cares if she didnt have the guts, not everyone is assertive, and some are to assertive. For those who are not, the nurse is the pts advocate, if she doesnt want certain people in there then take care of it in a appropriate way, have you never done that before? I have, it doesnt bother me a bit. I have also seen pts tell people to leave the room and alot of times, certain family members will wiggle their way back in, and it isnt unreasonable that the pt maybe to exhausted or in to much pain to keep telling people that she doesnt want them there and to leave, Im happy to step in, in a very nice way! So dont read more into the birth plan than is there. ITS REFRESHING AND HILARIOUS!

I am a newer nurse also, and like you at my previous job we generally used #22's, never had a problem then so why now. A really good nurse I work with told me I was waiting to long to advance the cath, the cath gets warm and wont move as easy and you have to push so hard then, that the vein blows. The second you get return advance the cath before the pts heat warms it up to much. I havent missed one since, except for a really hard stick, so I should say I havent missed one since, from blowing the vein! Good Luck

A few things, one thing I remember from my psych rotation in nursing school re theraputic communication, is NEVER ASK WHY! In re to smoking you already know the answer, addiction is a disease. Do you want someone to say because it feels good, they like it, they are afraid of withdrawl, they have tried and tried to quit but have started again or failed. Nurses are human too. My goodness I would never think of asking an obese person why they ate so much, or ate fatty foods. You have to accept the whole person, bad habits and all. Some really good points have been made. I eat healthy, while others may not, I dont drink coffee, while others do, I wear a seat-belt, while others may not, I dont gamble, I dont drink alcohol, but hey Im the DD! But I do smoke! None of us are perfect, everyone does something that is not healthful. My family is strongly opposed to smoking, yet my grandfather died of lung cancer and NEVER smoked a day in his life! Living is a risk itself! The hospital I work at used to have a NO SMOKING policy for all employee's, if caught once you were counseled, caught twice you were provided smoking cessation classes, third time you were terminated, if I remember right. That has nowchanged andsmoking is allowed in designated area's for all. Another good point that was made is you can make a choice to take a quick break even if you dont smoke, I would hope though that smoker or not most nurses dont take breaks when their assignment is going to H#LL in a hand basket, and if they do thats another story. I work with many nurses that get report and go get their morning coffee, doesnt bother me a bit. Now even though I smoke, I NEVER SMOKE during my 12 hour shifts, I found what I think is a great secret for smokers, because I myself dont feel real comfortable leaving the unit and my pts, (Im a L&D nurse) even though I know other nurses would take good care of them the 5 min's that I was gone. Its just the anal and nervous part of me, but certainly dont mind covering for a smoker or nonsmoker while they take a break. I chew the Nicotene gum and love it, the first time I used it I wasnt sure about it, but it does work great. Besides not wanting to leave the unit, I dont smoke at work because I dont want to be asked why, or looked down upon for smoking, I dont tell anyone I work with that I smoke. In the morning I dont smoke while wearing my scrubs, I keep my work bag and coat in a area of the house I dont smoke (my non-smoking work appearal). Even though the gum works, dont ask me why I dont use it all the time, I guess I just havent decided any reason is good enough to quit the real thing, until now, so please read on. After much planning and God willing my husband and I have decided to try and have a baby. We would like to start trying at the end of July this year. I obviously plan on quitting, and D Day is set for June 1. I have spoke with my OB and FP doc. My mom has even offered to by the gum or patch to help, she and my dad worry sooo much about the smoking. So everyone who has quit or tried, I would love to hear any words of wisdom and advice. To be honest Im a scared.

We use 18G, agree with another poster if its b/c anesth wants a 16 they need to put it in.

Just remember you passed the same state board exam to obtain your nursing license as your fellow BSN nurses did, you are no lower than them. Pursue your dreams!

Im not sure where you work and what area of nsg, but please know there are many of us RN's who "roll our sleeves up, and dig in" remember many units in hospitals have gone to totol pt care, and that means we do everything. I work in labor and delivery, I have noone to give my meds, clean up the massive mess after delivery, give my antepartum pts bedbaths and get them on and off the bedpan, or clean the projectile vomit off every square inch of the room they spewed for the 5th time, I am it and I do it all for my pts very willingly, and honestly I wouldnt have it any other way. I feel like I have the best possible grasp on my pts condition with TPC and can give the best care to my pts, and have a great relationship with them.

I second that!!!!!!!!!

BEST OF LUCK TO YOU!!!!!!!!!!!!!!!!!!

