Tag: education

The Things You Do Make a Difference

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Traciby, Traci Turchin

“But we had this for dinner LAST night” the five year old says.  My joke with the nine year old falls flat because he’s too busy sighing over his lack of clean socks.  “That’s IT!” I tell my husband with a wink, “I’m running away from home and going to work where I’m appreciated!”

I’m one of the luckiest nursing students in the world.  By day I drown in books and deadlines and elementary school paperwork and laundry, but by night I work as a CNA at the birth center of my local hospital.  I know, while the little efforts at home might go unnoticed, no small kindness is missed by our patients. 

We tuck those small kindnesses into our hearts and carry them around, forever grateful. Continue reading →

Top Ten Misconceptions About the Use of Nitrous Oxide in Labor

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by Michelle Collins, PhD, CNM, FACNM

The use of nitrous oxide as a labor analgesic has taken hold in the US in the past three years. It has been used widely in Europe for decades, with favorable results, along with comes educational information but all the perpetuation of myths.

10. Using nitrous oxide in labor is “just like” when you use it at the dental office. It’s not. In dental offices, the concentration of nitrous oxide to oxygen is variable, so the dentist can increase or decrease the concentration based on the patient’s needs. Dentists may use concentrations of nitrous oxide of up to 70%. The dentist also places a small mask over the patient’s nose, through which a continuous stream of nitrous oxide is delivered.

During labor nitrous oxide is only used at concentrations of 50% nitrous oxide to oxygen – no higher. And the stream of nitrous oxide is intermittently administered by the woman herself using either a mouthpiece or mask with a demand valve. The demand valve opens only when the woman inhales (breathes in) – which is when the gas is released. When the woman exhales (breathes out), the valve closes and the gas stream is stopped.10 Misconceptions about Nitrous Oxide in Labor

9. You will be confined to bed while using nitrous oxide. You will still be able to move around while using nitrous oxide during labor. About 10% of nitrous users may experience some dizziness, so your care providers will want to see you stand or move about without difficulty before they let you up on your own, but many women use nitrous oxide while standing, squatting, sitting in a rocking chair, or on a birth ball.

8. Continuous fetal monitoring will be required with nitrous oxide use. Whether you have continuous or intermittent fetal monitoring should be dictated by your obstetrical status, not because you are using nitrous oxide. In other words, if you are a candidate for intermittent monitoring, that does not have to change to continuous monitoring just because you begin using nitrous oxide.

7. If you choose to use nitrous oxide, you cannot use any other pain medications. A fair number of women who start out using nitrous go on to have an epidural placed at some later point in their labor. Using nitrous oxide earlier on allows you to maintain your mobility and stay upright, allowing the baby to move down well in your pelvis before being confined to bed with epidural anesthesia.

6. Nitrous oxide will stall your labor, or slow contractions. There has not been any research showing that nitrous slows down labor or causes contractions to be less strong or happen less often.

5. Nitrous oxide will harm the baby. Nitrous oxide is metabolized (processed) in your lung tissue, but because some of the gas passes into your blood stream, some can also pass through the placenta and go to your baby. However, studies have not shown adverse effects on babies of mothers who have used nitrous oxide in labor.

4. There is a point in labor when it is too late to use nitrous oxide. Actually, some women don’t begin using nitrous oxide until they are in the pushing stage. Other women don’t use it at all during labor, but find it very helpful if they need repair of any tears in their birth canal.

3. My family members can assist me with holding the nitrous oxide mask or mouthpiece if I get tired of holding it. As well-meaning as family members are, this is one area where they can’t help. A safety precaution for nitrous oxide use is that the laboring woman holds her own mask or mouthpiece. When she has had sufficient nitrous oxide, she won’t be able to bring her hand holding the device to her face. Allowing someone else to hold the mask/mouthpiece overrides this safety feature of nitrous oxide.

