...NURSING IN LABOR AND DELIVERY 2 Nursing in Labor and Delivery I have been interested in the labor and delivery area of nursing for as long as I can remember. I currently work in an obstetrics and gynecology medical office, so I only get to experience the antepartum and postpartum phase of pregnancy. I would love to work in labor and delivery as a nurse some day. I love working with people, especially in high-pressure situations. I would thoroughly enjoy creating a positive labor and delivery experiences for both mothers and family members, before, during and after babies are born. I thrive in fast-paced, stressful environments. I would be great at ensuring the safety and comfort of mothers and newborns throughout the early stages of babies' lives. Nurses do not need any specialized education or certification to work as a labor and delivery nurse. Like all areas of specialty medicine, hands-on training will progress as one works in the specialty area of interest. Labor and delivery nurses require compassion, critical thinking, decision-making, and communication skills. Additionally, labor and delivery nurses should have some general medical-surgical nursing background. L&D nurses must be able to communicate well with patients, families, and other health care providers. They must be skilled in prioritizing patient needs and cope well with a fast-paced, sometimes stressful environment. Average labor and delivery nurse salaries can vary greatly...
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...Life after college seems so far away, but I know it will be here in no time. Which is why this is a great assignment to start thinking about my after college plans. After college I have plans to get a job as a nurse somewhere. Experience working as an RN so I can be able to specialize and become a pediatric nurse or a labor and delivery nurse. I chose this profession because I love helping others, but I also love kids. I think birth is so fascinating and interesting. Things that will help me achieve this goal is keeping up my grades. In this field having good grades is something you NEED, especially in your science classes. I also will apply for internships at hospitals to get hands on experience working in the field I would like to go into....
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...Paper) RN (Labor and Delivery Nurse) Instructor Miller RN (Labor and Delivery Nurse) When I finish school I would like to become a Labor and Delivery Nurse. The reason why I choose to become a Labor and Delivery Nurse is because I get excitement out of women baring children. Working in obstetrics is a rewarding field that allows you to work with new families and newborn babies. Being a labor and delivery nurse is a well-paying job with excellent benefits and rewarding job satisfaction. It requires several years of education and training, but it provides you with expertise in an area that won’t fluctuate with changes in the economy. EDUCATION There are a number of different paths through which to gain a nursing education. You can obtain a bachelor’s of science degree in nursing, an associate’s degree or a diploma. Programs prerequisite mostly is including math, science, and health sciences. Additional languages and computer skills will help you obtain a position later [source: Discover Nursing]. If you are wondering how to be a labor and delivery nurse, there are a few steps you’ll need to take. As with many nursing professions, it’s usually a good idea to start off as an LPN (Licensed Practical Nurse). This entails a one-year program assisting RNs (Registered Nurses) for the purpose of on-the-job training. After working as an LPN you will likely want to become an RN with a Bachelor of Science in Nursing. This is a four-year program. To become a labor and delivery...
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...Sahoo, Ryan O'Leary, Seth Hall, Adriel Estrada Federal Express Item Pickup Labor Fuel Maintenance and depreciation Subtotal Long-haul transport Flight and truck-related expense Hub labor Hub depreciation Subtotal Delivery Labor Fuel Maintenance and depreciation Subtotal Advertising Sales Information technology Customer service Corporate overhead Total cost Margin Price $1.64 $0.10 $0.31 $2.05 $0.22 $0.21 $0.54 $0.20 $0.97 $8.55 $0.45 $9.00 Cost per unit $1.09 $0.07 $0.21 $1.37 Item Pickup Labor Fuel Maintenance and depreciation Subtotal Long-haul transport Flight and truck-related expense Hub labor Hub depreciation Subtotal Delivery Labor Fuel Maintenance and depreciation Subtotal Advertising Sales Information technology Customer service Corporate overhead Total cost Margin Price Airborne Express Cost per unit $0.87 $0.06 $0.13 $1.05 $2.44 $0.30 $0.25 $2.99 $2.78 $0.18 $0.00 $2.96 $1.48 $0.08 $0.19 $1.74 $0.00 $0.21 $0.32 $0.12 $0.41 $6.82 $0.19 $7.01 Assumptions Pickup Labor Fuel Long-haul transport Flight and truck-related expense Hub labor Hub depreciation Delivery Labor Fuel 60% of Fed Ex 80% of Fed Ex Station and ground operations + Flight operations & maintenance / Yearly Deliveries 60% of Fed Ex Fully depreciated by 1996 60% of Fed Ex 80% of Fed Ex $1.96 (Flight ops & maintenance + Depreciation & Amortization) / Yearly Deliveries Maintenance and depreciation Sales Yearly Deliveries (excluding Sundays) Yearly S&M Expenditure Per Unit Information Technology...
