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AZBlueBell

AZBlueBell

Labor and Delivery
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AZBlueBell has 1 years experience and specializes in Labor and Delivery.

AZBlueBell's Latest Activity

  1. Ok I’m going to be honest and prime my response with this: I read it all halfway through, and then skimmed. So take it as you will! I think based on what you said you miss from tele (apart from the “elderly” pt part!) that you may be a better fit for L&D. I say that as an L&D nurse who routinely gets floated to PP. I started in L&D so I have nothing else to compare to other than my floats to PP. But let me tell you, when I am floated to PP i am bored to death out of my mind 98% of the time. It is a very task-y type job, with the things you described (breastfeeding, the baby is “hiccuping” etc) seeming so dull and repetitive. As someone who doesn’t even do PP on a regular basis, I am consistently far ahead of my other PP coworkers in terms of charting and being on top of whatever needs to be done that shift. For example, I am starting my 2nd assessments when they are just sitting down to start their 1st. At first I thought maybe I was just doing it wrong? But after speaking to other L&D nurses (most of which started in PP), it just all comes down to time management. I find myself on PP pulling up the L&D fetal strips just to have something to do/look at while at the nurses station! In a way, I imagine those fetal strips would make you feel at home with your tele experience. We are constantly watching strips, even those that are not our own! Things can change in an instant in L&D. I have run to another nurses room when the baby is down to the 60s only to have the heart tones back up to normal by the time I open the door. And on the flip side, I have ran down that hallway to a baby in the 60s and had to help roll that pt back to the OR with baby tones not coming back up all and we are just praying for a decent outcome. I always thought I wanted to take the path of school> PP > L&D. And many people argue this is the best path to go! But my own experience is that of being so thankful that I went straight to L&D, where my heart is, and where I am constantly being challenged. Now, if you’ve made it through reading my whole response (and not skimming!) I’d say give it some time and then decide. Give at least 6 months before deciding anything major. Ask if you can shadow L&D. Ultimately, then you can figure out where you will be happiest!
  2. AZBlueBell

    Cesarean section ,skin to skin

    Skin to skin in the OR is great! But it is, and should be, the responsibility of the baby nurse to oversee that skin to skin time. As circulator, we have enough we have to do and physically are unable to watch over the skin to skin time! Doesn’t matter how close to the end of surgery they are. I agree, that was an unsafe situation. If your unit is to continue the practice of skin to skin in the OR, I think better practices and expectations should be in place.
  3. AZBlueBell

    Banner New Grad Experience

    I was not offered on the spot. I think they called me a few days later to offer me the position.
  4. AZBlueBell

    SIMS at Banner New Gead Program

    They are like school, but less stressful. I mean, yes you’ll still stress about it but they really emphasize the fact that these SIMS are to help teach you and guide you as opposed to pass/fail you. So I found them to be more laid back. It’s also about teaching you their way of wanting things done. IV starts, Foley’s insertion, hanging blood, central line care, Alaris pump...those are the ones I remember. And then depending on your unit, you may have other specific days. Like OB, OR, or ICU.
  5. AZBlueBell

    The Newborn Bath

    This is an issue at our work place too (ie dayshift feeling baths are dumped on them). However, our techs are pretty good about checking back with patients around 0600 if they had refused a middle of the night bath to get it done before shift change. Babies are taken from the room at some point during the night anyways for weight, so sometimes we can get the baths clustered into that time. But sometimes, the parents still just want it during the day when they are fully awake to witness the first bath. And if that’s the case, then we respect their wishes! And I think dayshift ultimately knows it isn’t dumped on them on purpose, but they still don’t like it.
  6. AZBlueBell

    Skin to skin after delivery

    Pretty much the same for our facility as well, except we do q30min vitals on baby. No specific timeline for baby staying skin to skin. We encourage at least until the first feed or first hour, but we’ve had moms that keep baby with them until the last possible second. “Hey, we need to transfer you to postpartum and need to get baby weights and measurements first”. Our facility sees a lot of natural mamas and so constant skin to skin is very common for us.
  7. AZBlueBell

    Postpartum assessments

    We do head to toe 2x per shift regardless. Our section mama’s also get a head to toe immediately in PACU along with frequent vitals until the 4 hour mark. Then it’s q4hr til they hit 24 hrs PP, then goes to Q6hr vitals which is also standard for our vaginal deliveries. Once stable and outside of the necessary frequent vitals right after delivery, all our mamas are on q6hr VS and fundal checks.
  8. AZBlueBell

    Bloody Urine in Foley Catheter Postpartum?

