PeepnBiscuitsRN

My whole thing is that we serve many cultures who, no matter how many times you try to convince them that they DO have milk, and the baby is getting colostrum, too, they refuse to believe it. Even if you teach them to hand express they don't beleive it's enough and baby will starve. Grandma is standing by with a bottle and in some of these cultures- grandma is the wise woman you don't argue with- and they don't want to argue either. Secondly, many of these mom's are on baby number 5-6 (7,8,9) and what happens is dad brings the siblings in to meet the new baby (and often the next youngest is no more than 15 months old or so) and drops them off....buh bye. OR the siblings and the WHOLE DANG FAMILY, all 24 of them come at once to visit. Dad hangs out with the other men, outside the room. I frankly don't begrudge mom for bringing baby to the nursery so she can sleep because once she gets home she's going to have a zoo on her hands (and many times those are the kids we- the crabby old nurses are scolding to not run screaming down the hallways and climb on chairs and pound on computers and run into other people's rooms.) I agree that breast milk is better for baby- unless you're like our second biggest population, the kids who decide it's fine to drink and smoke THC while pregnant with no intention of stopping, or using Meth. I'm just saying we're so big on kissing fannies, we're going to tork off a lot of people.

My hospital is working toward becoming baby friendly. This entails that we promote rooming-in and breastfeeding, which I have no problem at all with- what I do have a problem with is how we are being presented with it- and how we must now interact with our patients. Our patients come from a very diverse spectrum of cultures who are set in their ways and I guess I don't really feel it's my place to be like "well welcome to America- this is how we do it, too bad so sad." We have been ordered to move all formula, nipples and pacifiers to the back room of the nursery (which has also undergone a name change to make it less accessible and friendly sounding) so that NOBODY sees it, patients or family. We don't want them to think we promote formula or artificial nipples. We are instructed now to council every mother who has chosen to formula feed, or do breast/bottle combo on the "dangers of feeding formula to your baby". Yes, these very words were uttered and in writing. There's serious talk of making the mother sign an informed consent before giving the baby any formula- acknowledging that she is aware that she is causing harm to her baby by giving him/her formula, and that they understand that breast milk is superior to formula. We must extensively chart WHY mom is choosing formula. We have to now keep all the shades in the nursery down so that people don't look in, and THINK it's a nursery and again to make it an in-accessible place. This really seems out of hand to me. I love where I work, I love the field but boy, we are in for some troubles when a mom from another culture other than white-upper class wants to put their baby in the nursery so they can sleep, or can go for a walk, or wants to formula feed and then gets a 20 minute lecture implying that they're a bad mom for choosing this method. Is this true of any other hospitals out there that are baby friendly or are in the process? I feel like they're trying to brainwash us, or like it's becoming a cult-like atmosphere!

You're in MN? I'm in MN and where I'm at is a VERY racially and culturally diverse place. We have on the unit I work at: Hispanic nurses, Hmong Nurses, Somail Nurses Ethiopian Nurses, African Nurses, African American nurses and we're all treated the same regardless. You don't get promoted unless you have some experience under your belt, and if the gal who did get promoted-who had the same amount of experience as you did, then unfortunately she knows someone who knows someone. That's how it works in that case. It may be the facility you're at- muscle through it, get your one year of experience and move on to somewhere better. I'll tell you though, at the hosptial I work at, it's true- white middle-class/upper class nurses are becoming the minority and the nurses who get the special treatment are the ones who have worked at said facility since 1976 and they've earned it. I have no doubt you're picking up hostile vibes- but mind that you're not putting them out there too. That just spirals and nobody is happy.

