Mississippi_RN

At my hospital, the Pediatrician is automatically there for every cesarean section. So, the NBN RN that attends with them are the ones who go to the OR table to receive the baby. The towel is sterile that MIGHT come in contact with the OB handing off. However, if it is one of our OBs in particular, you are more concerned about CATCHING the baby then merely taking it in the proper manner.

You can put both through the same IV "site", however, where I work our Safety Standards require us to run them on seperate pumps.

Every infant receives the Hep B immunization 1 st dose (with mother's consent) but infants of Hep B positive mother's get the immunoglobin also.

Otherwise known as Procardia... LOL Docs at our L/D use it a lot. Its also a tocolytic and can be used for mild onset PTL (guess that is how it works with the blood pressure too...relaxes the blood vessels etc.) As for the PIH, I have never seen anyone come in past a week for that related to pregnancy.... Maybe she was just stressing over the baby! :uhoh21: Babies are a big thing, especially for an 18 yr old. I know I just about obsessed over mine and I was 21. However, to think about it, you are technically in your "postpartum" period for 6 weeks, right? (You know... no sex, no douche, no tampons for at least 6 weeks or until dr oks blah, blah, blah... ) So maybe it is possible.

We use OBIX, which allows for an electronice trace and computer charting, as well as a paper trace. Its a pretty good system, IMO, however, some of the forms, i.e. delivery summary, admits, need to be tweaked slightly. All in all though, you have to get the hang of it, but then you get hooked! It is entirely possible to go back and chart on a patient using the trace. I know a lot of times, when we are WILD, all I have time to do is chart the really, really important stuff, like ROM or complete dilatation, then go back and chart little stuff like routine checks on FHR and contraction pattern. I would like to NOT have to do that but sometimes it happens that way.

I have heard of bulging bag of water making the SVE seem one thing, and then when ROM occurs, SVE seeming to shrink somewhat. Not by much in the case I have had experience with (like 1-2 cm MAYBE)...but then, cervix dilated to complete in fairly short order.

LOL...you know, the next goal of mine is to learn how to speak Spanish fluently... which isnt easy, especially when most of the Spanish people down here anyway speak a lot of "slang". I work in OB mostly Labor/Delivery so I have gotten the most used phrases: - No empuje (Don't Push) -Empuje (Push) -examen lady partsl (lady partsl Exam) pronounced ex-a-meeen baaa-hi-nal lol -cuando es su cumpleaños (when is your birthday) -cómo lejos aparte están las contracciones (how far apart are the contractions) -usted necesita algo para el dolor (do you need something for pain) -respire (breath) -lleve a cabo su respiración y empuje (hold your breath and push) -cuántas veces le tienen sido embarazado (how many times have you been pregnant) -cuántos niños vivos usted tienen (how many living children do you have) -entiende inglés (understand English?) -entiende espanol (understand spanish) I could go on and on with the "bits and pieces" I have learned... (or rather been able to write on a note card and show to the patient). Although, I have found that, while note cards are all fine and good while they are still coherent in labor... once the pushing starts, they really dont care anymore!

On most procedures, it is AAT usually starting with ice chips, then sips of water, on to clear liquids, and so on... Depends on what they had done and how they handled the anesthesia though I guess. I know that, say, on a Lap Choley that is one of the deciding factors of exactly how soon you are discharged is when you can keep at least liquids down.

I was at work in a hospital billing department. I guess it was about break time for some of the people and they were in the break room watching TV. I remember walking in and looking at the TV the minute the second plane hit one of the Towers. I, too, remember thinking before seeing the second plane hit "how could someone be so stupid to hit a building that big?" Then, I slowly realized it wasnt an accident, but deliberate. Then, little by little, I heard about the Pentagon and the other flight that the passengers diverted. It took a while for everything to sink in for me. But, I remember, for a long time I was scared...I felt HORRIBLE for all the people in NYC (would have for ANYONE) but I couldnt help thinking "well...they picked NYC this time, but whats to say they couldnt hit here next time???" It is a day that will be in the history books... and I just wish to God it wasnt so...