    Our c-section mama’s are the only ones who transfer to PP with a foley. Our vaginal deliveries, if they have a foley in for delivery, will have it DC’d at some point in the 2 hour recovery before we take them to PP. some providers like the foley out for pushing, some don’t. If I have one already in place after a delivery, I take it out right before my last fundal check, so basically at the 2 hour mark just to keep the bladder out of the way for bleeding. If for some reason a mama needs her bladder emptied during recovery and cannot yet walk to pee, we straight cath them. as for the color, I have seen a range. Anywhere from clear, to yellow, to pink, to colored bright red (blood tinged bright red, not to be mistaken for just straight blood). I’ve been told by providers it’s sometimes due to trauma from pushing (thus some providers like it DCd when pushing). Kind of depends. If it is straight BLOOD and not just red tinged, this would indicate a complication to look at immediately.
  9. AZBlueBell

    Transitional Care Nursery! Help!

    1. We have a “transition Nurse” role assigned each shift. This is typically a NICU Nurse, but if NICU is full and they can’t spare a Nurse then an L&D Nurse can take this role as well. Typically it is one person assigned as this role each shift. 2. We aren’t required to stay in the room, at all times for those first two hours. We are in and out very frequently so they aren’t alone much but they have their call light when we aren’t in room. Typically our transition nurse cares for baby thefirst two hours and the L&D Nurse cares for Mom. Sometimes, if it’s very busy the transition Nurse will catch and release meaning they come for the delivery/apgars and then the L&D Nurse takes over care for both Mom and baby after that. 3. We sometimes do STS in the OR, depends on the situation. The transition Nurse stays with the baby for this. When you say you’re having trouble with staff wanting to keep the baby in the room, what does that mean? What do you do with baby at the moment, they are delivered and leave the room?!
  10. AZBlueBell

    39 IOL

    My facility allows elective IOL at 40wk only. At 38wk1day they are allowed to try a cervical ripening. Basically they are admitted as an observation pt, they get PO cytotec (up to 2 doses) but if no significant cervical change (must meet th BISHOP requirement) they are DC’d home.
  11. AZBlueBell

    stethoscope question

    I have a Littman (I forget which series) but it has both Mom and infant on it, I just turn it and flip to the large or small size depending on if I’m listening to Mom or baby.
  12. AZBlueBell

    Ratios

    Yes, my facility does that. And even at that, it's not even that we report off our other pt to another nurse completely, we just give a quick rundown and they watch them while we deliver/recover the other pt. Only ones we are usually kept 1:1 is if they are a TOLAC (but I've been paired 2:1 even with a TOLAC before, learned my lesson and that won't be happening to me again!) and an all natural labor pt. But sometimes we get so maxed out we have to still have 2:1 with a natural and we just make it work until we can't. Our natural labor pt's are typically intermittent monitoring so it's ok until they get to the 7cm or so, then they really require 1:1.
  13. AZBlueBell

    Banner New grad, what to expect?

    No, the first week is orientation days (I may have had 1 shift on the floor, I don't remember). Then the second week you have another class about safety and you'll have another class on CERNER, plus floor shifts. The only "lectures" I got were part of my academy training which happened a month later or so and was 2-3 hour classes once or twice a week. Then I had two SIM days, one for new grad RNs and one for my service line (the amount of SIM days you have varies based on your unit). I started on the floor the first or second week with my preceptor and everything else was sprinkled in between.
  14. AZBlueBell

    Getting Mother/Baby/L+D with NO experience

    Network as much as you can! Reach out to people and get your name out there. Send resumes and keep applying.
  15. AZBlueBell

    Banner New grad, what to expect?

    Congrats! You'll have an orientation day in Mesa full of the "paperwork" stuff like logging into email, getting the Kronos and mobile pass app setup, talking with the BSS new grad manager, and then working on BLCs (online learning modules). You'll have SIM days at some point, the amount of days you have to go is determined by your service line. Also based on your service line will be an "academy" you have to go through during orientation, done between or during your regular floor shifts. Any certifications and classes required for your service line will be sprinkled in as well. And then if course, your shifts on the floor. Good luck!
  16. AZBlueBell

    Labor and Delivery Jobs

    I made contacts with as many people as I could during clinical rotations and kept in touch. I made sure they knew from the start that this was exactly what I wanted to do. Networking is what helped me get the job. It sounds like your already out of school so I would say try and meet nurses and managers in the unit you want to be on, reach out and show interest!
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