Patti Turner

Writer. Nurse. Shutterbug. Maker, MyIntent Project

  • Home
  • Writer
    • Musings
    • My Writing
    • On Writing
    • Words Worth Repeating
  • Nurse
    • Health
    • Labor and Delivery
  • Shutterbug
    • Girls Trip 2015
    • Scotland
    • View from the Hilltop
    • Views: Around the World
  • Vegetarian
    • Recipes
  • MyIntent Project
  • About
  • Contact
  • Log In
    • Lost Password
    • Register
    • Reset Password
Home » Nurse » Labor and Delivery

Labor Nurses: Do You Have a List?

May 30, 2017 by Patti 4 Comments

tear drop on leafCalling all labor and delivery nurses: do you have a “list” at your hospital to determine which nurse is “up” for the fetal demise coming to the labor unit? Do you rotate a demise assignment based on seniority, date order of who did it last, or do you assign the patient to somebody you think is good at this sort of thing? Or is it like every other assignment – you get what comes in, regardless of who did what when?

Lists.

Nurses have lists for everything. There is a seniority list (for holiday and vacation rights), a pull list for who got sent to another unit when, a list for who gets to go home in a snowstorm and who has to stay. There are sign-up lists for party food, who put money in for lottery tickets, and a list of who wants to order out. And a demise list. I like all those lists but the last one.

I hate that list.

What if you were the patient with a perinatal loss and you heard the staff fighting over which nurse should get the dreaded assigment? I daresay you would be appalled.

We’re nurses. We are caring, compassionate, and trustworthy. Patients and families with perinatal loss trust us to see them through the horror. They trust us to handle the tiny body with respect, photograph it, take footprints, get a lock of hair, measure and weigh it, swaddle it, then stay with them while they say goodbye. We have to support them during one of the most difficult events in their lives.

Nobody likes to go to the morgue and place a baby in the chiller. It’s horrible. It sucks.

Life and death.

Life comes with death. Granted, the death part is a less often in labor and delivery than it is on a medical/surgical floor, emergency room, or one of the intensive care units. Do the nurses in those areas keep track of who had the last patient death and make assignments based on the risk of which patient might kick the bucket this shift? I’ve worked at many hospitals in many specialties, and I’ve never heard of it before. Only in labor and delivery.

We are all going to die one day. I hope the nurses taking care us aren’t fighting over who should get stuck with the assignment.

I’ll do it.

Supporting families experiencing sorrow are some of the highlights in my career. Give me the assignment every time there is a fetal demise or non-viable infant due to deliver. I care about and for all patients and families, in the joyous moments and in the depths of their sorrow. It is why I became a nurse.

I’d rather take all the depressing assignments from now until I retire, lest these patients get stuck with a nurse who doesn’t want to do it, can’t handle it, whatever. Because if I can give even one moment of solace to a family in despair it will be worth it.

Nurses, spill your guts.

Do you have a list where you work? Do you like it? Hate it? I want to know how the rest of you feel.

 

 

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery, Nurse Tagged With: fetal demise, Labor & Delivery, labor nurse, nurse, nurse problems, perinatal loss, RN, the list

April the Giraffe Labor & Delivery Live Cam – Addicted!

March 3, 2017 by Patti Leave a Comment

April the GiraffeeApril the giraffe is due to give birth at any moment. I’m hopelessly addicted to watching the live cam, waiting for the big event to happen. Sure, I could watch the video after the fact, but there’s something about witnessing a live birth as it happens. It must be the labor and delivery nurse in me.

It must be the labor and delivery nurse in me.

Labor and delivery and the birth of a new life fascinates me. Even after 30 years working as a labor and delivery nurse I still tear up and get emotional when a baby is born. Any kind of baby – human, animal, egg hatching, etc.

Addicted.

My name is Patti and I am an addict. I’m addicted to labor, delivery, and birth. I work as a labor and delivery nurse, I watch shows about labor and birth of all kinds of species, and I’m especially addicted to watching live cams. My current addiction is to April the giraffe. She’s due to give birth at any time.