2. Nitrous oxide is offered at many hospitals and birth centers. Until 2011, there was really only one hospital in the US offering this option. Since that time, use of nitrous oxide has dramatically increased and there are currently over 100 hospitals and 50 birth centers offering nitrous oxide. Though it has come a long way, there is a long way to go to ensure that every woman who desires to use nitrous oxide in childbirth, has the opportunity.

1. Nitrous oxide makes you laugh (hence the nickname “laughing gas”). Despite the nickname, inhaling nitrous oxide doesn’t leave women laughing like hyenas! Because nitrous oxide decreases anxiety, it puts women more at ease and they may be more talkative and relaxed… but don’t count on side splitting laughter!

Michelle CollinsMichelle Collins is currently Professor of Nursing and Director of the Nurse-Midwifery education program at Vanderbilt University School of Nursing. In addition to the teaching and administrative aspects of her job, she maintains an active clinical practice as part of the Vanderbilt School of Nursing faculty nurse-midwifery practice.  Currently she is a blogger for Nashville Public Television for the popular series Call the Midwife.

Resource on Nitrous Oxide For Nurses

AWHONN has a Nurses Leading Implementation of Nitrous Oxide Use in Obstetrics webinar to describe the history of nitrous oxide use to present day and the necessary steps nurses need to take to initiate nitrous services at their institutions.

Nitrous Oxide as Labor Analgesia, Nursing for Women’s Health, Volume 16, Issue 5, pages 398–409, October / November 2012.

Our Nurse Changed Our Lives

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Jessica_Familyby, Jessica Grenon

When I think back to the birth of my second child earlier this year, tears almost instantly begin to fill my eyes.

Unlike the birth of my first child three years prior, this isn’t because I am overjoyed by thoughts of holding my baby against my chest for the first time while I stare in awe at the life my husband and I created, a life that I grew in my own body and delivered into the world after many, many hours of hard labor. Instead my eyes fill with tears because I think of my labor and delivery nurse and how I believe her actions on that day affected the trajectory of my life, my son’s life, and the future of our family.

I am not a nurse, I don’t even work in the medical industry, but for the past nine years come June my work has brought me to the annual AWHONN convention, where I support the online system used by those submitting proposals and assist presenters’ presentations. Through this work I have read hundreds of abstracts and watched dozens of presentations on standard topics such as home births and skin to skin care for newborns, to more memorable subject matters like how to care for a vaginal piercing during a delivery.

My work with AWHONN does by no means make me an expert in the field of labor and delivery, but on January 30th of this year, I had gained enough knowledge from working with AWHONN to know what the possible outcomes could be when something suddenly went wrong during the birth of my son.

After 13 hours of laboring in the hospital, the time had finally come to begin pushing. Not yet knowing the gender of my child, I felt extra encouragement to push as hard so I could finally meet my baby. It took only 21 minutes of pushing to hear the words, “only one more push, Jessica, and you will be able to hold your baby!”, however, that was quickly followed by a sudden shout to stop pushing.

Stop pushing, but why? I looked down and between my legs I could see the head of my baby, turned toward my inner right thigh; he was silent and lifeless. Right away I knew that it was shoulder dystocia, and like any mother, my mind went to straight to thinking about the worst case scenarios. Was my baby getting oxygen, would he have brain damage? Is his shoulder going to be broken? I don’t care if he has broken bones, bones heal, just make sure he can breathe! Just last June at AWHONN a presenter and I had a conversation about shoulder dystocia, what was it that she said the other outcomes could be?

The next few minutes were all a blur me screaming at the doctor to help my baby, my husband kissing my head and doing the best he could to stay strong for the two of us, the student midwife attending her first delivery still holding onto my left leg waiting for someone to give her instructions and then there was a voice that I will never forget. Then the firm voice of my labor and delivery nurse as she turned to the doctor and said, “Doctor. Would you like me to call for another set of hands?” I got the sense that she wasn’t asking for permission, but rather she was politely informing the doctor of her intent to ask for assistance because she knew it was needed.