I found that the one time I had a student with me, I felt totally discombobulated. I forgot stuff, I fumbled with stuff- and I work on an OB floor so we're not passing a lot of hard core stuff too often. I don't know, maybe you've oriented people before but as another poster said, you've shown your orientee that even experienced nurses are human and make errors. You're showing the right attitude- you're not being defensive or denying it. Sounds like you had your peer-review and it went fine. I don't know, I look at passing meds like driving. I don't care how hard you're tailing me- I'm going to go the speed limit on the freeway when it's snowing. I'd rather make you irked than die. So- what I mean is yes, sometimes time is of the essence with getting a medication, but always remember that no matter how hard a doctor taps his/her toe and taps their watch, you're going to keep that patient from further damage. The docs seem to have so many safety nets and get out of jail free cards whereas nurses don't.

We're a closed unit, but we have an overflow unit that's on cardiac- a wing of that unit is reserved for low-risk lady partsl birth patients only. At first I was a little skeptical, especially since this was the unit I came from and we saw a lot of stuff there, including people withdrawing from everything under the sun, to dementia patients who would scream and yell all night long. Then they said we were going to be a closed-off separate wing. As for bringing med-surg to your floor- I'm thinking about how that would look on our floor with 21 beds and I'm thinking no. We encourage mom's to walk in the halls- especially after a c/s. We also encourage mom's and dad's to walk the halls with the babies in their little crib-buggy things. Not to mention all the people in transit from room to nursery and back. Add to it that we have a high volume of visitors- many with other kids who tend to wander out of their rooms. We allow visitors past the visiting hours time just because nobody is sick on the floor and often the visitors are very helpful for mom. To have a new mom/baby in a room adjacent to a dementia patient screaming all night would be horrible for both parties involved. I think the crying babies would become a problem as would the screaming. And as for male patients...well, even though women tend to stay in their respective rooms, there's still a lot of lady bits...especially with us being so pro-breastfeeding now.

I had a patient recently probably complain about me. Why? Well, see she was nice as could be all shift long but at 11:20pm she put her light on. Where was I? In report, talking to the night nurse who would be taking care of her next. Well...I get out of report and another nurse tells me rather smugly "oh you'd better get into 5, and bring a new cover for the bili bed because her baby had a blowout." So I did that. I walk in and what do I see but this mom crying. She right away unloads on me "HOW LONG DOES IT TAKE FOR SOMEONE TO ANSWER MY (BLEEP) LIGHT?! My baby had to LAY THERE in her own (BLEEP) and pee and my (BLEEP) back hurts! (boo hoo hooooo)" Babydaddy is holding said baby in a blanket staring off into space, baby is naked. I am apologizing to her, explaining that I was in report. Patient continues to whimper. "Now my baby needs a bath because I didn't have no wipes or NOTHING!!!" "I'm so sorry. Lets make it right, ok? I'm cleaning up the bed and we'll get baby all cleaned up ok? I'm so sorry..." Lets pause now and hear from nurse Peep's inner running dialogue: "Oh. Your baby pooped? What a rarity. Had a blow out? GET USED TO IT!! My daughter had mega blow outs every stinking time we went out to eat that required complete outfit changes and sometimes a sponge bath right there in the bathroom! Now, you're not post section. You're going home tomorrow. Your legs worked enough to waddle up to the front desk and rant and rave about nobody answering your light after 15 seconds- why couldn't you just change your baby? Was it too icky? You didn't have no wipes or nothin'? Well I'm sorry but just as nobody is going to correct your grammar, nobody outside the hospital is going to remind you to get wipes. Oi. That was a FANTASTIC way to end the night.