I graduated 1 1/2 yrs ago from nsg school. For as long I can remember I have had a passion for L&D, and a great interest in home health (the hx of it interests me, and the close 1:1 relationship and care you can provide your pt) so I knew I would eventually end up in one of these area's. After graduation much to the urging of everyone I bit the bullet and went to work on a MS/Tele unit for 4 mo's until I broke my wrist and arm, and didnt have PTO or ESL and had to resign, but was welcome back after recovery. I was browsing while quite bored the newpaper and found a home health case mgr med/surg position in my area with a wonderful co. (the first home health agency in hx) and really had to sell myself at the interview b/c they usually want at least 3-5yrs exp. Got the job and was determined to do well and prove myself. With all the paper work (now done on a laptop) and million other things to do I ended up working 6 days/wk approx 12-16hrs/day, I did well and was actually asked to orientate a new employee! but after 7 mo's of that you can imagine what a toll that took on every aspect of my life. I finally decided to try and find a job that was a passion. Called my old OB mgr and she gave me a chance straight into L&D. I LOVE IT, the shifts fly and I cant get enough, I ask a million questions, and read whatever I can and still love to watch anything on Discovery pertaining to L&D. I look back at the first 2 jobs and cant believe how happy I am right where Im at. I guess I took a little bit of everyones advice after graduation did M/S, did a area of interest to me, and then went to my favorite area of nsg all in a short time. I can tell you I sure dont recommend 3 jobs in 1 1/2 yrs, I felt like a failure leaving home health so soon, especially since my prior job was only for 4 mo's, even though with both jobs I obviously had good reason for leaving. My unit has approx 6 RN's who came to L&D right after graduation and they dont regret it, on the other hand the RN's with MS experience have such a wealth of knowledge, and I many times wish I could have stuck MS/tele out for 6 more mo's to say I did it, and also to gain some more of that valuable knowledge, b/c everyday in tele/ms was full of learning, and so many L&D pts have medical hx's that involve area's of MS eg. mom's w/pm's or DVT's etc. So you have to make the decision that works best for you. Sorry for the novel, just wanted to let you know theres grad's who travel all the possible roads. Best of luck to you, and remember if its your passion you will not think of it as a job, and will love every minute of it!

Heather, your license is on the line here, and that as well as a positive outcome for your pt and baby are the bottom line! I think you are going to be hard pressed to find any RN to back this practice up. On my unit, we go to a max of 24, anything over that we call the doc, then the highest we go at our hospital is 40 (that high is rare), which is not generally done, the pt must have NO risk factors, and godforbid can not be a VBAC. Also we maybe have one or two docs that will Pit a VBAC, and if it is done its of course 1:1 and done with the greatest caution! We do have a couple of doc's who always say "be aggressive with the Pit, even if the strip is bad, and just like another person said, I smile say okay and then do what I know is right, using my judgement. I cant understand why some docs will risk so much, just so they can be at the dinner table by 1800? Gather all your facts ASAP and start up the chain of command because this is crazy!!!!! Best of luck to you!!!!!!!

I second that!

Hello FrumDoula- It sure is funny you say to educate yourself on something that scares you so, because 2 weeks ago I took a 2 CEU/CNE shoulder dystocia class, and I have to tell I was more scared when I walked out of that class than I was before I went! First, I work at a hospital where 99% of all our pts have epidurals, and they are of a how would you say it a "upper class group" of pts who expect nothing less than their birth plan to be followed to the tee, and nothing less than a PERFECT outcome. I am well aware of the manuevers,(McRoberts, Rubins, Woods screw, Delivery of posterior arm, SP pressure in oblique orientation, and God forbid Zavanelli's) and have been in one serious dystocia of my own and assisted 2 other nurses births with dystocia's. You have approx 4 min's to deliver the body, so with a epidural, getting the pt on all fours will take at least half of your time, and if it doesnt work you dont have much time left. Brachial plexus injuries are the 2nd leading cause of obstetric lawsuit!!!!! Then you run such a high risk of large perineal lac's, including 4th degree, cervical lac's, and pp hemmorrhage, all of which you need the doc there to take care of. So for those of us trying to avoid injury to our pts (mom and baby), and lawsuits we need the doc there. The dystocia's I have been in, the mother and fetus had no risk factors of dystocia, so as you know, you may have a comp on your hands that you have 4 min's to deal with, and it can take the doc well over that to get there, or any "OB in the house" for that matter to arrive. Knowledge is power!!!! but in some cases all of the above doesnt work, and I have to have the doc there for the next step. By the way our unit just recently had a pt in which the Zavanelli maneuver was preformed and section was done with a good outcome (uggggggggggggHHHHHHHH)!!!!!!!! But its a reminder it can happen anytime without warning and it is out of the regular RN's scope to perform many of the interventions!!!!!!!!!

This woman is nuts and as others have said dangerous!!!!

I am in my 4th of 5 month orientation on labor and delivery. L&D has always been my dream and I love almost every minute of it. My preceptor is the most wonderful and skilled nurse with a wealth of experience and knowledge, some docs she would rather not call but she always calls them, and I know others that dont call on purpose. But she has seen so many bad situations in delivery that what would have happened if she didnt call the doc, many times you dont know until the you have minutes to intervene, interventions that only a MD can perform. What happens when you have a shoulder dystocia and only minutes?, or a bleeder? or the thousands of other things that go wrong in delivery. I know I am such a scared young nurse and will one day after years not cringe at the thought the doc doesnt make it like I do now, but the liability is out of this world. My preceptor has been sued two times, both of which were deemed not her fault, one was a mother who had a amniotic fluid embolism (I know not currently used term anymore) and another for what was a very uneventful labor and delivery but the baby had some deficits in its 6 month and so of course the doc and RN were sued. It just doesnt seem worth it too me, and I know it doesnt to my very seasoned preceptor (23 yrs as a labor RN). In only 4 mo's I have seen probably 15 deliveries go to H#$LL in a handbasket in minutes. Our hospital delivers the most babies in our city, so there is quite a variety of things to see and learn and go wrong everyday! If I wanted to deliver babies and deal with that end of the job I would go to med school or become a CNM. Just being a L&D nurse comes with enough liability, I want no more than that. If every attempt and honest effort was made to get the doc to the delivery in time thats one thing but if on purpose you didnt ensure that happened, could you live with yourself if a bad outcome occured?