The doctor nodded as my nurse instantly took one side step closer to my head, she looked me straight in the eyes and smiled as she pushed the call button for the nurse’s station and requested another attending physician join us in my delivery room. A moment later the door swung open and the already crowded room began to fill with more people. In an instant, my nurse and another doctor were in the delivery bed with me, pushing on my low abdomen , doing all they could to change the position of my baby.

In this chaotic scene I once again heard that firm voice calmly say, “Doctor. Would you like me to call in a NICU team?”. The doctor nodded yes and soon a NICU team stormed into the room to wait for my son to be born to take over his care.

At the end of this ordeal, I was blessed with a perfectly healthy child; not one bruise on his body, no torn muscles, no broken bones, and no lack of oxygen to his brain. He did stay in the NICU for two days to be supervised for a potential infection, but otherwise all 10lbs, 5ozs of him was unscathed during his traumatic birth .

It may have been my doctor’s hands that brought my son into the world, but it was my nurse’s voice that I credit for my son’s health and our future without the need for further medical treatment.

Would my son have been fine if he were stuck during the birthing process for another couple of minutes? I don’t know. Fortunately because my labor and delivery nurse spoke up during a time of crisis, I don’t have to find out.

JessicaJessica L. Grenon is the Director of Continuing Education Services at The Conference Exchange, where she has worked with AWHONN since 2007. She, her husband, and their two young children enjoy traveling and spending time with their extended family, especially with her twelve nieces and nephews.

 

Resources on Shoulder Dystocia

Definition: Shoulder Dystocia is the impaction of the fetal anterior or posterior shoulder behind the material pubic symphysis resulting in delay in a cephalic vaginal delivery. This creates a high-risk intrapartum complication affecting both mother and baby.

For Parents: Health providers can’t always predict or prevent shoulder dystocia, but there are some risk factors you can learn about.

For Nurses: AWHONN has a Shoulder Dystocia online product to help prepare clinicians for this level of critical care event.

Beginning Breastfeeding, Breaking Down Barriers

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by, Summer Hunt

You’ve heard it time and again: Breast is the best. But many moms-to-be express concerns over breastfeeding, from doubts about their abilities, to time constraints, and everything in between. However, moms who have experienced challenges and broken down breastfeeding barriers will tell you this—it’s worth it.

Same goal, different struggles

Erin Lee and her family

Pictured above: Erin and Hung Lee with Emersyn, Paxten and Mylo

Pictured above: Erin and Hung Lee with Emersyn, Paxten and Mylo

“Just because something is natural doesn’t always equal easy,” says Erin Lee, RN, BSN, IBCLC, mother of three. As a registered nurse (and now a board-certified lactation consultant), she was fully aware of all the benefits and knew that she would breastfeed. What she couldn’t predict, though, was how many bumps in the road she would encounter.

“I had a long intense labor, and they had to use some suction to get my daughter out,” she explains. “She had a strong oral aversion, and I had flat nipples, which made latching almost impossible. On top of everything else, she was extremely jaundiced. I wanted and needed to breastfeed her, and I was determined to—but it wasn’t easy to get started.”

Lindsey Grissett knew before her daughter was born that she would breastfeed. “It was just something that made enough sense to me not to question,” she says. “I was further encouraged to educate myself on it by both my doctor and my husband.” Birthing at a Baby-Friendly® hospital meant Lindsey had a lot of support. “I was signed up for breastfeeding classes well in advance, and I don’t think I had a single question go unanswered,” she says. “I felt both mentally and physically prepared.” Shortly after giving birth, baby Emma latched right on as both mom and baby got the hang of things.

Breastfeeding wasn’t without its challenges for Lindsey, though. “There were times when I would stand in the shower, stare at the wall, and wonder how it was possible for an individual to function on so little sleep,” she recalls. It felt like the baby was hungry all the time… I was exhausted.” Lindsey learned a lesson in patience and teamwork as mom and baby found their rhythm. “It’s a process—you have to use different hand movements, massaging your breast to get the milk flowing while trying to get her mouth in the right place… or else all that hard work literally just leaks away.”