Previously, I watched (was addicted to) Katie the giraffe’s live web cam as she gave birth to Kipenzi in April 2015 at a Dallas zoo. When she was pushing I wanted to shout “Well done! Well done!” in a British accent as the nurse-midwives do in the PBS series Call the Midwife. I watched Katie and her baby for months on the giraffe cam. When baby Kipenzi had an accident and broke her neck, dying instantly, I was devastated.

Before the giraffes there were the eagle cams (eaglets are so cute) and the panda cams. Any impending birth or hatching cam.

I need April the giraffe to birth her baby already so I can get back to my real life!

April the giraffe.

You can join the birth watch of April the giraffe on YouTube – the link can be found at www.aprilthegiraffe.com.

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery Tagged With: addict, April the giraffe, Labor & Delivery, labor nurse, pregnancy, RN

Worst Day /Best Day of my Nursing Career

August 4, 2016 by Patti 3 Comments

worst/best day of my nursing careerLast week a question was posed to me on Quora : Can you tell me about the most stressful incident that happened in your nursing career? It got me thinking about the worst day and best day in my nursing experience. Although I don’t dwell on the bad times, I never forget them (as I mentioned in Running into My Labor Patients in Public and Working as a Labor and Delivery Nurse).

The Worst Day of My Nursing Career

I admitted a woman to the labor and delivery unit. She said she was 26 weeks pregnant and didn’t feel the baby move. At 26 weeks gestation (a picture, not for the faint of heart) the mother should feel the baby move often. Though it is too early for formal fetal kick counts, most moms know the patterns of their baby’s movement.

I turned on the fetal monitor and attempted to find the fetal heart rate. My own heart sank as I palpated her belly, looking for a likely spot to place the monitor. Her belly wasn’t firm and rounded, but soft and without tone. I couldn’t locate fetal heart sounds. The patient was becoming more distraught with each passing second.

I summoned one of our obstetrical residents and he came in right away with an ultrasound machine to look at the baby’s heart. I held the patient’s hand while he performed the ultrasound. The heart was still – an intrauterine fetal demise. It would be stillborn. We can use whatever medical terms we want, but in the eyes of the mom, her baby was dead. It was heartbreaking.

She cried. I stayed with her. She called her husband and family to come. I stayed with her, and also with her family, while the patient and her family grieved over the news.

When the initial shock eased somewhat, her physician explained what had to be done: induction of labor. She’d give birth, as usual, but there was nothing usual about it. The baby was dead. And she had to deliver that dead baby. The doctor explained what would happen, but it was the nurse’s job to carry it out (me). Draw blood, start an IV, give medication through the IV to bring on labor, see that her pain was controlled, push with the patient until delivery was imminent, receive the baby at delivery, and do post-mortem care. And, of course, provide emotional support for her and her family.

Meanwhile, I needed to ask the patient many emotionally difficult questions required by the State for filing the fetal death certificate. I also had to explain the “disposal” options, the autopsy options, and ask whether she (and her family) wanted to hold the baby. After the birth, I would need to try to make the baby presentable – clean it, take footprints, pictures, get a lock of hair, weigh and measure the baby, and swaddle it for mom to hold (and somehow prop up the chin, which invariably hangs slack). And the saddest part for me: later taking the baby to the morgue and placing it in the refrigerator.

The patient and her family (there were six or eight sisters and aunts present in addition to her husband) understood the baby was dead, and by the data obtained from the ultrasound measurements, it was likely the baby died a week or so ago.

Her labor was mercifully quick for a first-time mom. Her extended family remained present for support of their loved one (I never left the room except to obtain medication or supplies). She pushed a few times, and her baby boy slipped out. It was obvious to me, by the condition of the skin, that it wasn’t a recent death. Otherwise, the baby was perfect. They all cried. So did I.

I received the baby and put him in an infant crib. The patient previously requested I do all of the post-mortem care in the presence of her and the family.

