matchstickxx

We see plenty of "false alarms" where I work. Many are just women who honestly think they are in labor or are having a complication. They are all assessed and then appropriately managed or sent home after some education. We also see a few women who think if they come in often enough that we will finally just induce them because they are tired of being pregnant. I have heard a 32 week gestation mom plead to be induced because her older child was born at 30 weeks and he is "okay"...just had to spend a few weeks in NICU. :angryfire Needless to say, when she was found not to be in labor she was sent home. She was also sent home again, after assessment, about six hours later when she came back in. Now I know why she was so curious about how late I was working that night. Any pregnant woman who thinks she is in labor or experiencing a medical problem should call her OB and discuss what is going on. If she cannot get in touch with her OB she should come in to the hospital to be seen if she feels it is an urgent matter...Better safe than sorry. BTW, don't "feel bad" about "disturbing" your OB with a concern or possible labor. This is why they are paid the big bucks.

I guess we are lucky to have purse lockers at work. We bring our own locks and clear them out at the end of our shift. I have to wonder either about her judgement or the veracity of her story. More importantly, she should have never left the patient's bedside without calling for relief. At my hospital, a sitter is not to provide any care for the patient including feeding or even toileting the patient. His or her only job is to ensure the patient's safety and to call for staff if the patient needs anything. This sitter should be reprimanded for leaving her patient alone even if only for a few moments. The theft was pretty minor compared to what could have happened.

58flyer, I'm happy to hear you were able to open up to your PCP and that he actually heard what you were telling him. I'm also glad to hear that he has office staff who are willing to make sure he follows through with you. I wish you the very best.

Let your instructor know and then don't dwell on it. Chances are you were far enough away that you were not exposed. Be aware of early s/s of meningitis and if you think you are experiencing them, see your physician and mention the potential exposure. Again, I wouldn't dwell on it. If you really were at least 10 feet away at all times then you're fine.

What do you think is actually going to happen if you are cared for by female healthcare professionals? What exactly is your fear? (Please, do not actually answer that question here.) Make an appointment with the urologist your doctor trusts most to care for you. Sit down with this urologist and explain your fears. If you cannot find an office with an all male staff, would you feel better if the male urologist were present with you the entire time you were exposed? Would that make you feel safer? Maybe you should consult with your therapist and try to find the best way for you to cope with this pressing situation. Even if you do find your ideal all male team for this situation, I think you still need to talk to a therapist. What would happen if you were in an emergent situation and the only caregivers available were female? Would you be making the appropriate decisions based on your healthcare needs or based upon how you could best avoid or minimize contact with female healthcare professionals? Best wishes and let us know how things turn out.

If this doc was so strongly against a patient hiring a doula, why did he not tell her earlier in the pregnancy and not when she was near term? I do not think it is very fair to the patient to spring this on her near the end of her pregnancy. If he feels so strongly about this then he should include this restriction in the info provided to new prenatal patients. It should not come as a surprise to the patient in the last month of her pregnancy. As stated before, she should ask specifically what his objection is to doulas. Then she can decide whether or not she should be looking for a new ob/gyn in the future.

I found out today that I have shingles. I will be calling my supervisor in the morning, but I was wondering what your hospital's policy is on whether or not you are allowed to work with a shingles outbreak. If I were scheduled to work tomorrow I would be calling in because I feel lousy. Luckily I am not scheduled again until Saturday and hopefully the antiviral med I was prescribed will help me feel better by then. I work in the NICU and am not sure what our policy is. I want to work if I feel better but I also don't want to risk exposing the babies I care for to the chicken pox virus. That could be devastating to an immature immune system. My PCP said he usually tells his patients they can work if they feel up to it, but in my case he said he wasn't sure. Also, any suggestions on "comfort measures" for shingles? The pain is driving me nuts. I have been taking ibuprofen but will call my PCP in the morning to tell him it isn't helping. He said if needed, he could call in a script for something stronger but I was just wondering if anybody had any tips for getting through this without pain meds.

