JAHJF

My hospital allows them, if the primary ob (or on call doc) is in house once active labor, and we have 24hr anesthesia coverage, we have ob residents in house 24hrs to assist and we have 3 or's on our unit. However, very few of the area doc's "allow" their pt's to VBAC, they just go for the repeat c/s.

We do Labetalol gtt on L&D, we have one special room w/cardiac monitor available and if by chance two pt's need a gtt we have another portable monitor. vs are q5min during bolus and q15min while gtt runs. We try our hardest for these pt's to be 1:1, for the simple fact they always see to have other things going on, but I also work at a large high risk ob/tertiary/teaching facility.

My license reads Professional Nurse and that I have complied w/all things needed in order to practice as such

We are 2 units combined LDR and HRPU (high risk perinatal unit) and we keep all Mag pts till it is finished then they go to MBU until discharge.

Most nights one pt on pitocin and another pt of some sort (pp mag/pre-e, ptl on mag, induction w/cervidil, svd or c/s-recovery, just depends), a good night just that one pit pt, a bad night, 2 pit pt's

Can't help w/# of drapes, but when I worked Step-down we always called the leg incisions - vasoviews?

I calculate like Envy's post describes. At my hospital 180-240 is adequate. As for charting, if pt is on pit they get an exam page done q15min (including fhr and iupc/mvu).

We have an RN and a RRT that are NRP trained (both work in NICU) and a NNP or Neonatologist at every c/s delivery, of course they all come to the high-risk births and an RN and RRT come to all other deliveries. Also-all of our L&D RN's are NRP trained and we usually have 2+ at every delivery depending on level of emergency (have seen up to 5-6 in an OR for a very scary situation) So 4+ NRP trained persons at every delivery.

We have computerized charting and then when a pt is transferred from L&D to the MBU all the notes, etc are printed out and placed on the chart.

We have one OB who orders a shave and enema prep on every pt of his that is admitted for labor or induction, many refuse but some who have had several babies with him over the years are actually ok w/it b/c it is what they are used to having happen w/this particular MD?

Courage is grace under pressure - Ernest Hemingway Within every adversity lies a slumbering possibility - Robert Schuller Quality is never an accident; it is always the result of high intention, sincere effort, intelligent direction and skillful execution; it represents the wise choice of many alternatives. - Williams A Foster

Hate to say it but my husband did go through labor and birth both times I did, he just didn't do the physical, but he was there at my side and emotionally (both of which can be exhausting d/t length of labor or emergency situations), I've never seen my husband at tired as the morning my son was born, I labored ALL NIGHT and then had an emergency c-section under general, my husband isn't a medical person and was scared to death (an abruption is scary looking to anyone) and worried about losing his wife and child. So needless to say my son spent his first night from about 11pm till about 5am in the nursery and we both slept (besides I got plenty of sleepless nights after we were discharged home so why not take advantage that you have someone to help you while you are in the hospital?) 3/4 area hospitals have nurseries (1 has rooming in w/only a special care nursery) and I encourage moms to let baby go to nursery so they can sleep or nap during the day and so do the postpartum nurses.

Our CRNA's always remove the epidural catheters before leaving the OR and have "post epidural/spinal anesthesia orders" that they can check off, usually allowing for IV morphine, something for nausea, something for itching and toradol if the morphine doesn't work (these orders are to be followed for 24hrs post op then the OB's PO med orders kick in). We normally only use a morphine PCA when a mom has had a c/s w/general anesthesia.

#1 @ 20 #2 @ 24

I work in TN and the admission/registration papers cover labwork, vit K, eye ointment, hearing screen, once on the postpartum unit mom's sign a separate consent for HepB and circumcision.

When I had my c/s my doc told me that

---------------------ACID-------NORMAL RANGE-------BASE pH____________________________7.35-7.45_____________ PCO2 (resp)______________________45-35______________ HCO3 (metabolic)__________________22-26______________ PO2_____________________________80-100_____________ BE______________________________+2/-2_______________ O2 SAT__________________________95-100______________ -----------------N=normal Example: Pt in respiratory acidosis --------------------ACID-------NORMAL RANGE-------BASE pH_______________7.306_______7.35-7.45______________ PCO2_____________51.0__________45-35_______________ HCO3_____________N(24.9)_______22-26_______________ This is what I used in nursing school. Hope it helps.

Never seen toradol used but Indomethacin is an NSAID used b/c it inhibits protaglandin synthesis and can be given to premies to help close a PDA?

Maybe Limited Metabolic Panel (like BMP)?

There are only two lasting bequests we can hope to give our children. One of these is roots; the other, wings. Hodding Carter We can do no great things - only small things with great love. Mother Teresa From small beginnings come great things. Proverb Life itself is the most wonderful fairy tale. Hans Christian Andersen The greatest gift is a portion of thyself. Ralph Waldo Emerson Those wo bring sunshine to the lives of others cannot keep it from themselves. J.M. Barrie There are two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle. Albert Einstein A perfect example of minority rule is a baby in the house.

The Paradoxical Commandments People are illogical, unreasonable, and self-centered. Love them anyway. If you do good, people will accuse you of selfish ulterior motives. Do good anyway. If you are successful, you will win false friends and true enemies. Succeed anyway. The good you do today will be forgotten tomorrow. Do good anyway. Honesty and frankness make you vulnerable. Be honest and frank anyway. The biggest men and women with the biggest ideas can be shot down by the smallest men and women with the smallest minds. Think big anyway... ...People favor underdogs but follow only top dogs. Fight for a few underdogs anyway. What you spend years building may be destroyed overnight. Build anyway. People really need help but may attack you if you do help them. Help people anyway. Give the world the best you have and you'll get kicked in the teeth. Give the world the best you have anyway. -Kent M. Keith

New to my facility but it looks like about 200+/- a month not sure maybe more (only been here one month) without asking someone and I'm at home now. 4 triage rooms 3 ORs and a PACU Antepartum unit with 6 LDR possible rooms and 6 other rooms (1-2 of these has become storage during recent renovations) L&D unit with 12 LDR rooms (one of which can function as an emergency OR)

Where I work the MDs have RN's that round with/for, write orders for, etc. and they or the doc pull all tubes/wires.

Tx the pt not the machines. (Did my 1st yr in cardiac) -Check your pt before you call a code if you see Vtach on the monitor screen, they might just be brushing their teeth :) [happens all the time] -Someone in flash pulmonary edema, barely moving air, can have an O2 sat of 97% [this really happened to me, lucky for me and the pt I went with my assessment skills] -You can see a heart rhythm on a screen and still not have a pulse [went to a code once in SICU, when I got there the nurse said it was ok we could all leave b/c she had done CPR and got a rhythm back (the poor man was still gray and not moving/breathing-this was obvious to the code team); she was treating the monitor and we were looking at the pt] I've been in High risk L&D for 2weeks on orientation so lots more to go but thank you all for sharing, I've learned some very important things.

Large teaching hospital-all residents use sterile gloves for all sterile spec exams