DorselFin

Klone, No, for any infant that has MEc at rupture. They do no visulization of the cords. they dry ans stimulate before checking to see if there is any mec in the airway, at all. I have only ever been taught that NICU or RN/RT at delivery so that if the kid needs help they have it. If the kid doesn't come out screaming, you don't promote it until cords have been visualized. They had no idea what I was talking about. The nurse herself said that with her last mec delivery, she was worried beyond belief about what was coming out of the mother becasue she had no clue what to even expect due to the consistency of the mec. With particulate mec, she passed a delee down to clear it and get it out of the way so the baby could breathe. Unless you are talking about delivery staffing, then yes. LOL I always understood NRP guidelines to be that ther is one person at delivery whose sole responsibility is the infant and is trained in NRP.

There is no manager at this time. She was removed due to her own poor nursing capabilities. ANd this has been going on far longer than I have been there. No one has ever said anything, they just went with the flow.

I know!!! I just couldn't believe it!!! And its not that they are being bullied into it, its just that they truly did not know any different. There are so many things that are unsafe here. Beyond the out of scope, how about they use a delee suction to clear Mec when the fluid has mec present at rupture? I just can not understand the lack of common practice knowledge. I had to explain to a nurse who has been at this for 5 years why a delee does nothing for the poo that may or may not be in the airway. Keep in mind they are literally just dropping a delee in, no ET tube blade, just passing it dowm like normal.

Thats what I told all of the staff! The first thing they will say when something goes wrong is well I didn't set the pump! I refused to back down and refused to set the thing. I still refuse and the girls on the unit are now starting to follow my lead, not only on this but alot of other unsafe practices in their unit. They are trying to convince me to apply for the open DIrector position because of it.

LOL, I did all of the above the second the Doc literally threw a fit in the room when I asked her to set the pump. It has started a large uproar among everyone.

The state board states that it is not in our scope for an OB patient. We have the orders much like a PCA, and here it is widely accepted as common practice. But common practice is not always correct. IN this case, the advisory opinion states that unless we are a CRNA or LIP we can not do those things if there is an opioid in the bag. My concern is not only for myself but also the nurse that are doing this currently. They know they are not suppose to be initiating the pumps, literally connecting and setting bolus and basal rates (based on an order), and then starting with no MD in sight. That is not allowed in OB.

I never really had a problem with this except for Peds. I will say that after 6 yrs in L&D that its not as hard for me to deal with the demise pts, but I never had an issue with the preterm babies. If it is deliver or mom dies, then deliver. Its a no brainer for me. I had a pt who waited and waited against the advice of her MD and ended up gorked out in the ICU because her body just couldnt tolerate it. I had another that was in severe HELLP and I delivered her at like 26 weeks or something crazy, but her organs were starting to fail, so delivery is the only option. I am very personal with my pts and bond, but for the most part I try to look at things clinically and that it was not my choice to make regarding thier care in that sense. I still have a really hard time with the demises though. I will pass on those if I can. I would NEVER work in any unit other than L&D, its home. And you will know where home is when you find it. Don't look at the baby as if it were you in the bed, it makes it easier that way.

The nurses are setting up, initiating, and connecting epidural pumps in OB patients. The board states in the Advisory opinion that to do this with an OB Pt the RN must be a licensed Independent Practitioner or CRNA. I have spoken to the sister facility also located in Az, and the director of that unit confirmed what I believed, that it is in fact out of scope to manage the epidural pumps

I am currently on assignment with a travel company at a facility located in Az. If any Az nurses can chime in here I wold appreciate it. I want to make a complaint about nurses (more than one) practicing out of their scope. However, I'm not sure how to make a complaint about how the unit is run. Because it is not just one nurse, it is the entire unit. They are doing it knowing that the doctors should be the ones that should be preforming the task and none of them stand up for themselves. When I did, the Doc basically said they were taking me to administration becasue I refused to do the task that is completely their responsibility. I have already spoken to my company about it, but more needs to be done so that it does not occur any longer. Is there any consulting perosn or group I can speak to first to determine how to best handle this? I have never been in a situation where there was blatant disregard for stand of practice.