Finding help when you need it

For Erin, having the support of an International Board Certified Lactation Consultant® (IBCLC) made it easier to focus on one thing at a time. “Even though I’m a nurse, she saw things I couldn’t see,” Erin says. “She realized my daughter was jaundiced. She also helped me establish smaller goals instead of worrying about getting her to latch. I pumped my milk so we could focus on feeding her and getting her to gain weight. Then we worked on overcoming her oral aversion, and then… she latched!”

Lindsey Grissett

Pictured above: Lindsey and Raymond Grissett with Emma

Lindsey agrees that a lactation consultant was a huge help. “They called a few days after being discharged, asking if everything was going okay. They set up appointments for me to come in, show them my progress, and make sure she was taking in enough.” It was a lactation consultant who recognized that Lindsey’s baby girl was also jaundiced, she adds. “Several months after I had Emma, I still received phone calls to see how I was doing. I was so well taken care of!”

An indescribable feeling

While you can read a bundle on the benefits of breast milk, there’s one thing that you can’t find in a class or a book—the physical and emotional closeness that develops between mom and baby. “The bond you feel while you’re feeding your baby… it’s incredible,” Erin says. “Until you experience it, you can’t know how powerful it is.”

“The most valuable thing about breastfeeding was definitely how close it brought me to Emma,” Lindsey says. “There so many times when I just wanted to sleep, or eat, or shower in peace… but even when I was at the end of my rope, it was such a great feeling knowing that she needed me. That was my motivation to keep going.”

Turning lemons into… breast milk?

After a difficult breastfeeding journey, Erin knew she could use her experience to help other women. “I was working in pediatrician’s office, and I shadowed the IBCLC there, seeing the moms and babies come in, some of them having the same issues I did. I wanted to help them overcome it—I became very passionate about it.” She became an IBCLC in 2013, and in 2015 she cofounded a private practice lactation business.

“Most people will encounter some sort of struggle,” she says. “For some it might be a few days or weeks, others might take months to get the hang of it. Just because the baby doesn’t latch right away, or you have a little discomfort at first doesn’t mean it’s the end. With the right support system, you can do it. It’s so empowering—being able to provide this essential need for your baby.”

For first-time moms (or first-time breastfeeding moms), Erin offers up this advice:

Educate yourself. Not just about the basics of breastfeeding, but also on normal infant development. The more you know, the more prepared you’ll be for what’s to come.

Build a support system. Find a health care provider that’s supportive of breastfeeding and understands that it’s something you want. Find an IBCLC, and attend La Leche League meetings even before you give birth. Talk to your mom if she breastfed, or your friends who did – these are the people you’ll be texting at 1am when you’re at your wit’s end and you need someone to tell you it’s going to be okay.

Be gentle with yourself. Your only job right now is to nourish your baby. The rest of it, cleaning the house, putting dinner on the table, losing baby weight… it can wait. You take care of your baby—everything else will fall into place.

 

Summer Hunt

 

Summer Hunt is the editorial coordinator for publications at AWHONN.

 

 

 

Resources for Moms

Ask Our Nurses: How Will My Baby and I Begin Breastfeeding? (video)
Ask Our Nurses: How Do I Prepare For Breastfeeding? (video)
How to Overcome the Challenges of Breastfeeding (article)
Breastfeeding Fixes (article)
Download our brand-new Breastfeeding Parent Pages here.

Erin Lee, RN, BSN, IBCLC has worked as a registered nurse in the Pediatric Intensive Care Unit at Boston Children’s Hospital, Georgetown University Hospital and All Children’s Hospital, among others. She is the cofounder of Suncoast Lactation Consultants in Bradenton, FL, where she lives with her husband and three children.

Lindsey Grissett is a mental health community court liaison in Anniston, AL, where she lives with her husband and daughter. She enjoys working out, traveling and hanging out with her family,  and watching her little girl grow.

Pregnancy test

Trying to Conceive After Miscarriage

Aimee Patrick and Charlieby Aimee Poe

My husband and I always wanted a family. The summer before I turned 29, we decided to start trying. Little did we know there would be a roller coaster of a journey ahead.

