malibu03

our whirlpool doesn't have the jets powered by re-circulated water. the jets are all air powered, much cleaner.

I am looking for opinions and research info regarding whirlpool use and Labor. I am one of a team at my hospital trying to formulate a guideline for our whirlpool use. Some of the things I am considering are GBS status, ROM status, dilation, and the like. Any help appreciated! Cristy

In my short OB career, (4 months) I have seen 4 pts chose not to parent their infants. All four of these birth mothers did in fact end up terminating their parental rights, although there was one patient I was pretty sure would end up deciding not to go through with it. She and her BF (not the FOB) bonded w/ the baby, changed diapers, cared for him, etc. In our hospital, we allow (if we have room) the adoptive parents to stay in a room and also spend time with the baby. I think I must live in a unique county, something about adoptive parents being able to have the infant as soon as the court papers are signed, and I think in neighboring counties, the infant must first go to foster care. I am in a special position in that I am (or will be soon) an adoptive parent. I will hopefully be going to China to get our daughter within the next 8 weeks:D . Naturally, I think I sympathize with the adoptive parents, but want what's best for the child.

for me, it wouldn't be enough. However, others may be a different story. I have a 6 month orientation, I'm currently in month 4, and am nervous about being "kicked out of the nest". I know that after orientation, I will have a time where I will be working with a mentor, and all my colleages are very helpful. Can you ask for more help/longer orientation if you need it?

OOOHHHHH!! This is currently a hot topic at our hospital. Supposedly the our state BON is ambiguous on the issue. Nearby states do not allow nurses to adjust epidural pump infusion rates. Our hospital policy is that if nurses have taken an anesthesia class provided by our hospital, they may increase the ml/hr, or give a bolus. Personally, I don't feel comfortable doing such, but then again, I'm new and everything scares me.

Yes, I have given it once for a 31 weeker. Supposedly it can be given until the 34th week, and I have to think about why it works, (brain is hurting)....something about prostaglandin inhibition.

Thanks everybody, for your kind responses. I did hear the thing about the monitor paper before, and have used it. On our unit, we have a laminated paper chart that I use to compare finger spacing to dilation cm. I thought I was on track, but not so. We don't have the plastic one with the ridge around the perimeter, but I have seen those. I have had pt's put hands under their bottom, but have never tried the bed pan for a posterior cervix, I may try that. OK, now only two more months to go on orientation. Yikes!!:uhoh21: Thanks again for your replies!

Hi everybody. I am a grad nurse working in OB, I'm in month 4 of 6 months of orientation. Basically I'm on my own for inductions and spontaneous labor, and just ask my preceptor an occasional question and usually do pretty well. Yesterday was a different story--induction on a GDM patient (primip), not quite 39 weeks, 2-3/50/-3 at time of admit. Started on low dose pit, long story short was that at shift end yesterday, she still hadn't delivered, and was 7-8/90/-1. I called the night shift nurse a few hours after I got home to check patient's progress, and was told that her cervix was not 7-8 as I thought when I left, but more like 5-6, confirmed by the new nurse and doctor. I have always been pretty much on target with my dilatation checks, so I'm not quite sure what happened. I feel terrible and somewhat mentally challenged. The patient is fine and delivered lady partslly later that night. I just ordered a pocket dilation guide online and I regularly compare my measurements to the chart we have on the unit.Does anyone have any suggestions on improving my dilation measurement skills? Any help appreciated!!

Wow, I'm really sorry that happened to you, it sounds like one of those days/nights from the edge. I don't even know what to say except, "That really sucks", which I'm sure is not at all therapeutic! LOL!! Certainly safety is an issue here. I can't make any judgment since I was not there. I hope it gets better for you, and the patients very quickly.

In a perfect world, I'd say 1:1. Yikes, still contracting through the mag at 3gm/hr? At this point, I would certainly be thinking of transferring her, but wondering if more stabilization is needed for the 100 mile ride to the level III. We recently had a 30 weeker, 3/50/-2, bulging bag, contracting q 2-3 min on 3gm/hr Mag and we transferred her to a level III fairly quickly. You have to tell us what happened!!