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Topics About 'Labor And Delivery'.

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  1. When I was a freshmen in high school, my friend’s mom was a Labor and Delivery nurse. She talked about her job often, and I always found her stories fascinating. I would ask tons of questions, and she noticed I was super interested in OB nursing so she invited me, her daughter, and a group of students from our class, to come to the hospital and show us around. She took us to a class room and talked to us about her job. Showed us different instruments used during labor, and described the process. She even showed us real placenta. Everyone found it gross and uninteresting, but honestly I loved every minute of it. I knew that’s what I wanted to do when I grew up. No other career excited me in any way. Well I graduated high school, went to college and got into nursing school. Once I was in nursing school, I realized that half the nursing students in my cohort wanted OB. I was shocked and disappointed that area was so popular. There are only 3 delivery hospital areas in my area, so obviously not all of us could work there. I also looked online and found out how popular this specialty was, and how extremely difficult it is to get into. My heart sunk. All this work for a pipe dream, when I thought it was a realistic plan. During my clinical rotation I met a nurse that told me she applied to OB several times in the last ten years and couldn't get in. From what I saw she was an excellent nurse, so if she can’t get in, how can I. I was an average student. I absolutely loved learning and my clinical rotations, but nothing about me stands out as an excellent nurse. Other students in my cohort were much smarter, and far more gifted. I’m just OK. I feel like I wasted my life. Other areas of nursing are fine, but not anywhere near as exciting and special to me. I had one day in clinical at the labor and delivery unit, and I thought, this is it! I’ll never work here, but at least I had one day to live my dream. Best day of nursing school ever, even cried after. I graduated nursing school and never took the NCLEX. Every time I sat down to study I got depressed. I feel sick when I think about nursing, and now don’t know what to do. My family is extremely disappointed in me not taking the NCLEX, and just having a minimum wage job. I’m thinking about taking the NCLEX and getting a normal floor job, even though it doesn’t have a strong appeal to me. I feel like an idiot, and wish I could back in time an punch myself. Why did I think it would be so easy? I also had a clinical in the OR and loved it. I looked it up and found out that was hard to get into also but not impossible. from what I understand the hospitals only accept pari-op once a year and there is no guarantee of getting a seat. Any advice would help.
  2. the_whatsername

    L/D Care Plan Help PLEASE

    I am a level one RN student on my first OB clinical rotations and care plans are still very new to me. I must turn in a concept map with supporting data for each of my diagnoses and an intervention sheet with at least 6 interventions and patient responses to each. Minus the patient responses, here is what I have so far: #1 Nursing Diagnosis Acute Pain r/t uterine contractions and stretching of cervix and birth canal Supporting Data External monitoring of contractions, Patient states "I am hurting," noticeable facial grimace, muscle tension, increased RR, Client rates pain as 9/10, diaphoresis Goal Client will report that pain management regimen relieves pain to satisfactory level Outcome Client will maintain Interventions Assess pain level every hour and prn Administer Stadol IV every 4 hrs and prn Assist with epidural Provide nonpharmacologic techniques Encourage client to try different positions Teach simple breathing and relaxation techniques Limit visitors as she desires Keep informed about the progress of labor and Baby's condition Prevent pain when possible during procedures #2 Nursing Diagnosis Fatigue r/t childbirth Supporting Data Unknown (help) Goal Patient will verbalize increased energy and improved well-being Outcome Patient will verbalize environment is suitable for satisfactory rest during my shift Interventions Assess level of fatigue prn Allow client to express what best helps her relax Limit visitors as she requests Prepare the environment to promote rest Administer pain medication to relieve pain and promote rest Limit the number of times she is interrupted Try to administer medication, check VS, or or other actions in one room visit Teach methods to help relax #3 Nursing Diagnosis Anxiety r/t fear of unknown and situational crisis Supporting Data Facial tension, increased perspiration, increased pulse (?) ----- (This doesn't sound right) Goal Patient will have vital signs that reflect baseline and will verbalize decreased anxiety Outcome Patient will have a relaxed facial expression and body posture between contractions Interventions Determine the couple's plans for birth and work with them as much as possible Explain all activities, procedures and issues that involve the client Stay with client as much as possible during labor ? ? #4 Nursing Diagnosis Risk for Infection r/t multiple vaginal exams and tissue trauma Supporting Data Unknown (help) Goal Patient will remain free from infection Outcome Patient will free from signs of infection as evidenced by normal VS during my shift Interventions Assess and report signs of infection such as Swelling, discharge, increased body temp and warmth Follow Standard Precautions Use sterile technique when inserting Foley Use appropriate hand hygiene Teach patient proper perineum care Teach patient the symptoms of infection and when to report to physician Teach patient proper episiotomy care Monitor VS
  3. I am a second degree/career student who garduated with her BSN in December. I returned to school specifically and soley to pursue a career as a CNM/FNP. I feel a strong calling and passion for midwifery and primary/well care. I know I need at least one year of experience before I can even apply to grad school (and realistically need to work and pay off some student loans) but am nervous about working in the L&D hospital setting. My 12 week L&D preceptorship was hard for me, as the hospital I worked in was not mother-baby centered and my coworkers did not have an innate trust in women's bodies. Unfortunately, I live in Las Vegas and that is the norm and my family is stuck here for the next few years. Having said that, I understand that my views are my own and talking to a woman in labor about natural/gentler options is not the right time. I have no problem finding ways to support a laboring mama being induced, epidural, etc. I do find it personally heartbreaking to see some of these mamas ending up with traumatic c-sections when providers fail to listen to the natural rhythms of labor and push too hard. Do you think this attitude and the knowledge that it won't be forever will be enough to get me through a few years as an L&D nurse? Are there other options for gaining experience that I am overlooking that will allow me to pay some bills? Luckily, I had a baby in March so still have several months to think about things before returning to work in the fall. I'm just so worried about burning out before I even make it to grad school. Thanks so much, Kim

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