I've been in L&D for almost two years now, but only 9 months as an RN. I had a pt come in the other night who was 5 cm, she was a G3P2 and was able to ambulate from triage to her L&D room. When I got her to her room and she'd have a ctx she would just sort of pause, she was really in control. I went to the nurses station to get her consents and my pt's friend came out and said that the pt was having some pretty strong ctx's. I went back in the room checked the pt and she was 7 cm's. I asked another nurse to come in and help with an IV so that I could get the rest of the room ready and my pt started pushing. She pushed twice and said the baby was coming out. I lifted her sheet and sure enough there was the baby's head. Baby had a tight nuchal X1 that wasn't reduceable, I supported the head and perineum, just like I"d seen hundreds of times, and delivered the baby!! Pt had no lacerations and baby was fine! It was incredible, and the funny thing is I wasn't nervous or anything. I'd had lunch with another allnurses board member (whom I met online here about 2.5 years ago and who'd actually ended up being my charge nurse at another hospital I've worked at) and we'd talked about delivering babies and some of the mistakes that OB's make here in the US, and easier ways to deliver babies. I just remembered everything she said and it worked!!
Oh, and from the time I got my pt until she delivered, was less than 30 minutes! It's amazing how quickly things can happen in OB, it sure keeps you on your feet :chuckle
Wow great story..! I am still a student precepting in L&D right now, but I want to know how do you set up the sterile field, start an IV, get the bed ready, grab extra hands, etc in like 10 minutes... Or do you just deliver?? Ahhh sounds like an adrenaline rush!
You hit the call bell, and say "she's delivering" and help comes to do the rest, while you have your gloves on, ready to catch.
You really don't need anything other than gloves and a clean blanket to catch a baby. The clamps, scissors, bulb syringe, etc, can all wait.
You hit the call bell, and say "she's delivering" and help comes to do the rest, while you have your gloves on, ready to catch.
You really don't need anything other than gloves and a clean blanket to catch a baby. The clamps, scissors, bulb syringe, etc, can all wait.
Jen
I'm the only nurse in the OB dept. in this little hospital so the call bell is of limited use. Just want to say here thank heavens for a great CNA the other night with my "4 minute delivery" who managed to simultaneously (almost) flip on the warmer, whip open the sterile OB pack, call another unit for a second nurse and call the doc to tell him my hands were full and I couldn't talk to him, but he should come in.
Experience has also taught me that if you can't get to the gloves (happens) you can sort of protect yourself by sticking your hands under the chux to support the baby/perineum during delivery.
Please excuse my ignorance, but I am a second year Midwifery student and i have had eleven catches. catching is the easy part, it is the care either side of the catch that is the difficult part!!. Last week I had a g4 p3 who had been fit and well untill 10 mins before the delievery. bp of 125/185, nearly did my head in. I also got to see my first manual removal of a placenta. Thnak goodness the Ob was there, but as a First year i got my first catch while the midwife was off getting the forcepts to rattle at our woman who just wouldnt push the baby out. i told her we could do it and we did. Just as the head was crowning the midwife, ob and back up midwife walk in! I got a pat on the back for that one!
I'm the only nurse in the OB dept. in this little hospital so the call bell is of limited use. .
Yeah, even though it seems my unit is quite a bit larger, unless someone saw me go into the room, the call light might not be answered right away as we use Voceras and answer our own call lights. When this happened to me, thankfully, I had the husband open the door and call down the hall to the desk that I needed help. I was also able to call the resident on my vocera as baby was crowning, but she still didn't make it. Again, great job to you!
Iv's sterile feilds, preps, calling for the doc at a nvd. hee hee i am sorry but we midwives do 70% probably more of the delieveries by ourselves with a back up midwife. AND I WASN"T TRAINED AS A NURSE!!! I respect what you guys do and a first catch is amazing, it took me a few days before i came down, but what gets me really excited now is an unmedicated birth with no intervention at all. Women feel so empowered and it is great to help them get the birth they want. Sometimes i wish more people could see how natural birth can be. No iv's, no ctg, nothing but the women, her support and a midwife or two......lovely....you should come down here and see our style of practice. we have autonomy and are Lead Maternity Carers. we do referrals and antenatal and six weeks postnatal. Babies dont even get seen by paeds unless we refer. home birth is at about 10% and rising. water birth is used and we celebrate with our women every day throught the normal everyday experince of birth. I LOVE IT!!!!
Kiwimid - this forum primarily consists of OB nurses (NOT midwives or docs) in the United States who are NOT responsible for doing deliveries, and we are NOT technically trained to do them (nor insured to do them, or paid nearly enough). Obviously babies sometimes have their own ideas about when they want to come out, and in these rare cases the nurses step in and do what they have to do. In these situations yes, it is usually just catching, but it is still special and wonderful to have had that role in the beginning of someone's life, especially because it's something we hardly do. So let us be excited, okay?
hey i never ment to rain on anyones parade. to be honest there is a part of me that misses getting that excited. its hard to find people who understand as there are few forums for student midwives which is why i love to read the threads here. they seem to reflect how i feel at times. sorry to those i have offended. it is such a amazing and sad feild we all work in and sometimes you just need a shoulder and an understanding ear.
I worked OB for 8 years and never had to catch a baby . .. .thank you God.
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RNLaborNurse4U
277 Posts
You hit the call bell, and say "she's delivering" and help comes to do the rest, while you have your gloves on, ready to catch.
You really don't need anything other than gloves and a clean blanket to catch a baby. The clamps, scissors, bulb syringe, etc, can all wait.
Jen