I took the FM course from AWHONN that they came to my hospital and offered (director set it up... one of the few things constructive she has done... ) Anyway, it really really cleared up a lot of things for me as far as reading the strips and interventions. I would recommend it to anyone interested. I also have entertained the idea of joining AWHONN and was taken back by the price.

LOL... I would rather have my Unit Clerk (Floor Secretary called here) and my CNA than I would another nurse! Having someone at the desk to put in orders, answer the phone, and basically just keep things organized is invaluable when you are having to run up and down the hall all day. I would never, ever say that my Floor Secretary is useless... or even less than priceless!

I don't know that this is the correct forum to post this in...but I suppose it will do. I have a question regarding the legality of something. You hear all about those websites that you can get prescription medicine through. I'm not talking about the pharmacies from Canada or Mexico that they were talking about people getting sugar pills from...but a pharmacy from in the USA (where, I suppose, you have just as much of a chance of getting sugar pills... ). Well, I, as well as my director, two other nursing directors, and the DON (come to find out later) went through this website where you complete a health questionnaire, it is sent to a AMA Board Certified physician...and they write you a prescription for the medication (in our case Adipex for weight loss). Then, the prescription is forwarded to a pharmacy where you are able to purchase the medication. The medicine is not ALL that much cheaper than in a regular pharmacy. You don't get a copy of the paper prescription, however, the medicine bottle has a pharmacy name, address, phone number, name of med, strength, "take as directed" directions, and the doctor's name. It ALSO comes with a handout (just like from the real pharmacy) telling you all about the Side Effects, possible Adverse Reactions, what to stop taking med for, things to report to Dr etc papers. Everything is EXACTLY the same as getting it from a personal Dr...except you never have to physically lay eyes on the Dr... (or pay for the office visit). My questions is this: I am have searched and searched and searched ALL over the internet trying to find something that lays my mind at ease that this is legal. I do NOT want to do anything illegal and risk loosing my license. I am worried that, if I am drug tested, I know the Adipex with show up as Amphetamines...I want to know if me showing the prescription bottle will be sufficient evidence to support me not being a drug abuser. I take this medicine AS directed...IF not less. However, if it will risk me loosing my license in any way...I would stop in a heartbeat. I didn't know all the other directors and even the DON did this until my director and I were talking one day and she told me. They ordered it from the DON's house. That eased my mind SOME...but not much. "the higher they are, the farther they fall" Also, when I went to my DR for the first time as a new visit...I even listed the Adipex on my home med list and I told her how I got it. She didn't have a problem with it. I'm not trying to hide it in the least. I just wanted to get all of your opinions/help with this matter. Thanks, MS RN

I always have a hard time with the patients who have had any loss... but I still take the time to acknowledge how they are feeling as well as how they are feeling (emotionally). I remeber there was a firl who m/c at 19 weeks. The mementoe boxes were for 20 weeks or older, and the night shift nurse had already but the fetus in Formulin (long story). I got the baby band with all the information on it and the foots prints they did take (thankfully) and made two little cards (one for mom and one for dad) and decorated it with the baby band on each one (there were two-- one was to be for her and one for baby). She was so happy to get that....I couldn't do anything but hand it to her cause I was crying so hard. Gets me now even... One of the hardest things I do at work...is I feel too much about my patients. I mean, most every nurse cares...but I have always been sensitive to sad stuff. (why I can't watch a LifeTime movie now...) Every time we will have a DNR patient on our unit that passes away...especially if they have been there for a while...it is SO hard for me to go back in there... and to see the family cause they have been up there with us soooo long.