And then …

What Made it the Worst Day in My Nursing Career

The patient screamed. I expect a patient in this situation to cry, and maybe scream in grief. Then the whole family screamed. They screamed at me:

“Do something!”
“Why aren’t you doing CPR?”
“Get one of those breathing bags!”
“You’re not trying to save my baby!”
“Oh my God, she’s letting the baby die!”
“Why aren’t you calling a pediatrician if you don’t know what to do?”

It was mass chaos. They were screaming all at once. I was frozen. There was no saving to be done, and I couldn’t abuse that little body with pretending. They expressed understanding beforehand – the baby was dead, probably for quite some time. I guess they were not able to process in their hearts what their minds heard.

I have never felt so useless, so helpless, so inadequate as a nurse in all my life.

It was nearly the end of my shift. I functioned like a robot, doing the post-mortem care and handing the swaddled baby to the mom. Her family gathered around and took turns saying hello and goodbye to their family member. At some point the screaming stopped. I don’t remember when, or what I said to them. Traumatized by my inadequacy as their nurse, I cried the rest of the night at home.

Their grief was greater than mine, I know that. They not only lost a baby, but the hopes and dreams of the man he would become and how their lives would play out. I’d only lost the notion and confidence that I was a good nurse, able to care for families in a way they need and make a positive difference in their lives.

The next morning, I dreaded getting up and going to work. But then something beautiful happened…

The Best Day of My Nursing Career

When the charge nurse gave out the assignments to start the day, she said the patient I had yesterday requested me as their nurse. It must be a mistake, I thought. So with a heavy heart and zero confidence, I went down the hall to the patient’s room.

The family was still there – they’d stayed all night with the mom. When they saw me they crowded around me, hugging me. Tightly. The patient thanked me for my care during labor and delivery, and said she would not have been able to get through it without me. Her family members each in turn thanked me for the caring and support I showed them during the ordeal. They said having me as their nurse made all the difference in their ability to get through the day and their thankfulness and appreciation knew no bounds. They couldn’t have done it without me. I made a difference in their lives, they said, and though they were grieving together they also had joy in their hearts for what they thought was the best care in a bad situation. And the mom said if it never happened, they would never have met me, and known how kind and caring a soul could be.

And those few words made my day, and made that day the best day of my nursing career, ever.

*Details were changed to protect privacy (no HIPAA violations).

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery, Nurse Tagged With: best day ever, birth, fetal demise, Labor & Delivery, labor nurse, nurse problems, nursing career, RN, stillbirth, worst day ever

When is the Baby Coming?

April 5, 2016 by Patti 1 Comment

When is the baby comingWhen is the baby coming? I have the answer. And I will tell you. I promise.

The Questions

When is the baby coming? My labor patients, their families, and friends ask me this question all the time. Sometimes it is incessant. The same thing asked a variety of ways:

What time do you think the baby will be here?
Let me ask you something, what time will the baby be born?
How long is labor going to take? What time will he/she arrive?
You’re a labor nurse, you must have some idea when the baby will come, right?
When is the baby coming?

What the Labor Nurse Thinks

If I had a penny for every time. . . . .

I don’t have a crystal ball. I can’t see into the future. Yes, I’ve been doing this job for 30 years. No, it doesn’t help me make predictions. It could come in two minutes or two days. It depends on lots of variables.

Variables

The number of variables to the progression of labor and delivery would fill a book. Here are just a few:

Is labor being induced? Are you due? Overdue? Did your water break? Is there meconium? Is your baby showing signs of fetal distress? Is the baby in the vertex position (head down)? Do you have preeclampsia? Are you bleeding heavily? What is the estimated fetal weight? How dilated is your cervix? Is it effaced? Are you a good pusher?

Do you have patience? These things take time. There is no need to beg for a c-section because you are tired or because you think it is taking too long. You’re going to be a parent. You will be tired for the foreseeable future and then some. And you will surely need patience. Time to start practicing.

The list of variables goes on and on.

Labor Defined

Are you actually in labor? Dilated? Six is the new three when defining labor vs. Braxton Hicks contractions. Here is the current definition of labor.