I got my first positive pregnancy test in September. I knew my life was about to change. I quit smoking, which was a huge deal for me. My husband and I were thrilled. At my first ultrasound, there was silence. The verdict was devastating: I was miscarrying due to a blighted ovum.

My doctor advised me to wait two full cycles before trying to conceive again. I didn’t track anything; I just guessed at when I was going to be ovulating. In February, I got my second positive test. Though nervous, I had a better feeling, thinking the odds were low I would have a second miscarriage.

We picked out names, I looked at birth plans, and at 8 weeks I started building a baby registry. We were cautious to share the news, waiting to tell even our parents. On March 20, one week after announcing our new addition, I went to the restroom and noticed blood. I immediately fell on the floor crying. In that split second, my dreams of our family were crushed.

When they did the ultrasound in the emergency room, they wouldn’t let me see the screen, saying only that they couldn’t detect a heartbeat. I felt like I died inside. My doctor ordered a D&C (dilation and curettage) and told us to wait two cycles.

This time, I took ovulation and trying to conceive (TTC) seriously. I continued taking prenatal vitamins, educated myself, and tracked my ovulation with digital ovulation predictor. The moment I saw the little smiley face letting me know I was ovulating, I told my husband it was go-time! The two-week waiting period after that felt even longer than the two cycles we had to wait to start trying again.

Aimee and PatrickOn July 11, I got my big fat positive! I called my husband, and then I called my mom, who was so supportive. I had a form of PTSD after dealing with two miscarriages, and I didn’t want to tell anyone I was pregnant, so as to avoid the embarrassment.

At 6 weeks, I had my first ultrasound. When we saw that tiny little heartbeat, I cried. My doctor put me on progesterone. We had our next ultrasound at 11 weeks, and there was our baby, active and wiggling around. It was amazing! I wasn’t used to seeing my ultrasounds. Every time I saw my baby felt like a miracle. We learned my due date was March 20—the date of my second miscarriage. Everything was coming full circle. Even more exciting, it was a boy!

CharlieAs badly as I wanted to meet my son, he was even more anxious: At 34 weeks and 4 days, Charles David Poe made his appearance. His birthday is February 9, the same date I had my second positive pregnancy test the year before. Tiny but strong, Charlie came into our lives so fast and has made it indescribably beautiful. It was beyond worth it to have gone through all the turmoil of TTC to get to this amazing part of my life.

Aimee and Patrick maternityAimee Poe is an experience specialist at Verizon. She loves playing video games, watching movies, hanging out with her family, and flexing her creative muscle with various projects.

 

 

Nurse expert and Healthy Mom&Baby Editorial Advisory Board member Susan Peck, MSN, APN shares her best tips for those trying to conceive.

  1. Timing is key. “Many women don’t know there is a small window of opportunity each month for conception to occur. Talk to your health care provider about how to predict ovulation based on the length of your menstrual cycle—there’s an app for that!”
  2. Quality, not quantity. “Couples may not realize that having sex multiple times a day can actually lower sperm counts. I usually recommend daily or even every other day during the few days before during and after ovulation.”
  3. Patience is a virtue. “If you don’t get pregnant right away after going off birth control, that doesn’t always mean something is wrong. Most couples will take 4-ish months or so before conception occurs.”
  4. Plan ahead. “Preconception care is so important. Talk with your health care provider about any health problems you have that could affect pregnancy as well as the safety of any medications you take.  You may need to switch medications while trying to get pregnant. You can reduce your risk of neural tube defects by beginning a prenatal vitamin which includes 0.4 mg of folic acid before getting pregnant. Now is also the time to quit smoking.”
  5. Leave the lube. “Using a lubricant during sex can make it harder for the sperm to swim the long distance to the fallopian tube. If you must, try using a sperm-friendly lubricant like Pre-Seed instead.”