Good thing she didn't get to wash his hair. She may have tried to dye it to match the toenails. I'm glad to hear that the nurse who had him after you transferred him would keep her in line. I really think unless this guy's name is Dennis Rodman he probably wouldn't appreciate waking up to painted toenails. Really, painting someone's toenails while they are asleep (sedated) sounds like an immature frat house prank. BTW, since you knew the next nurse would handle things appropriately, I don't think it needed to be your place to go talk to this woman about her inappropriate behavior. If I were the next nurse, I really think I would have called in the nursing supervisor to be present during the discussion with this woman about this behavior and why she would not be allowed back into the patient's room unsupervised. I would involve the supervisor so that this woman would know she was not going to be able to go "over my head" to complain about me.

Oops....That's what I get for trying to type and talk at the same time and then post without proofreading.

Open reduction internal rotation, I think....Not an ortho nurse....can you tell?

There was a story in the local paper a couple of years ago about a woman who delivered one twin at 18 weeks. They were then able to stop her labor and she got to 35 weeks with the second baby. The mom was admitted with PTL and the first baby ruptured shortly after she went to the hospital. At my hospital, we would have done whatever we could to stop the labor including, if possible, a cerclage. We aren't always successful, but at least we know we did everything we could. Barring any threat to mom's health, we would not be augmenting preterm labor at 20 weeks.

I remember the anxiety of waiting for my test results. I took the NCLEX a couple of years after they switched to computerized testing. I couldn't imagine having to wait for 12 weeks for my results. I would have gone insane. My test shut off at 75 questions and I honestly had no idea how well (or poorly) I did. One of my classmates who took the test at the same time I did found out her results 4 days before I did. By the time I got my results, I had convinced myself that they must process the "faileds" differently and that is what took extra time. As it turned out, my classmate knew someone in the licensing office. She let my classmate know when the licensing bureau had her test results. I had to wait for the good ole USPS. I hope you get your results soon and, of course, I hope you passed the test.

http://http://www.npr.org/templates/story/story.php?storyId=7821354 Here's another link to the story. It says the baby had a monitoring device on but it wasn't clear if it had GPS. I wasn't aware of any baby transmitters with GPS. Ours can only detect the baby inside the hospital. Also, I'm not sure how much good GPS would be. I imagine someone kidnapping a baby would likely remove any transmitter from the baby as soon as they had the baby.

I once had a visitor go to administration to complain to the DON about me. My transgression...I could not tell her when a particular patient had gone home. It was my first day back from vacation and I was not familiar with this patient. Nothing I said would appease her. Fortunately, one of the administrators was on the unit when this woman made her scene and the administrator actually backed me up and said I acted appropriately and the visitor was being unreasonable.

I wish we were a locked unit. We have had more have had more than our fair share of "baby-daddy" and "new girlfriend of baby daddy" drama recently. Don't even get me started on the patient who we had to move three times because she kept calling the ex and telling him where she was but "don't you dare come up here." Then she would put on the call light and tell the nurse he was on his way to "beat her up and take her baby." We were so happy to see her be discharged but we worry about the baby. We did notify child protective services but I'm not sure how much good that would do if the FOB was really as violent as the patient claimed he was. BTW, he never showed up so we don't know what the real story was there. We only had the patient's side of the story and obviously had to err on the side of caution.

I can understand being made to stay that first day, but once they let the day nurses go, I would have questioned the need to keep the nocs nurses over another day since the day nurses proved that people could get home and back. During the last snowstorm, the hospital had a list of 4WD owners who were willing to pick up employees and take them home. I own a 4WD, but my name isn't on that list. I would give a ride to a few nurses who live out my way, but I do not want to be trying to find houses in unfamiliar areas in the snow.

For the 2 hour circ baby, a patient advocate could have been helpful. I have assisted with circ's before and most only last about 10-15 minutes. Baby should have Tylenol pre-procedure and sweet-ease on a paci during the procedure. Before we started using sweet-ease, I was skeptical about it's effectiveness, but since we started using it a few years ago, I am a believer.

By state law, our newborn screens can't be done prior to 48 hours. We had a mom who had to bring her baby back for a repeat screen because her baby's screen was done a whole two minutes early. Exception, NICU does the NBS on almost all baby's on admission or prior to the baby receiving any blood products. They will then do a repeat screen after the baby is 48 hours old.