When is the Baby Coming?

I know and I did promise to tell.

The Answer

When it gets here.

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery Tagged With: birth, Labor & Delivery, labor nurse, pregnancy, time, when

C-Section Rates: Do Nurses Play a Role?

March 13, 2016 by Patti 2 Comments

c-section ratesC-section rates are the topic of many conversations. In the United States, roughly one third of all deliveries are operative (C-section).The rates are reported and publicly available. Pregnant women want to find a doctor with a low rate. Hospitals are trying to reduce their operative delivery rates. Insurance companies don’t want to pay out for the more expensive delivery method.  Why is the C-section rate so high, and who is responsible? Click To Tweet

I recently saw a video by Dr. Neel Shah that made me question the role of the nurse and C-section rates. Dr Shah and his team of researchers are considering hospitals as a factor. Across the country, why does hospital A have a low C-section rate compared to hospital B, when high risk factors and other variables are removed? Watch this three minute video. It will get you thinking and asking questions about what we can do to lower C-section rates.

You can read about Dr Shah and the Childbirth Overtreatment Project in-depth at the Ariadne Labs website: https://www.ariadnelabs.org/childbirth-projects/.

C-Section Rates by Hospital

It is very easy for a pregnant woman to find out what the C-section rates are at any hospital. The Leapfrog Group makes it simple. Click here to find the rate listings by state.

Obstetrician C-Section Rates

Obstetrician C-section rates are not published publicly. You can ask a provider what his/her primary C-section rate is, but they may not know or tell you. An interesting and informative article from ACOG, Safe Prevention of the Primary Cesarean Delivery, can be read here.

Does it matter what an obstetrician’s C-section rate is? I don’t think so. This will come as a surprise to the pregnant women out there looking for a doctor to give them the normal vaginal delivery they want. But consider the odds of that doctor actually being there the day you deliver. Say you see a doctor in a practice of five physicians. On Monday through Friday, one of those doctors will be on call for deliveries each day. You have a one in five chance your own doctor will deliver your baby. On the weekend, many practice groups cross cover. That reduces greatly the chances your own doctor will be on call. Do you know every one of those providers, how they manage labor, and what their individual C-section rates are?

Labor & Delivery Nurses

The person with you all day or all night, managing your labor minute to minute, assessing fetal well being, and functioning as a patient advocate is your nurse. It’s not your personal physician – their role is prenatal care, actual delivery, and post-partum care. Labor, and the management of labor (according to hospital policy and physician orders) falls solely on the nurse.

Is labor progressing? Does the patient need oxytocin (Pitocin) to help regulate contractions, or to induce labor? Do you have any idea when this drug should be used, how it is used, how often the drip should be increased and by how much, or reasons why it is decreased or shut off? Do you really need Pitocin at all? I know because I’m a labor and delivery nurse. So do my fellow OB nurses. But do they use their knowledge to act appropriately on your behalf?

Hospital culture, discussed in Dr. Shah’s video, plays a role. If you have many patients laboring and few beds to put them in, you need to increase the throughput. How? Start Pitocin. Push the Pit. Get that labor moving. The question every L & D nurse hates: What's the Pit on? Click To Tweet It doesn’t matter. What matters is frequency, duration and strength. How often are the contractions, how long do they last, and how strong are they to palpation. Are the contractions adequate to dilate the cervix?

Does the nurse give too much Pitocin, causing uterine hyperstimulation and the resulting fetal distress? Does the nurse dawdle with turning up the Pitocin, hoping to avoid a change of shift delivery and the resulting paperwork and keeping her late to leave? What is the staffing level like? Is the nurse doing something else – caring for more than one patient at a time, preventing timely increases in Pitocin? Are the nurses switching assignments in order to manage a busy labor unit? How many different nurses did the same patient have during her labor? (Read this article: Continuity of nursing care and its link to cesarean birth rate.) And those are just a few examples of nursing influence, a mere scratch on the surface of hospital and nursing culture.