I think there are a lot of LPN's who are more knowledgeable than any RN I know. When I was oreintating to my floor, the LPN that worked there taught me just as much as the RN did... every person has different experiences to offer you. A different perspective of sorts. And...to tell you the truth...in our NBN there is a CNA (I have never thought of her this way) that has worked there for almost 30 years...back when that is all there were in the Nursery. She said they would push a red button on the wall to call a nurse out of Labor Room if they needed them. Otherwise, it was just them. She can tell you more about a bad baby, or a good baby that is showing signs of going bad, than most of the RNs. Experience is worth more than any amount of education in the world. I know the NBN will be lost without her :loveya: whenever she retires.

:uhoh21: ...no way. He didn't. [bANANA]LOL[/bANANA]

Everyone of our deliveries gets an IV--part of the routine orders for even observation almost. For the induction patients, they get Cervidil to posterior fornix x 24 hrs, then remove. Wait one hour, then start pitocin drip at 2 mu/hr titrated with LR to total rate of 125 cc/hr. Increase pitocin every 30 min by 2 mu/hr based on FHR, ctx pattern etc. Some drs stray from the main formula i.e. starts a pretty good contraction pattern on their own. Once they are delivered (meaning placenta delivered) a bolus of 500 cc LR+20 units pitocin started -- then every delivery gets a total of 2 liters LR+20 pitocin after delivery, then d/c if bleeding stable. Even cesarean sections get 2 bags of LR with pitocin, starting after placenta delivery in OR. However, I have often pondered--couldn't there be a simpler way sometimes? I mean, women have been having babies since the beginning of time. I mean, I know maybe the standards of care are somewhat better now. I just think in some instances things could be left to go a little more "natural". It almost seems like the "specialness" of having a baby, one of the most wonderous events that happen in healthcare, has been made more and more "routine". The individual circumstances of each patient and their delivery is not taken into context sometimes. Some of it is impatience of Dr...however, I have seen some nurses who just wanted to "get it out". I believe, and try very hard to practice, that every birth, no matter who or how old they are, is special. I try to take the time to explain to patients what we are doing, why, and get their input on things. Sometimes this is not possible, i.e. emergency situation, but a lot of the times it is easily done. Sometimes something as simple as putting a patient on the bedpan or keeping them clean and dry while they are stuck in the bed can make things better. I especially try to remember this on my Magnesium Sulfate patients. I was on Mag for 3 before delivery, thru 2 cervidils and 12 hrs of Pitocin induction, and then, for 2 days postpartum...so I know what it feels like to just have someone take the time to help me get washed up. I remember those two nurses who helped me get washed up early one morning more fondly than anyone else from my stay. I want people to remember me that way. LOL....I think I got off topic some oops

Dont be discouraged! As said before, a lot of facilities are having to go mostly non-latex (if not at least have an option for anything). I mean, think about it, if they have a patient that comes in that is allergic to latex, they have to treat them just like any other patient. That means having the non-latex equipment/supplies to treat them with. However, if it was ME (just because I am one of those "better-safe-than-sorry" folks), I would purchase my own non-latex gloves and keep a box in my locker. I know, i know, they need to provide them for you. But just to be on the safer side, and for convenience, that way you would always be prepared. Also, wherever and whenever you start to work, I would seriously take the time to read on most of the equipment you will be dealing with to see if it contains Latex (and if it does--where is the alternatives??). That way you wount tend to get caught up in an emergency (or a dr gotta have it RIGHT now-gency) and get messed up. At least you would be aware. For what it worth -- I am not allergic to Latex, but rather the powder INSIDE the gloves... I have to keep my sights set on powder-free gloves.

