OBERrural

I've been using it for 6 months. Before this I used QS and another program I can't remember from about 15 years ago. I feel like I have problems finding where to chart everything. I feel like half the time I'm searching where to chart what I need charted. I work in a VERY small hospital now (which is new for me) and we only have 1-10 deliveries a month so I don't get much practice with it. This is a big change from my 1-3 deliveries a shift where I worked before. Maybe if I used it more frequently, I'd feel better about it, but so far, it's not my favorite! I agree that they need people who actually use the charting to develop it. On a side note, I have been modifying things quite a bit to fit our needs. I'm in contact with Cerner almost every shift I work, trying to get things just how we want them.

We have it. It is called Fetalink and I'm not enjoying it.

You could take NRP and a basic fetal monitoring course. Most of the training is on the job, but this would let them know you are serious. Network, if you can. That always helps too.

I understand, when I worked in a big city hosptial, all of the departments kept to themselves too. I just started working rural this last year and it is a whole new world.

In North Dakota they do.

Depending on the size of your facility, could you volunteer to help in ER on their busy days? I work in a small, rural OB and when we don't have patients I ask to float to ER and have started to be oriented to ER. It's a good way to get your foot in the door and worth a try. Try talking to the ER manager. Good luck!

I've been a L&D nurse for 9 years. It took me about 4 weeks to even feel what I was supposed to be feeling and by the end of my 12 weeks, I was much more confident, but still had experienced nurses double check me for a long time.

One more thing, I would look into the legality of being on-call and not getting paid. I'm not sure that they can do that.

When I worked in a large hospital we took 10 call slots every 4 weeks. We always had two people on call per four hour block. Now I work in a rural hospital and we only have 1-10 deliveries a month (crazy, I know!). We do not take any call. They call all of our staff if we need help. If no one will come in, they divert our patients to another hospital. Not the best solution, but when you only staff one RN per shift and only have 4 full time nurses total for the unit, it's what we have to do.

Don't be scared! You can do it. You have an amazing amount of experience and a 2 year break won't hurt anything. I recently rentered nursing after a 7 year break. They were thrilled to get someone with 8 years of experience, even though I had not practiced in 7 years, and I was very grateful they gave me the chance. I think you will be just fine, especially if you'll be attending school during your break.

You can't control everyone else's behavior, but you can make suggestions and start getting things changed. Every place I've ever worked, we practice very independently as L&D nurses. The doctor is barely there until delivery. Most of the things you discussed, you should be able to do with your own patients. There is no rule that says you can't change the patient's position. Nobody is going to be the with you for pushing so just let her push the way nature tells her to. Pit the way you want to pit and when your patient gets to complete let her labor down. If other start seeing this, they may follow your lead. Remember, no patient is cut and dry. You have to adapt to your particular patient. Yesterday I couldn't get my patient to change positions during labor and that was fine with me. I'm a very laid back nurse and I think if the doctors see that in you, they will follow your lead! Good luck!

It sounds like you just need more practice. Your technique sounds good. I would say any chance you get, check a cervix, even if it is not your patient. Try to check a closed thick cervix, a swollen cervix, a cervix with scar tissue from a LEEP, etc. Practice, practice, practice...it will get easier. If you work in a small hospital, this will be a little harder, but eventually it will click. Don't feel bad, it takes everyone a while to catch on. I felt like I was never going to get it and then one day, it just clicked!

It's possible, but I personally would want experience in other areas first. I did one year of med-surg first and don't regret it one bit. You'll use the skills more than you think and your critical thinking skills will be much sharper.

I agree with everyone else. Usually you will only feel an internal and external os when the cervix is thicker. I'm not sure what your preceptor is talking about. In the beginning , just focus on finding the internal os. Don't worry about the external for now. That will come with experience!

I am also in the Midwest (iowa) and agree that new nurses start out at $21/hour. I have 8 years experience and don't make much more than that. Good luck!