The nurse has a huge amount of control about what happens during labor – whether labor progresses to a vaginal delivery, whether labor fails and results in a c-section, or whether your personal labor plan is followed and communicated to the whole team. But the nurse isn’t the only player. The patient (frustrated, tired of waiting, unable to tolerate pain, begging for c-section) and the baby (fetal distress) tie our hands. We can’t control everything, but we sure can control a lot. Do nurses play a role in c-section rates? Hell yes! Click To Tweet

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery, Nurse Tagged With: c-section rates, c-sections, health, Labor & Delivery, nurse, nurse problems, pregnancy, RN

Running into My Labor Patients in Public

August 11, 2015 by Patti 2 Comments

Running into My Labor Patients in Public

Running into My Labor Patients in Public

I Probably Won’t Recognize You

Running into my labor patients in public happens frequently. Everywhere – the supermarket, the park, restaurants – a man, woman, or couple with a baby approach me in public and begin to talk to me like we’re old friends.  They look vaguely familiar, but I have no idea who they are. It’s awkward for a moment and then I’m reminded that I helped deliver their baby weeks or months or a year ago. I’m sorry I don’t remember you.

I don’t remember you because you are fine.  Your spouse is fine.  Your baby is happy and healthy. Your labor and delivery were normal and without complications. Those are good things, and the reasons why your case was not noteworthy enough to stick in my brain. Besides, you don’t even look like the woman I took care of. You’re back to a normal weight, wearing fashionable clothes instead of a hospital gown.  Your face isn’t puffy and your ankles are’t swollen the size of tree trunks any more. You’re okay, and because I had no worries about you, I could let you go.

Be happy I can’t remember you or your family or your baby.  Because if I do remember you, something bad happened.  That’s what sticks in my mind. The sadness and heartbreak of a pregnancy or delivery gone wrong haunts me forever.  Those are the people I remember, but wish I could forget.

I remember the lady presenting to the the triage unit with a complaint of decreased fetal movement and I could not find a fetal heart, breaking all our hearts.  I remember the woman who died from an amniotic fluid embolism. I remember the patient who had a stroke in labor and was later taken off life support, leaving her husband with a baby and no wife. I remember the couple with a history of six miscarriages, and now this seventh pregnancy was ending at 21 weeks gestation with ruptured membranes and infection.  I remember the woman with an intrauterine fetal death who screamed at me to do CPR when the fetus was finally delivered 12 hours later. I remember the ambulance bringing a pregnant woman, bleeding, blood spilling over the side of the stretcher, a placental abruption that killed the baby and tried to kill the mother.  I remember the woman diagnosed with cancer who put off chemotherapy to give the fetus a chance to grow to viability. The anomalies, the premature babies, the losses – the list of women and complications is endless, and I remember them all.  The crying, sobbing, screaming, and the silent agony of a broken heart.

So if I don’t remember you, please don’t be offended.  It’s a good thing. You, your baby, and your family are well. I don’t want a reason to remember you forever.

It doesn’t mean I don’t care – I do! I’m happy you and your family are well. I loved the time we had together and the privilege of caring for you. If you run into me and I give you a blank stare in a moment of awkwardness, give me a gentle reminder.  I love to see my patients doing well and I’d love to hear about your family.

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery, Nurse Tagged With: Labor & Delivery, Mother & Baby, nurse, nurse problems, Patients, pregnancy, RN

Working as a Labor and Delivery Nurse

July 20, 2015 by Patti 4 Comments

The Coolest Job

Labor & Delivery

Labor & Delivery

Working as a labor and delivery nurse is the coolest job ever.  I can’t imagine doing anything else, except for writing. And right now I’m writing about being a labor and delivery nurse – life is good.

Nearly 34 years ago, I was a patient on the labor & delivery unit where I now work. It wasn’t an easy delivery.  I developed preeclampsia and had labor induced.  I was scared, in pain, and worried about my baby, who had the nerve to be in a posterior position (can you say “back labor?”). No epidurals back then. Throughout it all, my nurse stayed with me, cheering me on, making me comfortable, distracting me from the pain, and providing emotional support. And as she predicted, the moment the baby was in my arms the trauma was wiped from my memory.

