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Altalorraine

Altalorraine

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Altalorraine's Latest Activity

  1. Altalorraine

    Breastfeeding Question for L&D nurses

    Let me start by saying that I have no idea who your CNAs were, but I've noticed something similar with a lot of older African-American women, including grandmas and great-aunts, who tend to be very concerned that the baby is "hungry" (including the unborn and the newly born). I think it is a cultural expression of love and concern and maybe anxiety coupled with a lack of information about what a newborn infant needs in terms of nutrition. I try to educate where I can. Altalorraine
  2. Altalorraine

    What would you do?

    NOWHERE in my post did I say she has to do as I do. I have to wonder if you even read what I wrote. I said nothing about forced fertility. If she doesn't want a child, she shouldn't have one. Period. Words like "torture" are inappropriate here. Saying that the birth process is "bad" is inappropriate. Calling it "gross" is insensitive. Saying that anyone who would want to go through the process must be totally unaware of the ramifications is insulting. These are the poster's words. She didn't ask for clarification or education. What is offensive is coming to a site-- a site where personally and professionally the process of giving birth is held in very high regard-- to schmooze about how disgusting birth is. It's a matter of respect. The title of her post is "What would you do?" She says she wants to talk to nurses because we're rational. She is asking for advice. In her first two posts she made it clear she didn't want to have a child. She is asking for medical/psychological advice/support about whether she should have her tubes tied secretly. It wasn't until AFTER I and several others posted that she expressed her ambivalence. Are we, a bunch of total strangers, convincing her to have a child after all? Since when do we give advice on such things? Altalorraine
  3. Altalorraine

    What would you do?

    What are you seeking here? Advice on how you, as a grown woman, should handle your mother? That has nothing to do with OB nursing. I do not change my opinion that someone coming to this site to discuss how disgusting birth is (in general terms since you provided no specifics of your complaint) is offensive. Altalorraine
  4. Altalorraine

    transfer kit for laboring moms

    I don't understand how you are not talking about treating. Where I work our docs will hold hour-long rounds to decide how to treat a PTL patient. I don't know what useful thing can be done in hurry other than BMZ (which I suggested) and perhaps mag (which you said you had). The truth is, *nothing* has been shown to prevent preterm delivery. I understand you are traumatized by the delivery of the 23 weeker, but you have to know that even a big hospital OB department probably wouldn't have been able to stop it. Altalorraine
  5. Altalorraine

    What would you do?

    I guess I'm trying not to be offended by your description of birth as bad and horrible and your wondering why women would want to go through it. Clearly you *don't* understand the mentality of women who do it. My four natural births were the most wonderful, empowering things I've ever done. They are sacred events in my memory. I don't think you owe anyone an explanation for what you do and don't want to do, but you may not get a lot of sympathy for your stance which seems just a bit insensitive. Altalorraine P.S. I do wonder why you are posting on a board for OB nurses who tend to be pretty pro-birth when you are not even a nurse and don't plan to have a baby.
  6. Altalorraine

    transfer kit for laboring moms

    I think what you really should have is a close working relationship with an OB care center so they can direct the care of patients from a distance. I don't think people not in an OB speciality should mess around with treating OB cases on their own; consultation is required. OB is an extremely complex specialty with potential for bad outcomes and litigation. (Suppose you gave terbutaline to an abrupting woman to "stop her labor"- you could have a massive hemorrhage.) If delivery is imminent, you can't stop it (nor should you in many cases. And yes, treatment varies depending on gestation, maternal/fetal condition and provider preference. That said, I can think of several things you could do. First, put an 18 gauge IV in; when we get patients with 20s we have to stick them again. The second thing is have betamethasone on hand (follow established guidelines for use). Finally, one lifesaving thing you could have in your kit is Cytotec (misoprostol) to manage postpartum bleeding. Altalorraine
  7. Altalorraine