After delivery, their VS are checked Q 15 min for 2 hours, then Q 4h. Alot of the other stuff depends on the doctor. We have one doctor, however, who is predictable to "T". They get Demerol PCA with 10 mg continous, 10 mg PCA (patient) dose, lockout every 10 min and 150 mg four hour max. They have a foley, incentive spirometry Q 2h while awake, CBC in am, TED hose, plexipulse, NPO x ice chips, Kefzol 1 gm Q 8h, Reglan 10 mg Q 6 IVP. We check lochia and fundus Q 2h at first, then about Q 4h (depends on how well the patient is doing). Check drainage for breakthrough drainage, and empty JP drain Q shift and prn. Check foley Q shift (beginning and end), circulation checks in BLE, instruct to TCDB at least Q 2h with position change, they can get Phenergan 50 mg IM Q 4h prn n/v. Usually the next morning, foley is d/c'd (with 3 void checks) (and specimen send to lab for u/a and c/s), clear liquids are given, Lovenox 40 mg daily (or 30 mg BID if a large person), IM Demerol for pain and Tyl #3, Reglan given PO, with Haley's MO and Trinsicon, IV d/c'd and PCA of course. Pretty much taken care of from then on.

I have never been tested. However, nothing I take has not been prescribed so I dont think I would have a problem. I did worry for a little while because I was prescribed Adipex through the internet. I had to complete a medical questionnaire, a doctor evaluated it and the "prescription" was sent to a pharmacy and the medicine came in perfectly legal bottle, with directions for use, information about the drug, name of pharmacy, name of doctor, name of drug, etc. Therefore, it seems perfectly legal to me. However, for a little while (and in some of my panicky moments) I still kinda get paranoid. LOL.. Im strange like that though. (BTW, med comes from inside U.S.) I even told me nursing director about it... to get a second opinion. Turns out, her, another director and the DON *all* do the same exact thing.... LOL

OMG! I looooovvvveee flip-flops. ALL I wear in the summer is t-shirt, jeans and flip-flops to match my shirt. I have Old-Navy, Wal-Mart, some from Avon, etc. I have probably 30 pair. My best fried says I should join FFA (Flip-Flop Anonymous) because I definitely have an addiction! LOL... :lol_hitti

I doubt very seriously we are in the same facility. And I do know that you know absolutely nothing about anything that goes on in a day of mine... Therefore, quite the hypocrite arent we when suggesting I dont have a positive attitude. I simply believe in telling the truth, which a lot of people cant handle.. (Maybe you are one of those )

I work on the PostPartum unit at my hospital. We are connected to NBN and L/D as the Maternal Child Care Unit (or something to that effect). But basically, at my hospital, we get the moms and the NBN gets the babies. The babies come out to the moms after shift change and after the Pedes make rounds in the morning, and then, can either go back when the mom needs a rest, or needs to get some teaching, or can "room-in" with Mom.. especially if they are brest-feeding. If the baby is on IV or bili light, or for some other reason cant come out to mom, we encourage mom to go to Nursery and visit with baby, where there are rocking chairs, etc to encourage bonding. So, basically, we take care of the moms and their bodies as they go back to normal from being pregnant. Watching for excessive lady partsl bleeding (called lochia, considered excessive when soaking approx one pad/hr or passing excessive clots), any sign of temperature (over 100.4), severe pain not controlled by meds (usually NSAID like Motrin or Naproxen with every meal, with Tylenol #3 for more severe pain) or nausea/vomiting. We aid with pericare for moms with stitches after tear/episiotimies and with breast care whether mom is breat/bottlefeeding baby. On the ceasearen sections, we add in incision care and basic teaching of patient port-op. Some of us, like me, work in ALL areas...so we can help a little more with teaching in the care of baby... or helping with problems on the few Intrapartum moms we get still pregnant with UTI, etc. I love it. Wouldnt work anywhere else in hospital permanently. However, we only do about 100 deliveries/month (slightly rural hospital though) so we also have to pick up a good bit Med/Surg overflow. Now, I really like this aspect in that I do not loose my skills... I have dropped NG tubes, accessed PACs, dealt with chest tubes, central lines, and any other types of patients. I even did an Exchange Transfusion today....and I had never even heard of the procedure! The only patients we CANT get (or really not supposed to get) are ones with infectious diseases, pneumonia, flu, open decubitus, bronchosopys, fever of unknown origin etc due to the increased risk of infection of the moms and the babies. We also cant get ANY heart/telemetry patients since we are one the East side of the hospital and telemetry can only work on the West side of the hospital. Overall though, I like our unit a lot. Big turnover though. C sections only stay 3 days, lady partsl deliveries 2 days... so always getting new patients.