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...Comparison of Delayed Versus Immediate Pushing During Second Stage of Labor for Nulliparous Women with Epidural Anesthesia Comparison of Delayed Versus Immediate Pushing During Second Stage of Labor for Nulliparous Women With Epidural Anesthesia The research was done by Erica Gillesby, BSN, RNC, is a staff nurse, Labor & Delivery, Exempla Lutheran Medical Center, Wheat Ridge, CO, Suzan Burns, BSN, RN, is a staff nurse, Labor & Delivery, Exempla Lutheran Medical Center, Wheat Ridge, CO, Amy Dempsey, MSN, RNC, is a clinical nurse specialist, Labor & Delivery, Exempla Lutheran Medical Center, Wheat Ridge, CO, Kami Mogensen, BSN, RNC, is a staff nurse, Labor & Delivery, Exempla Lutheran Medical Center, Wheat Ridge, CO and other registered nurses to determine if the use of delayed pushing after the onset of the second stage of labor decreases the time of active pushing and maternal fatigue. Participants were randomly selected from nulliparous women, with continuous, standard dose, lumbar epidurals who reached the second stage of labor and assigned to two different methods of pushing, randomized by computer. The first group was the immediate pushing with a sample of 39; the second was the delayed pushing with a sample of 38. The participants were older than 16 years, viable, vertex singleton fetus and fetal age of 36 weeks or older. Cesarean delivery, samples with a maternal weight ≥275lbs, due to increased risks for both mother and fetus, magnesium sulfate...
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...CLINICAL PRACTICE GUIDELINES ON INTRAPARTUM AND IMMEDIATE POSTPARTUM CARE 2012 A collaboration of the Department of Health and the Philippine Obstetrical and Gynecological Society 1 The mention of specific product brands is not meant to suggest that they are endorsed or recommended by the Department of Health (DOH) and the Philippine Obstetrical and Gynecological Society (POGS) in preference to other products of a similar nature that are not mentioned. All reasonable precautions have been taken by DOH and POGS to ensure that the information contained in this publication is accurate. However, this guideline is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the guideline lies with the end user. In no event shall DOH and POGS be liable for damages arising from its use. 2 ii MESSAGE The primary aim of MDG 5 is to reduce by three quarters by between 1990 an 2015, the maternal mortality ratio,especially among less developed countries. The Philippines is among those with high maternal mortality rate (MMR). In 2006, our MMR was 162 deaths/100,000 live births, however, the Family Health Survey in 2011 showed that the MMR has increased to 221 deaths/100,000 live births. It is therefore important that we mobilize our efforts together to avert further deaths of our pregnant mothers. The Philippine Obstetrical and Gynecological Society (Foundation), Inc. (POGS) stood up to the challenge of World...
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...Pediatric Nursing Professor Gahan El Camino College May 14, 2013 Obstetric History G.D. In the midst of an empty Labor and Delivery floor on May 9, 2013, there was a lone laboring mother-to-be with the name of G.D. This individual was of Hispanic descent, Costa Rican to be exact, and was a twenty-five year old female with a religious background in Catholicism. G.D. was in room 10 and eagerly anticipated the vaginal birth of her first child, as were her husband’s parents’ for their first grandchild. She had been laboring since her admission at midnight on May 8, 2013. While G.D. is technically a gravida 2, she is only para 1 as she had an elective abortion in 2009. When the room was empty, all that G.D. had to say about this abortion was that the timing was not right in her life for a child then and now she is prepared to be a mother with her new husband at her side. While G.D. originally planned to labor in the most natural manner possible despite being induced, she quickly changed her mind and accepted the epidural. According to Talbot (2012), the labor pain G.D. was experiencing was based on several factors such as cultural, psychological and physiological. She tried to maintain a natural labor with no rush in delivery as is common with Central American countries like Costa Rica, however this fetus called for a more immediate delivery. She had plans to breastfeed once this baby was born. This mother was ready to greet to the world a baby boy with the name...