It could work in your favor to work in a hospital first, because you could then transfer from whatever unit you start on to OB. That said, it might take more time for you to get hired in OB, firstly because if you got hired on say, cardiac or ortho or something it would be expected, or at least it would be classy to stick around for a year or so before zipping off to another unit or another hospital. In fact, a lot of managers would probably frown on someone who worked on their respected unit for 6 months and then split. Secondly, you'd have to wait for an opening at the right time. What I would suggest, whatever route you go is to think about why you want to be an L&D nurse. I'm not saying it as a challenge or anything, I'm just saying that recalling my interview for postpartum, the manager didn't want to hear "fluff" like "oh I just love babies!" (Well DUH!) Or "I want to be able to hold a mother's hand through labor..." yes of COURSE! But pay more attention to the hospital itself and the clientele it serves- an example: my hospital is inner-city. 85% or more of our patients are living in poverty, many are from broken homes, many are teens, and a large population are either Hispanic, Hmong or Somali (bi-lingual skills are naturally a huge plus). I find people fascinating, and I find the diversity of child birthing practices really interesting. I have a soft spot for teen-mothers, I feel like if I as a nurse can make a mom feel safe in the hospital and reassure her that her "babydaddy" isn't going to get past the front doors, then good. I like to feel useful to someone. That wasn't meant to sound like a "yay for me" sermon, but you get the idea. My manager was real upfront that people think they want to go into L&D because it's going to be just like "A Baby Story" or some other TLC show. So I'd say if you have a specific hospital in mind, research it. Know why you want to work in L&D (also be willing to start in Postpartum or Special Care Nursery). I agree with joining AWHONN. It looks good on a resume. It shows that you are willing to learn about this specialty on your own. Becoming an IBCLC is a pricey investment but if you have the resources then I'd suggest doing it. Don't bother with getting certifications- they'll train you and odds are you won't pay a dime whereas on your own you might pay...several dimes... plus, some certifications require that you've already worked in the field for X number of hours. I got my foot in the door where I'm at because I had both my kids at this hospital- the nurse manager was working the floor one day and was wheeling me down to the special care nursery to see my baby. I remembered her name. I came back a few days after discharge with a resume (and another thank you ). They weren't hiring at that time, so in the meantime I got a job on the cardiac floor, floated all over the place for a year and then applied to a special care nursery job, the recruiter called me and said that I wouldn't be considered for that because I had no experience, HOWEVER- there's a postpartum job that's not posted yet that I fit many of the qualifications for and my cover letter sounded like I'd do well there. So...I applied, interviewed and got hired. Right place, right time...

It is weird that someone would turn down a male student but not a male OB doc. I think culture would play a big part- I had a male student shadow me one day and we have a pretty diverse cultural spread- there are a couple of particular groups where it was just a no-brainier: no way- no males except the husband or brother are allowed in the room. Other folks were pretty indifferent as long as they got the idea that he was professional and not acting grossed out or being too visibly uncomfortable. That's the thing, if you act really uncomfortable, like you really super don't wanna be there, they're going to pick up on that and it will make them feel weird too. Personally I wouldn't have cared if I had a male nurse- just as long as you're letting me bleed to death or letting my baby get too cold.

I'm glad for the year or so I had in cardiac and med surg- taught me the fine art of time management and really broke me in. That said, however, I'd have taken a position in L&D or Mom/Baby in a heartbeat if it were offered right out of the gate. I can tell you that sometimes (playing devil's advocate here) what we think we want to do isn't really what we expect- I wanted to work in peds, had my heart set on it. Had a taste of it in clinical and in lecture and in reality in having my own children and realized that I couldn't hack it. Thought cardiac would be awesome, and while it was very good experience (I like being able to read and interpret an EKG strip) that too wasn't what I wanted to do. I'm only saying the upside to taking the med surg path is that you would have some skills unique to that field that are valuable that you wouldn't have in OB. I've lost a lot of my med-surgy skills since working in OB. If I wanted to suddenly switch and work in say, surgery, or ER or something like that, I'd have a hard time with skills specific to one area and it would be suggested that I get some time in med-surg. But once again- if you seriously want to work in L&D, I'd say grab it. It is hard to get in as it is, even with experience, so this is a pretty rare opportunity.