Funny...At my hospital, peds and NICU always seem to pull staff from postpartum. They seem to be the "preferred" units when it comes to getting extra staff. I know how frustrating it is to be floated out of your home unit...a lot. One thing my hospital did was to create an incentive program for nurses who didn't mind floating and would go "out of turn". They sign a contract and after 3 months they receive a small bonus for going "out of turn" if their home unit is overstaffed and someone needs to be floated to another unit. At the end of the three months, they are given the option to sign a new contract or to opt out and go back into a regular rotation of turns. It doesn't totally eliminate floating for those who don't want to float, but it does cut down on the number of times they have to float. Also, the receiving unit benefits by having a nurse who choses to be there and won't be miserable and mopey for the entire shift. It is much cheaper to pay these small incentives than it is to replace a nurse (or two) who has left because they are so frustrated with the floating situation. Also, the unit managers came to an agreement that there would be no pulling on certain holidays (Christmas, Mother's Day...). If necessary, the unit managers and assistant managers would come in and work to fill the holes. It's not perfect, but it is better than what was going on three years ago. Good luck.

The comfort of the shoe really depends on your foot. I love my Dansko's and own 3 pairs of clogs and even one pair of their sandals. I know people who hate Dansko's. One nurse I know said she threw hers away after wearing them 1 shift. They do take a little getting used to walking in, but they are not like wearing high heels. They aren't wobbly at all. I know people who swear by their Crocs, but I don't like wearing them to work. They don't have any arch support and by the end of 12 hours, my feet start to hurt. I now wear them for yard work. As someone else suggested, give whatever shoes you get a trial run around the house before wearing them to work.

I know this, but how many nurses who have actually experienced a near miss are too busy to write the incident report at the time and then, next thing they know, it is the end of the shift and they have forgotten about it? Sadly, I have heard nurses I work with complain about a near-miss event but when I ask if they wrote it up, they usually say that they didn't have time. At my old job I was on a medication safety committee. I know first hand that the hospital can't do anything about a problem if they do not know the problem even exists. We even simplified the reporting paperwork so that the nurse could either check a couple of boxes or, if there wasn't an applicable box to check, the nurse could write a quick message on the back of the page. Then imprint the form with the pt's addressograph and put the form into the pharmacy box. When we simplified the process to report, we started seeing more near misses reported. At my current job, the reporting process is computerized and it takes an average of 10 minutes to access the correct report and fill in the report. I do not understand why it is the burden of the nurse (reporter) to fill in the patient's address and occupation at the time the report is completed. This sort of non-relevant info takes too much time to look up and fill in and discourages people from taking the time needed to report a near miss.

Couplet care does not nessicarily mean LDRPs. My hospital does couplet care, but labor and delivery is a completely separate unit.

I know in the article Baxter states they haven't heard of any problems prior to the Methodist/Clarian incident. I just wonder how many "near misses" have actually occurred due to the similar labels.

Question #1: Are grandparents and/or siblings limited to certain hours for visitation? (i.e. 0900-2100). No set visiting hours except we close for report. We do limit the total number of visitors at the bedside to two visitors. One of these visitors must be a "banded" person. Question #2: Do you limit the amount of time of these visits? Siblings under 14 y.o. are limited to 15 minutes per day. We used to have a strict no visitors under 14 policy until recently. For most young children, 15 minutes is about as long as they can "behave" in the NICU. I know parents get upset about the time restriction, but there really isn't anything for them to do in the NICU. Bored children often either become noisy children or they try to find something to amuse themselves with and will start getting into things. Question #3: Do you allow grandparents to remain at the bedside during physician rounds? Generally, yes. Sometimes a neo will ask a visitor to step out for a few minutes, but for the most part the visitor gets to stay. Again, they must be with a "banded" person and the banded person is rarely asked to leave unless we are doing a sterile procedure with their baby or a nearby baby. Question #4: Does your unit have individual rooms or an open concept (multiple bed spaces within an area)? We have both. Most babies are in the "open area". The individual rooms are usually used for babies on isolation precautions and sometimes for stable multiples. Sometimes, when the decision has been made by the family to withdraw care for a critical baby, we will move the baby and family into one of these rooms to allow them to have some private time with the baby until the baby dies. In the case of the dying baby, we do make reasonable exceptions to the visitation policy.

Gloves should come off first so you don't contaminate yourself when you untie the gown or mask. That being said, I too have been guilty of pulling the gown off with the glove still on.