5 things that nurses wish all parents knew about newborn screening

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by Emily Drake, PhD, RN, FAAN

  1. Newborn screening saves lives.  In the first few days after birth, clinicians screen newborns for over 30 rare but serious diseases, most of which are easy to treat with diet changes or other treatment.  This screening, along with early intervention, can save babies from death or disability. Your baby’s pediatrician works with the state health department to ensure that this screening is done.  Many professional organizations including the Association of Women’s Health, Obstetric and Neonatal Nurses support newborn screening.

Continue reading →

Postpartum Recovery Tips for Moms from Our Nurses & Midwives

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In preparation for your new arrival it is likely you will take classes, read books and get advice from friends and family on how to take care of your new baby.

What you can easily forget in all the excitement is that you take care of yourself too!

To help you focus on YOU, we recently asked our nurses and midwives what postpartum recovery advice they give their patients.

We received advice for you from over 100 nurses!

Take note of the clear themes – limit visitors to take that time to bond with your new baby, accept help from others, do skin-to-skin and sleep when the baby sleeps!

Good luck in all your new parenting adventures!

Postpartum Care Tips from Nurses and MidwivesTop 20 tips from our nurses and midwives:

  1. Absolutely choose a hospital for the care you will receive and not the new beautiful building. You’re much more likely to receive a positive birth experience and the education you receive from your postpartum nurses will make all the difference in the world.
  2. As a former postpartum nurse, I noticed how often new mothers put their needs last. It seems often families look at postpartum time as party time. I have seen c-section moms sleeping in the same room as 15-20 family members talking loudly and passing baby around for hours. My best advice is for new mothers to have 1-2 designated family helpers to be there to help care for baby while she gets much needed naps throughout those exhausting first days. Baby’s hunger cues are often missed when there are too many visitors for long stretches of time. It is difficult for new mothers to set limits.
  3. Don’t be afraid to ask people to leave. I have seen so many new mothers that are worn out from feeling like they cannot turn people away. Turn off your phone too. I wish I did for the first couple of days.
  4. Breastfeeding is an acquired skill for you and baby, be prepared to be patient and try, try again. It is a wonderful thing for you both, but needs to be learned. Do not suffer in silence, please contact your OB/midwife for lactation nurse help/referral if you are having difficulty with latching and/or very sore nipples.
  5. Sleep when baby sleeps.

  6. If you had a cesarean, take a pillow for the car ride home to support your incision for the bumps in the road.
  7. Use the Dermoplast (benzocaine topical) spray before having a bowel movement…it’ll make the process a whole lot more comfortable and a lot less scary.
  8. If someone offers to come over so you can shower, take them up on it.  For c-section moms remember not only did you have a baby, but you had major surgery.
  9. Trust yourself and your instincts. Pick and choose the advice, tips, expert advice etc. that works for you. And know that if you’re worried about being a good mom, you already are.
  10. Padsicle! Pad, ice pack, tucks, then a spray of Dermoplast.
  11. Know your body. When you get home, use a hand held mirror to look at your perineum or you cesarean section incision. This way, if you experience problems, you will have a baseline to know if something is different, for example: increased swelling, redness, tenderness, or drainage from incision. It is helpful in knowing when to contact your physician with these issues.
  12. Limit your visitors. You will not get this time back. Use it to bond as a family, seek help with breastfeeding. Skin to skin is the best bonding tool! We want to help you succeed with breastfeeding. You can press your call light for every feeding if you need to. Your baby needs your love and protection. You are your baby’s primary advocate. Not all mothers’ choose to or are able to breastfeed. How you feed your baby is your decision and your nurse will support you. Ask visitors to wait until you’ve been home for at least a couple weeks. Settle in, recover. Don’t be afraid to ask for help. If someone wants to visit, ask them to leave their little ones at home.
  13. Sleep when the baby sleeps. Keep drinking water to flush out the excess fluids and keep hydrated. Accept help from anyone willing to cook a meal, run errands or do housework so you can rest and spend more time enjoying your new baby. Get outside for a walk. Fresh air and activity help to restore and rejuvenate sleep deprived minds and bodies as well as improve the blues!
  14. While planning your new routine, ask someone to watch the baby for an hour of each day for you to spend as you please.
  15. Good nutrition is key. Have a healthy snack each time you feed baby if you don’t have an appetite. Try to get a good four hour blocks of sleep several times a week. Ask support people to change, burp, comfort baby and only bring baby to you for breast feeding to extend your sleep when tired. Have a good support system and don’t be afraid to ask them for help. Soak up the sun when you can. Have an enjoyable activity to look forward to each week. Try to get out of the house, but if you can’t do something you enjoy at home or pamper yourself. Relax and enjoy your baby. Use what works for you and don’t try to follow everyone else’s advice.
  16. Accept offers of help and assistance with meals, cleaning etc. I tell father’s to give moms one uninterrupted hour to herself each day. She can bathe, sleep, read, or anything that she wants for that hour. Daddy needs time to get to know baby too!
  17. When you get home, set visiting hours and have each visitor bring groceries or food (they’ll be thrilled to get what you need). And stay in your pajamas. Most people will be less likely to overstay their welcome.
  18. Once “settled” in with the baby reach out to a Mother’s group ( stroller club, baby sitting co-op, Mommy and me Gym or Yoga class), to get out of the house and receive and provide support to other new Mom’s.
  19. Give yourself a break. Sit at the bottom of the shower and cry if you need to every now and then, parenting is hard work. Learning to breastfeed is hard work and so is incorporating another member into your family. Sleep deprivation and shifting hormones will, in fact, make you feel crazy at times but it will get better. You will find your new norm. It’s not all cute onesies and hair bows, it’s more like poopy onesies and newborn rashes, and that’s ok.
  20. You’re stronger than you think! Don’t worry about what others might think. Enjoy every moment.  Parenthood is a beautiful experience. Allow yourself grace & room to grow.