The otoscope thing sounds just silly. When I was an LPN I looked in ears and in throats and noses with an otoscope! The NP I worked under expected me to take the initiative and do those things. As for ambulating high fall risk patients? Happens every time at work when we get those new moms out of bed after a section! My orientation in cardiac a couple of years ago (I don't work there anymore) was a lot like yours. I had a different preceptor all the time, I was supposed to work nights, but they had me orient on days, and then KABOOM, night shift. First night shift, my preceptor was very nice. Very patient. Second night- my preceptor floated to a totally different unit- so I floated with her and then the whole "hey you're supposed to be sleeping right now, it's 1:30am thing kicked in". Later, out of the blue, I got chewed out by my educator- apparently my preceptors couldn't tell me I sucked, but they could tell her to tell me. And she sure did. I hope things work out better for you!

I'd say keep your mind open to everything. Consider your clinicals like a buffet, sample each thing and expect to change your mind, even if you don't think you will. I went into RN school as an LPN working in pediatrics, convinced I'd be working in peds- by the time I was done, I was really interested in cardiac and OB was in the back of my head sort of just sitting there doing nothing. By about 3 months into cards, and 6-8 months after the birth of my daughter, suddenly OB was just sitting there. I asked around, in fact I think I even came here and said I want to work in OB, someone talk me out of it, tell me I'm still high on baby juice from having just had my daughter. I think some people told me straight up- but I still was interested. So here I am now. I researched it: what kind of birth center were we? Were we traditional? Baby friendly? (We're on the border, working toward Baby Friendly) and most importantly- who do we serve? So many come into OB thinking it's going to be a fairy tale out of "a baby story" where the nurse and the family bond and have such a great time and the nurse teaches the mom, and it's intimate and just a dreeeeeeaaam. Well, let me tell you, our hospital isn't so much "A Baby Story" as it is "Teen Mom" or "16 and Pregnant" meets any kind of daytime talk show. And the "Baby Story" type patients we get actually turn out to be very "educated" affluent jerks with 30 page birth plans and parents that stand 0.5 inches behind you when you do ANYTHING. "What do you think you're doing?!" "Well, sir...this here thing is called a stethoscope, and I'm listening to your baby's heartbea- "Is this really a necessary procedure?" "Well...I guess if I were the one who just had a baby I'd want to know if their heart rate was okay" *Hem...haw...grumble...*

Whoops. Just saw you're already in the field. Awesome! Have fun with it!

You already said it- there's very little turnover. I work with some nurses who have worked in the birth center for going on 36 years now. It's their niche too. Though I wonder- and please don't take this wrong, how one can say that any field is their niche until they've worked it? You like to teach, and yes, there is definitely teaching to be done in OB. But when I worked in cardiac, there was teaching too- different kind of teaching, but still there was a TON of stuff to teach. Many of the nurses who have worked in OB have said they get these new grads, or nurses with about one year of experience who say that OB is their dream job, that this is what they're meant to do- and a month or so later they quit because it's not the fairy tale they thought it was. I know you said that you're not about "babies are so cute" and all, and that's good because while OB is generally happy and good, there's a lot of ugly on that unit too- babies getting taken from mom from CPS, babies born to 16 year olds who dress them up 6 or 8 times an hour like a dolly and then whine that the baby is crying and they're trying to sleep/watch cartoons/talk on their phone and while I'm at it- change the baby's diaper. Or the uber rich people with 46 page birth plans that give you the death stare if you pick their baby up. It's a popular field, I hope you get your foot in the door. Persist and give the managers good reasons why you're interested in it.

We have Vocera, and it's become a point of amusement to see how long it takes before the stupid "genie" recognizes our name so we can log in. The other night a gal with a pretty simple, common name had to try about 9 times before it recognized her! "Vocera" "Log Out" "I'm sorry, I didn't quite catch that. Vocera?" "LOG OUT" "I'm sorry, could you repeat that? Vocera?" "LOG OUUUT!!" "I'm sorry, I didn't understand. Vocera?" "*** YOU!!!" *Snide male voice* "I beg your pardon?"

