STABLE exam

[Ponder]

Help! I have been a nurse for 25 yrs. L/D for 15 and I have HAD IT!! I am at the end of my rope and ready to quit! I need advise from L/D nurses. Now they are making us take the STABLE exam, along w. NRP, ACLS, Adv. Fetal Monitoring I can't take it anymore. I am able to resuc. a baby and stabilize until the NICU arrives ( @ 1-2 min). Now I need to know about a 6 wk old baby readmitted w. RSV?? or Coarctacion (SP) of the Aorta?? WHY?? I don't want to know how to take care of babies older than a few hours. That's why I do L/D and they do NICU. I work for a large hosp. FOR PROFIT corp. where the bottom line is not pt. care it is $$$. The more "certified' and "tested" we are the more money they get from the insurance co.'s. I have had it... I just want to take care of women having a baby, not be strapped to a computer charting more than any other dept. in the hosp. Please is anyone else, who does not rotate between dept.s', required to take STABLE? I can't forsee EVER needing it unless we have a major disaster and then I'm sure there will be 1or 2 NICU nurses floating around. I want to add I am well liked and respected by my peers and the MD's I work with. I am a preceptor and have trained over 8 nurses in the 5 yrs. I have been w. my present job. I love L/D, not all this other B**S. Please advise...

[BookwormRN]

I don't work L & D, but I do know that the RNs on the L & D unit at our hospital just took the STABLE course. (Please keep in mind, we do not have a NICU at our facility)

[ktrot31]

I work at a large hspital in l & d also. I have not heard of us having to take the STABLE exam yet, but i can imagine it will happen soon. We also have a lot of responsibility...too much. We deal with it, so they keep piling it on. We just got a new computer charting system where we feel like we are in front of a computer more than with our patients. I just try to stay positive, but it sucks right now, and I love my job too. I will have to keep you posted if we have to take that exam. Hang in there!!

[NurseNora, BSN, RN]

I hear you Ponder. I'm very fond of fetuses, not so much babies. I am now working in a small rural hospital and have to do PP as well as L&D. I don't mind couplets, but I've said that if there is a baby needing STABLE support to get ready for transport, I'll be the one taking care of all the other patients on the floor while all the other nurses are in the nursery with the sick baby.

That being said, STABLE is an interesting program. I just recertified on it last week. Since we're all supposed to be cross trained to all 3 areas (since I'm very strong in L&D, they said it is OK that I don't do nursery), all the nurses in the department have to pass STABLE. It's not difficult and the program is interesting. It has more than I ever want to know about respirator settings and so on, but there was information in there that I found valuable.

Since you have an NICU, I'm surprized that they expect you to do STABLE. This is the first place where I've had to take it, but until now, I've worked in Level 3 units where we received the transports. Hang in there, there's still no place better to work than L&D. Think of it as free CEUs

[crysobrn]

Isn't Stable for smaller outlying hospitals that don't have a nicu?? I thought the point was to stabilize the baby to get them to a facility with a nicu... if you have one... not sure what you'd need it for??

[dawngloves, BSN, RN]

Think how good it will look on your resume when you leave that place.

[Jolie, BSN]

I understand, Ponder.

I once worked in an LDRP unit with a Level II NICU. I hired to do NICU and mother baby, but eventually was told that I had to cross-train to L&D as well.

That resulted in the following certifications: NRP, fetal monitoring, ACLS (since we recovered our C-sections). I was also expected to be able to care for high-rish ante-partum patients, laboring moms, scrub and circulate for C-sections, recover C-sections, do mother baby care, and staff the NICU.

It was simply too much. I quit and went back to strictly a NICU setting.

I agree that the STABLE course is typically intended for nursery staff who need to stabilize a baby for transport. I don't see it as being applicable for someone who doesn't staff the nursery or NICU.

[RainDreamer, BSN, RN]

I'm at a big level III NICU, we don't stabilize and send the kids out, all the kids are stabilized (if we're lucky) and then sent to US. Yet we're still required to take STABLE.

I actually LOVED the course, but that's just me, from being in a NICU setting. It'd be like if they made us take the fetal monitoring course ...... it'd be like Hebrew to me and something I never would use!

[prmenrs, RN]

I'm in a 10 bed Level 2 nursery. Great job, great people. Every year they hold the hospital wide skills "fair". I have to get certified in really useful things like restraints, bed to chair transfers, how to use these "slide" contraptions to evacuate someone in a bed out of the hospital (but they didn't have any thing to evacuate the babies!!!), fall prevention, and similar pertinent things.

Frosts my cookies, let me tell you, no end. I'm going on Weds am. Can hardly wait.

And then, next month, we have the Unit Specific skills fair, covering, you guessed it, stuff I might actually use.

At least they pay me for all this fun.

I keep promising myself that I'm going to come up w/something to pay all those med-surg folks back. I've decided "How to operate a Breast Pump" probably won't be allowed. How about making everybody get certified on baby car seats??!! Doesn't that sound like a great idea? Even the suits!! Nearly everyone either has kids, will have them, or will have grandkids, nieces, nephews...

Payback, Ponder, payback!!

[RainDreamer, BSN, RN]

I'm in a 10 bed Level 2 nursery. Great job, great people. Every year they hold the hospital wide skills "fair". I have to get certified in really useful things like restraints, bed to chair transfers, how to use these "slide" contraptions to evacuate someone in a bed out of the hospital (but they didn't have any thing to evacuate the babies!!!), fall prevention, and similar pertinent things.

Frosts my cookies, let me tell you, no end. I'm going on Weds am. Can hardly wait.

And then, next month, we have the Unit Specific skills fair, covering, you guessed it, stuff I might actually use.

At least they pay me for all this fun.

I keep promising myself that I'm going to come up w/something to pay all those med-surg folks back. I've decided "How to operate a Breast Pump" probably won't be allowed. How about making everybody get certified on baby car seats??!! Doesn't that sound like a great idea? Even the suits!! Nearly everyone either has kids, will have them, or will have grandkids, nieces, nephews...

Payback, Ponder, payback!!

Or better yet, how to correctly swaddle a baby, so they can't get out! That's a useful skill for everyone, as it can save your sanity!

Luckily we only had to do the hospital wide skills lab the first week of hospital orientation. It was a one time deal and totally useless. Yearly we have a NICU skills lab that's specific to the NICU.

[elizabells, BSN, RN]

I think my unit thinks it's fancy - I'm in the same position as Rain - babies get sent TO us, unless we don't have an ECMO pump available or something. So, consequently, I don't have the faintest idea what STABLE is. Never heard of it. So I'm assuming I probably don't have to be certified in it. Then again, there are a lot of things that we (supposedly one of the best) don't do, because they have a bullheaded "us against the world" kind of determination about "The Columbia Way".

[prmenrs, RN]

For a community "referring" hospital, the STABLE program is a great idea.

We do have ALS certified RNs, who can intubate, place UA/UV lines, etc., until the Neonatalogist gets there, and continue stablizing the baby til the transport team arrives and takes over. The ALS do an awesome job.