    Moms who want to feel absolutely NO pain

    I had drug-free, epidural-free births four times. Each experience was very different. But what gets me is that people start listing the reasons that my births were easy and their births were so hard so of course they had to choose epidural. The reason I had epidural-free births is because I chose to. Period. Altalorraine P.S. It is possible to have an epidural-free birth even with pitocin.
  8. Altalorraine

    Moms who want to feel absolutely NO pain

    I think the state of the cervix is usually how they judge who can get an epidural where I work. Having an epidural for a long time isn't good for you, and someone who is going to poke along at 1 cm for hours to a day like some inductions do is going to be immobile for a very long time. OTOH, women who come in for inductions for FDIU or terminations tend to get epidurals as soon as they want them. I suppose there is risk that they could poke along too, but they usually don't. As an aside, what I don't get is the people who are so afraid of pain yet also happen to be covered with tattoos and facial piercings.
  9. Altalorraine

    why was Dr. so upset? (long)

    What you should do is take him aside and tell him privately never EVER speak to you that way again. Once you make that clear, you can indicate your willingness to work with him to establish a protocol for how he wants you to handle his patients. I want to add: The doctor may have been upset because in case of legal action their decisions will be examined. If something were to happen, someone could look back and say, "The lates happened at 1400. Yet you took no action until 15:30." Considering what you said, that your nursing interventions were helpful, this doesn't sound to me like a critical case. It may have been more a matter of the doc wanting the baby to declare itself so he could section and go home. If you were needed on the floor to emergently help another nurse out, that seems like a reasonable explanation for why you didn't call right away. (You might want to consider whether you could have called the doctor right after helping the nurse with the crisis of the precip delivery but before you helped with bracelets and footprints.) It seems to me that the issue that really needs to be addressed is that how the physician wants you to handle funky strips and how the physician treats his colleagues. Some doctors would blast you for calling them repeatedly. Some blast you for not calling 10 minutes ago. It also may be a matter of the doctor learning to develop trust in you. Altalorraine
  10. Altalorraine

    Abx after ROM? How long before...

    We don't treat ruptured term patients with abx unless/until they're showing signs of infection. Pretermers who are ruptured routinely get a course of IV Ampicillin and then are switched to po. I don't remember the duration of the course of abx though. Altalorraine
  11. Altalorraine

    Abortion Assistance RN

    Me neither. I think L&D experience would be very helpful. We do a fair number of abortions where I work, some therapeutic, some genetic (not one of the wonderful, miracle-of-birth loving OB nurses on our floor refuses to take these cases). A lot of the things we do every day on our unit (supporting patients and families emotionally, managing bleeding and pain, administering medications) would be applicable to working in a clinic. As for safety, well you know they say if you don't do what you believe you have a right to do, the terrorists have won. We are careful in that we don't give out the names of the doctor(s) who do the procedures to people who just happen to call on the phone. Altalorraine
  12. Altalorraine

    IV policy

    Everyone gets one because we have a moronic NPO-during-labor policy. The well educated patients using the midwives are sometimes able to get away with a hep lock and po juice. Altalorraine
  13. Altalorraine

    Best and worst?

    I got a job in L&D right out of nursing school. The best thing is the nurses I work with. The worst is being treated badly some of the doctors I work with. I work in a high-risk unit in an urban hospital; there are not a lot of warm and fuzzy moments, but there are plenty of opportunities for nurturing, teaching and otherwise giving excellent patient care. As far as what you are getting yourself into, if you become an RN you are getting yourself into a world of opportunity. There are so many things you can do, you don't really need to worry about being stuck in something you hate. Altalorraine
  14. Altalorraine

    birth as transformative experience for fathers

    It's an interesting question. Where I work it would be presumptuous to assume that the mother and the father of the baby are in a romantic relationship. It has happened (more than once) that the father is on the phone with his girlfriend while the mother labors. I have all kinds of middle class values about what a family looks like and what everyone's roles should be, but I can't assume that my patients will share those values. For example, often it isn't the father of the baby who is the primary support person for the mother and new baby, rather it is the grandmother, sisters and aunts. Altalorraine