Yeah, I've had new parents who write down the name of each nurse they have for each shift of the days they spend there. It can be a good thing (when the few kindly souls write a thank you note and mention each nurse by name that they had) and then there's the stinky ones, the ones who think that since you're an employee of a hospital, you're out to violate their brand new bundle of joy with invasive torturous procedures. (You know us OB nurses...twirling our mustaches and rubbing our hands together diabolically!) Our badges have our photo, and our name with the initial of our last name. It's fun because on our unit there are 4 of us- myself included who have very similar sounding names...and at one point we all worked the night shift! Now two work the night, and the other two of us work evening.

1) The first time you decided nursing wasn't for you, that should have been it. Nobody else should have pressured you into going back to it. If you're not happy as a nurse, you'll burn out, you'll get short with patients and possibly worse. 2) We're in a low-income, working class situation too. My husband doesn't have stable work so he looks to me as the primary source of income. However, he is at least pulling his weight- he works freelance, he knocks on doors to see what he can do too, not even what he WANTS to do, what he CAN do. I suggest your husband do the same. Disabled? How much? Incapacitated? I can see where leaving your job on a dime with no backup is not a good idea, and it does sound like you've job hopped a bit to see what suits you and that's okay, and yet not so okay, you need stability. Bottom line: your husband needs to pull his weight. If he can find something to bring in some income beyond what disability checks can offer, then you could try to find something non-nursing. 3) If you go back for your RN, you'd better be certain you want to be a nurse. It's a big investment, yes it does open more doors than what your LPN can offer (and being an LPN is GREAT, I was one for almost 5 years). Best wishes, I hope you and your husband can find a balance. But if he continues to shut down and get worked up about it, then you need help further than just employment.

I was in treatment a couple years back and the nutritionist and therapist I was seeing said that many regular internists just have no clue how to handle eating disorder patients, and for all their knowledge don't seem to understand the response of the body to eating "regularly" after having starved oneself and that it's very likely that an ED patient would gain a lot of weight following treatment. She also says that society indirectly praises distorted eating and compulsive exercise. We're an ignorant society when it comes to eating disorders (do you ever forsee a reality show called "the biggest gainer" where eating disorder patients go through therapy and try to adapt to a normal way of functioning?) Oh- and the worst thing you can say to a recovering anorexic is "honey, you look great, you look HEALTHY."

When I worked on cardiac, I had this 87 year old lady whose ICD was firing (hence her admittance) and she was having repeated runs of VT. So the resident is up there- this hot shot young woman, and she's all striding down the hall being the empowered young female doc she is- she goes into the room, the woman has another run, symptomatic, and the doc comes out and is on the phone to the attending, sounding like a scared little teenager calling her daddy to rescue her. "I don't know what to do! She's...she's...all pasty and diaphoretic, and I...I..." and she's got tears in her eyes! Here's a personal one- when I was 18 I was in treatment for anorexia nervosa. I had been eating a non restricted amount of calories and of course I had put on a lot of weight- more than I lost and was considered overweight now. So the doc I'm seeing for some reason or another is lecturing me about how I'm overweight. I tried to explain to him what had been going on since I was 15 years old, eating a diet of no more than 700 calories a day and he says "and you know that's fine, some people really only need to eat that much in a day." My dad chimed in "but honey, you're not "obese". And doctor classy pipes up "actually, by the numbers you are obese, but not by society's image of the word." Needless to say there was a mild relapse.

When I was a new grad I took a night shift in cardiac- I'm now evenings in OB and love it to death. I think about how hard it is to find a nursing job, and how insanely lucky I am to be on evening shift and I seriously want to throw myself at my supervisor's feet and kiss them.

When I watch a movie or tv show in which birth is given and my immediate statement is "Congratulations on the birth of your squeaky clean 4 month old! By the way, that birth was rather precipitous- perhaps a drug screen for mom is in order and the baby should be bagged?" Or just being with friends and family and when someone mentions an ailment, my ears perk up and I go into triage/assessment mode and present them with a care plan they didn't ask for.