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...Review culture results. If a GBS culture is positive during the current pregnancy, regardless of EGA obtained, the patient is treated as GBS positive. If a GBS culture is negative, and was obtained > 5 weeks prior, re-screen for GBS. (* Do NOT screen at 35-37 weeks patients who: ○ GBS bacteriuria in present pregnancy ○ Previous infant affected by invasive GBS disease These patients will automatically receive prophylaxis at delivery) II. Intrapartum Prophylaxis Indicated: • Previous infant with invasive GBS disease • GBS bacteriuria during current pregnancy • Positive GBS screening culture during current pregnancy (unless delivered by cesarean section, in the absence of labor or ruptured membranes). • Unknown GBS status (culture not done, incomplete, or results unknown) AND any of the following: ○ Delivery at < 37 weeks’ gestation. (*see below) ○ Amniotic membrane rupture ≥ 18 hours ○ Intrapartum temperature > 100.4 0 F (≥ 38.4 C tympanic) ○ Intrapartum NAAT** + for GBS...
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...and medical decision making for specific healthcare environments and patient situations. Guideline for the Use of Oxytocin December 2012 INTRODUCTION The benefits of labor induction and augmentation must be weighed against the potential maternal and fetal risks associated with this procedure (1). The induction or augmentation of labor may increase the likelihood of neonatal complications or result in unnecessary cesarean section. These risks may be necessary to assume in complicated pregnancies, in which prolongation of gestation presents further risk to the mother or fetus. Prior to initiating oxytocin, the patient should be counseled about the indications for the use of oxytocin, the methods of administration to be employed, and the risks of failure, cesarean delivery, or fetal compromise. A physician capable of performing cesarean section should be readily available during the induction or augmentation of labor (2). UNIT STRUCTURE Each hospital’s department of obstetrics should develop a standardized, single, universal written protocol for the use of oxytocin for labor induction or augmentation. Standardization of an oxytocin infusion protocol is recommended to reduce medication dosing error and improve patient assessment. Elements of a protocol should include (2): Indications for the use of oxytocin for labor induction and augmentation. Methods for preparation and administration of oxytocin. Qualifications of staff authorized to administer oxytocin and monitor patients...
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...for them. 2. Amazon.com offers a very broad range of services and products at competitive prices. Its competitive priorities would include fast delivery time, on-time delivery, customization, variety and low-cost operations. As a business, Amazon.com is actually assembling a customized basket of goods that must be delivered in a short window of time in a dependable fashion. Low-cost operations are needed to remain competitive. To remain in business, Amazon.com needs to maintain high volumes of traffic. Operations strategy must focus on stock availability and quick, economical, and dependable delivery. 3. The hospital’s commitment to provide attention to patients arriving to the emergency unit in less than 15 minutes and never to turn away patients who need to be hospitalized implies that the facility must be designed to have extra capacity in both beds and emergency room facilities. It must plan on having extra personnel in the emergency room and also plan on having additional emergency personnel on call to take care of unprecedented heavy loads. In line with the mission statement, maximum utilization of the facilities (i.e., beds and emergency room personnel) would not be one of the performance objectives for the hospital. 4. FedEx traditionally has competed on the basis of fast, dependable delivery....
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...cost savings associated with doula support during labor and delivery are significant...