Nope. Because... there will always be small-minded, selfish people in the ER and the floor that think the most important thing happening in the WHOLE world is what is happening to them right now. I don't know about it from the ER side, but here is the floor perspective: We can be caught up ALLLLL day... maybe even what you would call qoute-unqoute "slow", but it NEVER fails..... at 6:30-7:00 pm, there WILL be a patient brought up from the ER and planted in the hallway in front of the nurse's station. Oh no... don't ask the nurse/transporter/resp therapist/dietary worker/maintenance worker to simply push the patient into the room and STOP... Merely taking the patient OUT of the hall so that the nurse can get into the room from closing charts, finishing up meds, checking on procedures getting done, clearing IV pumps, gathering I/Os, finishing "Hand Off Communication Checklist"s (i.e. "Patient Short Stories"), update the REAL report sheet, while checking sporadic beeping pumps, calls for ice, calls for bedpan/bedside commode, etc. NNNOOOOO... wouldn't dare ask them to do that... not even the little "play" nurse that is down there that is the Head Doc in ER's "wittle girl" who has taken boards 7 times and failed each time but still manages to work in the ER in the "Nurse" role MINUS the "Nurse" work. Now, to be absolutely fair, I understand the ER is busy... I understand that it is a whole different kind of busy all together. I also understand that it is not necessarily the nurse's fault (sometimes the docs). HOWEVER (and a big however) ALOT of it could be helped with a little thing called "COOPERATION", which, I dont know about other hospitals, most nurses in our ER are seriously lacking, as well as basic interpersonal skills. In other words, they do not have the ability to "play nice". Which becomes a problem when I, especially as Charge have the tendency to not take the stuff I just spent an hour cleaning off the total care turn Q2 h NH patient down the hall's booty for the 40th time today off of many people, if any. You ARE NOT better than me because you work in the ER. You ARE NOT entitled to special "rules" because you work in the ER. You DO NOT get any more leadway, or respect, from me because you work in the ER. I give everyone the same amount of basic human respect that I would want shown to me....that is, until you do something (like act like the hole the stuff I just cleaned off the total care turn Q 2h patient down the hall's booty for the 40 th time today came out of) that makes me rescind that respect from you. It would be wonderful...absolutely peachy-keen-oh-boy, if everyone in the hospital all walked around with smiles and sunshine and rainbows in there pocket with a piece of cake made out of baby's giggles and angels wings, always getting along, never passing without a smile and a kind word, and ALWAYS helping out wherever needed. But the truth of the matter is: they won't. Can't. Because we ALL, on the floor, in ER, in Radiology, in L/D, NBN etc, are OVERWORKED, OVERWORKED, OVERWORKED!!!! We have too many patients, too sick patients, not enough equipment, not enough help...not ENOUGH TIME to sufficiently carry our load comfortably... (You notice I said comfortably not preferably. Meaning, "making it", not "having it our way, all the time, or the highway". Like it has been said before, need rule about not being able to put off report, and not being able to transfer patient between 6:30-7:30 am/pm UNLESS going to ICCU, Surgery, L/D or somewhere they need to go THEN.

I don't know about the whole "requiring" you to wear makeup thing. I mean, I wear compact foundation and powder everyday...most people don't know i have make up on, but seldom do I wear eyeshadow, eyeliner, mascara etc. And never on a daily basis.

I TRY (really, really, really hard) when I make rounds in the morning to say "If you need anything, just push this buttom . My name is Amy and I will be one of your nurses today". I can admit I have been guilty of forgetting to the first round. But I try REALLY hard to do it...