Just wondering if anyone can share some experiences with small Labor units. We are moving to a small mountain town and the hospital that i'll be working at does around 10 deliveries a month. I'm used to 300++ a month. Apparently I will only be on-call until a labor comes in, then I labor, deliver, recover then go home. I've been told a full 12 hour shift is rare. RT comes to every delivery in case you need help with NRP. What are your experiences with this type of situation. I need to ask them more questions but immediately I think of the following questions...
*What if I have a prolapsed cord???
*What if baby takes a huge dump and it is taking too long to recover, do I leave mom's bedside to make phone calls, pull meds, prep for OR???
*What if I have a really bad baby with complicated, undiagnosed issues. I suppose i'd call ER for help. (Had a baby once with a webbed trachea, didn't do well)
I'm not a nurse yet but I thought I would add my .02 that the job sounds really interesting for someone with experience. It sounds like a great chance to really work with a patient and get to know them. Also to home your decision making skills. With the low risk cases it sounds like a dream job for a competent nurse:) With the high risk cases, it may give you a chance to really learn and grow your skills. Good luck!
I once worked PRN in a small hospital and most of the patients were low SES (so socioeconomically at high risk). If they were less than 35 weeks 6 days we did our best to send them off to Level 3 facility (one 50 miles and one 60 miles away). I ALWAYS had a CNA at a minimum working with me; never was I on the unit alone.
One night I had a cord prolapse. The dad yelled for the CNA, dialed 0 and told the operator I needed help. The ER doc and nursing supervisor were there pronto. Called in the OR team and the general surgeon on call who would do the C-Section. BTW she was 11 miles away and asleep.
Abd prep and foley done by the CNA. Antibiotic hung by nursing supervisor. I am trying to keep cord off head and calming mom and dad. FHR in 100-110 range. ER doc stayed to make sure we were all OK.
Ended with a great baby who didn't even need oxygen. Incision made 29 minutes after I "declared" an urgent C Section.
I've worked in quite a few very small rural hospitals both before I became a traveler and by choice in the 10 yrs I've been traveling. I frequently request these kind of facilities, which makes me easy to place as many are not comfortable in these settings.
I find that the other nurses in these hospitals are usually wonderful at jumping in to help when it "hits the fan" - doing what they can to help under your direction, minding your other pts. if any while you deal with the crisis. Rural docs also seem to be more responsive, coming in when called, staying to help until the transport arrives, etc. The smallest facility I worked in had a total of 4 nurses and 2 GREAT CNA's working at night for the whole hospital.
The other bonus of a small facility is that I got experience in things I hadn't done before by being that "second pair of hands" helping out in the ER and the floor under the direction of the nurse in that area when I had no OB pts.
I believe the ecmo for level 4 is correct. My hospital is a level 3 NICU, but those that need ecmo are sent to one just down the street--I know that Loma Linda can do ecmo so that would make sense.
Holy cow...Not a place I would want to be ALONE...Especially with litigation the way it is....ANYthing can happen. We just had a "healthy" mom with no risk factors and a slightly elevated BP, no headache, spots or ANY symptomology (no clonus or problem with DTRs) have labs come back with elevated lfts and platelets of 60......You just never know....
CEG
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I'm not a nurse yet but I thought I would add my .02 that the job sounds really interesting for someone with experience. It sounds like a great chance to really work with a patient and get to know them. Also to home your decision making skills. With the low risk cases it sounds like a dream job for a competent nurse:) With the high risk cases, it may give you a chance to really learn and grow your skills. Good luck!