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...of paper Introduction 4 History 4 Techniques 6 The Bishop Scoring System 7 Indications 8 Contraindications 10 Risks 12 Nursing 12 Conclusion 15 References Abstract Inducing labor has been occurring since before our time. There are two types of labor inductions, scheduled and elective. For purposes of this paper scheduled inductions will be focused on. A scheduled induction is defined as using artificial methods to start the labor process at a specific time. Inductions are performed for many reasons. In most cases scheduled induction are performed because of medical complications to the baby and/or mother. In healthcare, there has been an increase in incidence regarding scheduled inductions related to convenience for the mother as well as for the doctors. To better understand the complexity of scheduled induction the history has to be addressed. What is the reasoning behind changing the natural birthing process? This paper will explain the methods of induction: pharmacological vs. mechanical, and the indications thereof. Nurse’s play a key role in labor and delivery. They have to be prepared to address and treat their patients’ condition, as well as be knowledgeable on the contraindications of this delicate process. A mother also has to be aware of the benefits and risks before a decision is made to schedule an induction. Having a baby is said to be one of...
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...Thyroiditis * Postpartum Depression * Direct the initial management of the ill postpartum patient * Know the appropriate threshold for consultation with specialist Postpartum Hemorrhage * Be defined as a blood loss exceeding 500ml after delivery of the infant * Excessive bleeding that makes the patient symptomatic (lightheaded, syncope) and/or results in signs of hypovolemia (hypotension, tachycardia, oliguria) * PPH: occurs in 24 hour of delivery * the late PPH: occurs after 24 hour of delivery to 6 weeks * Obstetrical emergency that can follow vaginal or cesarean delivery * Incidence – 3% of births * 3rd most common cause of maternal death in US Causes of Postpartum Hemorrhage Four Ts | Cause | Approximate Incidence (%) | Tone | Atonic uterus | 70 | Trauma | Lacerations, Hematomas, Inversion, Rupture | 20 | Tissue | Retained tissue, Invasive placenta | 10 | Thrombin | Coagulopathies | 1 | Risk Factors * Prolonged 3rd stage of labor * Fibroids, placenta previa * Previous PPH * Overdistended uterus * Episiotomy * Use of magnesium sulfate, preeclampsia * Induction or augmentation of labor Management * Secondary steps * Will likely require regional or general anesthesia * Evaluate vagina and cervix for lacerations * Manually explore uterus * Treatment options * Repair lacerations with running locked #0 absorbable...
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... and culture, unlike most parts of Africa. It is common for women to marry at a young age, and the ability to have many children is highly valued. It is estimated that the maternal mortality rate is 1,400 per 100,000 women, one of the highest in the world. Somalia’s lack of medical care during pregnancy and delivery contributes to their high infant and maternal mortality rates. The experience of pregnancy and the labor and delivery process in Somalia differs in many ways from that of women in the United States. It is important that health care providers in the United States are aware of these differences because 32% of the refugees in the U.S. are from Somalia, so it is likely that providers will care for a Somali female at some point in their careers. In Somalia, cesarean sections are rarely discussed and typically not performed (Ameresekere, et al., 2011). Somali women also feel that the entire labor process is rushed in the United States. In Somalia, it is common to have a baby between 9½ and 10 months, as a larger infant is preferred. They also believe that it is up to Allah to decide when the baby is to arrive. Techniques are used to facilitate progression of labor and pain management, such as position changes,...
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...Medically Elective Caesarean Deliveries; Risks vs. Benefits Jason LeBeaú College of Du Page County Complex Medical Surgical/Leadership Nursing NUR206 17 October 2012 Medically Elective Caesarean Deliveries; Risks vs. Benefits Introduction Women have been giving birth for millions of years. Before the advent of technology, women just instinctively knew when it was time to give birth and their bodies did the rest. They trusted that their bodies were meant for this purpose. Midwives and village elders would come to be with the laboring mother and to help her through the process. Vaginal birth was not only considered the normal way of birth, it was also the only way of birth. Vaginal birth is no longer the only choice when it comes to delivering a baby. Cesarean deliveries (CDs) are now a lifesaving strategy. CD is a surgical procedure in which a doctor in an operating room makes an incision through the mother’s abdomen and down to the uterus. The baby is removed from the uterus and the uterus and abdomen are then closed with sutures. This takes place while the mother is awake and made numb from the waist down by either a spinal or epidural anesthetic. In emergency situations, a general anesthetic is used and the mother is put to sleep and is unconscious for the procedure. CDs were originally used to save the life of the mother, save the life of the baby or when a vaginal delivery wasn’t possible. Since the birth of CDs, they are now performed for...
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