The birth of my first child resulted in an epiphany:  I wanted to be a labor and delivery nurse.  I wanted to do all the things I saw my nurse do that day, and more.  There was only one problem.  I wasn’t a nurse. I was health claim consultant for a large and prominent insurance company.  My college courses were in business, not science. I had a long road ahead if I wanted to do this.

It took me six years and two more kids to finish the prerequisite science classes and nursing school, but I did it. I graduated when my third child was 13 days old.  A year later, I landed my dream job as a labor and delivery nurse at a level III perinatal center. I’m still there.

Working in a level III perinatal center means we see many complicated cases in addition to normal deliveries, mothers, and babies. Until I worked in labor and delivery, I had no idea how many kinds of maternal and/or fetal complications there could be.  No case is the same, and I learn something new every day from my colleagues and patients.

I’ve been asked if I get bored doing the same job year after year. The answer is no – because every day is different, every delivery is different,  every patient is different, and every family is different. There are vaginal deliveries, c-section deliveries, and a host of variations and complications including fetal distress, precipitous deliveries, shoulder dystocia, preeclampsia, hemorrhage, maternal comorbidities (diabetes, heart disease, hypertension, etc.), premature deliveries, and stillborn infants, to name a few.

“Your job must be so much fun” I’ve heard many times. Yes, and then no.  There’s more to it than that. It isn’t always a happy place.  Labor and delivery has highs and lows like everything else in life. Sometimes bad things happen despite best efforts to avoid them. There are no words to describe the pure joy of handing a newborn to mom for the first time, no words to describe the wonder in her eyes when the baby latches on to the breast.  There are no words to describe the deep sorrow when you can’t find a fetal heart rate, or when you hand a stillborn infant to mom. I’m constantly reminded of how precious life is, and how easily it can be taken away.

You can’t have, or appreciate, the highs without the lows. But no matter the outcome, I want – need – to be there for the families I serve.  Being a labor and delivery nurse and witnessing the creation of new families is an honor and privilege. I can’t imagine doing anything else. It’s the coolest job ever.

 

 

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery Tagged With: Labor & Delivery, nurse, RN

Labor Nurse – IAmA AMA

July 15, 2015 by Patti 1 Comment

Reddit: IAmA AMA Labor Nurse

reddit.com

/r/IAmA

I’m a labor and delivery nurse. Two years ago I hosted a discussion on the Reddit IAmA/AMA (I am a…ask me anything) site. The topic was “I am a labor and delivery nurse (RN) – ask me anything”.  It was great fun for me, but I realized  people have many questions about labor, delivery, pregnancy, or a career as a labor nurse, but there was nobody they felt comfortable asking.  Some were just curious.

You can read the reddit session here. The session is closed, but I’m still a labor and delivery nurse.

If you have any questions about pregnancy, labor, delivery, or becoming a labor and delivery nurse, or would like me to post on a particular aspect, ask in the comment section below.  I’d be happy to provide answers, give you direction for more information, and clear up anything on your mind.

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery, Nurse Tagged With: Labor & Delivery, labor nurse, pregnancy, RN

Seeding Baby’s Microbiome

June 30, 2015 by Patti Leave a Comment

hmp_logo_NIH_retinaThe Latest Trend After C-Section Delivery?

The theory is that babies born by cesarean section bypass the trip through the birth (vaginal) canal and thereby miss the opportunity to pick up (seed) with the mother’s normal flora (microbiome). To remedy the situation, gauze moistened with sterile saline is rolled like a tampon and inserted into the mother’s vagina an hour before the scheduled cesarean birth.  After birth the gauze is used to swab (orally?) the infant leading to “seeding” of mom’s bacteria.  Much like breastfeeding transfers the immunity of many illnesses to baby, seeding baby’s microbiome is thought to align the infant’s microbiome with the mother’s flora.