Since we're on a roll here- this is more of what the resident did, versus said. Had a 40 something year old Somali woman who had just had a c/s and was complaining of chest pain. Young, squeaky new male resident and the attending (a sharp, no nonsense young woman, of course) show up. We have the interpreter on the skype-type interpreter line, it's a male interpreter and if you know about Somali culture you know most of the population are Muslim, and most of the women are very modest and private. So this dweeb of a doctor comes in, faces the interpreter and begins talking to the interpreter as though the lady (and a bunch of her female family) aren't even there. Asking the questions to the interpreter, with his back to the poor woman. He then turns and proceeds to unbutton the snaps from her gown, pulls down the collar of her gown exposing her breasts and starts touching her chest all over: "does it hurt here? How about here?" I'm just looking at the ground, feeling horrible for all parties involved- you could clearly tell (unless you were young doctor clueless and his boss) that the women in the room including the patient were mortified- and he CONTINUES to just jabber away to the interpreter "does she have any dyspnea, is she tachy? Does she know she got a few liters of fluid in the OR and she had some pulmonary edema?" Using just nothing but a string of fluent medical speak to talk to a patient through an interpreter who at this point is looking like he'd rather be having a root canal than be privy to this spectacle!

The other afternoon an OB resident came by to check in with a patient, the OB doc seemed very perplexed as to why the patient was crying. "I don't know why she would be crying, that seems strange..." Because postpartum women NEVER cry. THERE'S NO CRYING IN CHILDBIRTH RECOVERY!! So what are some of the things a provider has said that just make you wonder?

I was wondering, do any of your facilities do this? Ours apparently does (which gives me hope with two sections under my belt). Is there any offical stance by ACOG or the like on the matter?

I think we have a Pit protocol, but many of the providers are pretty flexible. We have had the 3-4 day inductions as well, and if a woman truly wants to avoid the P, we do everything we can to facilitate that. True, some providers are itchy to start it, just as some providers have an itchy scalpel finger, but generally, unless the woman is not progressing, or progressing EXTREMELY slow, and her BOW is ruptured with mec and all that, then they will start talking Pit. I delivered at the hospital I work at, and with my son, the doc really REALLY wanted to get Pit going, but the nurses (I wasn't a nurse at the time) went to bat for me and it was a good 8 hours or so of walking, bouncing on the ball and the like before they went to Pitocin.

I don't mean to beat a dead horse here, but when I graduated from nursing school- a class of 75 students, I'd say about 68 of them stated they wanted to work in L&D. At my hospital, they were extremely picky about who they hired in L&D and the chances of a new grad being interviewed let alone offered a job were less than 1%. I'm not being dramatic, this came from the manager of L&D herself when I approached her with high hopes about working in L&D. "New grad? Thanks but no thanks, get your year of experience in med-surg then we'll talk again." So in other words you were just offered the winning lottery ticket, AND a compliment- you were one of the best they interviewed, and you second guessed yourself AND you second guessed them. Your e-mail made it sound like "well, I know you think I'd do well here and all, but I think you might have been too hasty." That said, now that the dust is clearing, I'd say keep volunteering unless you get a weird vibe from people. That or flat out approach the manager in person (gutsy thing to do) and ask what happened and be prepared to have to answer for your e-mail. New grads have a hard enough time finding a job period, but to be offered a job in your chosen specialty and then suggest that you're not satisfied is a bit of a slap in the face. Sorry this sounds jerky, but this is coming from someone who "pounded the pavement" for a year before getting a nursing job, and had to wait an additional year before even being considered for OB (which is what I wanted to do all along) and then an additional half year to actually get the birth center job. Beggars can't be choosers for new nurses. Oh, and I wanted to add, if you were to have taken the job and a few months in felt you weren't in the right place, or they felt that way, THEN they might have been able to move you around to Postpartum or NICU- internally. It's easier to move around when you're an established employee.