There is the “ew, gross” factor to get past in order to find merit in the idea.  After thirty years of nursing there is not much that gives me the knee-jerk reaction of “ew, gross”. I think my cure for the this was the time I had to poke holes in a man’s hand with a large bore needle (one through each fingernail and one on back of the hand) and apply medicinal leeches. Hurt in a work accident with a crush injury, the application of leeches saved his hand after microsurgical repair left his hand intact but arterial supply cut off by venous congestion. The leeches fixed that. Nothing came close to gross after that incident. So I should be okay with seeding a baby if I can get the facts.

As a hospital-based labor and delivery nurse, I have many questions about this practice.  Does it really help? Is there evidence-based medicine to support the theory? How long is long enough to leave the gauze in the vagina? From the time it is removed (prior to sterile drapes for surgery), until the time of seeding (after birth), how would this bacteria laden item be stored? Are there temperature requirements?  How do you know if there is “bad” flora included, such as group beta strep or bugs introduced during recent intercourse (see “Parsing the Penis Microbiome” for an overview). How can we know if we are killing a baby rather than protecting it? Of course, vaginally delivery may expose infants to bad bugs, but somehow it doesn’t feel the same as actually collecting and swabbing a baby with vaginal fluid and secretions.

A good introduction and articles about human microbiomes and the work being done in the field can be found at the National Institutes for Health Human Microbiome Project site and the CDC page on genomics and microbiome. It left me with more questions regarding microbes , pregnancy, delivery and infant health. A search of peer-reviewed journals did not turn up anything on seeding baby’s microbiome.  A Google search turned up articles on possible research but no facts. A few blogs addressed seeding, but they offered no links to proof of necessity or safety.

I don’t have the answers I need to incorporate seeding into my practice, but the discussion led me to research and learning about the role of microbiomes and practical application in medicine and nursing, just not in seeding a baby.

What do you think?  Parents, would you seed your baby? Nurses, midwives, and physicians, what do you say when a patient brings this up?

 

 

 

Share this:

  • Click to share on Twitter (Opens in new window)
  • Click to share on Facebook (Opens in new window)
  • Click to share on Pinterest (Opens in new window)
  • Click to share on Reddit (Opens in new window)
  • Click to share on Tumblr (Opens in new window)
  • Click to share on LinkedIn (Opens in new window)
  • Click to print (Opens in new window)
  • Click to email this to a friend (Opens in new window)
  • Click to share on Google+ (Opens in new window)

Filed Under: Labor and Delivery Tagged With: birth, Labor & Delivery, microbiome, pregnancy

Welcome!

I'm Patti Turner, labor & delivery nurse by day and writer by night. I enjoy writing fiction, reading, cooking vegetarian food, traveling the world, and photographing everything. Read More…

FOLLOW ME ONLINE

  • Facebook
  • Google+
  • Instagram
  • Linkedin
  • Pinterest
  • Twitter

Subscribe to Blog via Email

Enter your email address to subscribe to this blog and receive notifications of new posts by email.

MyIntent Project

What’s Your Word?

Twitter

Tweets by @pattiturner

Tags

birth bonjour change ciao dreams explore fall colors fetal demise Florence flu flu shot France health Hello Hilltop reservation hopes influenza Italy Labor & Delivery labor nurse meatless Mondays my writing NJ nurse nurse problems Orvieto Paris pics pitch pregnancy recipes RN Rome sick Siena success sunset travel photos vegan vegetarian Verona View from the Hilltop write writer ¡hola

Instagram

Load More...
Follow on Instagram

Categories

  • Girls Trip 2015
  • Health
  • Labor and Delivery
  • Musings
  • My Writing
  • Nurse
  • On Writing
  • Recipes
  • Scotland
  • Shutterbug
  • Uncategorized
  • Vegetarian
  • View from the Hilltop
  • Views from the Hilltop
  • Views: around the world
  • Words worth repeating
  • Words worth repeating
  • Writer

Gallery Tags

Girls Trip 2015 Photos of Scotland

RSS Feed

 Subscribe in a reader

Copyright © 2018 · News Pro Theme on Genesis Framework · WordPress · Log in

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.