Do you have advice for new moms as well? If so let us know. We’ll keep rolling out the advice.

For additional resources for mom visit our Healthy Mom&Baby website!

Tools for Survival as a New Nurse in the NICU

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By Lori Boggan, RN

It has been an amazing eleven year journey working as a neonatal nurse. The journey has taken me across the United States and beyond. Being a nurse has enriched and changed my life in so many ways. For that I am eternally grateful.

I still recall my first job. I felt like an impostor in my uniform.

I didn’t feel like a nurse because in my mind a nurse was someone who could start an IV blindfolded, resuscitate a patient while sleeping, and recognize all the signs and symptoms of septic shock at the drop of a hat.

Little did I know that there is no perfect nurse. There are nurses who are born skilled, those who are walking encyclopedias, and those who have the kindest hearts.

Combine all this and it’s almost like catching a glimpse of big foot, the tooth fairy, or even a leprechaun. With this in mind, the following are just a few recommendations for new nurses in the NICU…

Find your mentor
A mentor is a nurse that takes you under their wing and guides you. It may not be the mentor you were assigned to on your new unit, but you will find him/her. It often happens naturally. You find that nurse that loves to teach and your personalities just click. They are part teacher, part life coach, part parent or sibling, and eventually friend. They are the nurses you aspire to be. I have a trail of them across the globe.

Lori and her mentor Mary

Lori and her mentor Mary

You will be tested
The doctors will test you, the nurses will test you, the respiratory therapists will test you, and the parents will test you. It’s ok. It is normal. You have to prove that you have some clue, which you do! Trust me, you do! And with that, always trust your instincts.

Take care of yourself on your days off
Use your days off to enjoy your life outside of work. You work in intensive care. You need to find some outlet that has nothing to do with your job. Meet up with your friends, get a massage, run if you run, yoga if you yoga.

Handle with care
Our tiny patients are so delicate. No matter how stressed or rushed you are, handle them gently. Handle the parents gently. They are in shock and grieving. They need you.

Wash Your Hands
Hand washing still is the single most important thing you can do for your patients. Patients are still contracting and succumbing to hospital-acquired infections even in our most technologically advanced units. Our tiny patients have little to no immune defense.

Don’t Forget
When new nurses come through the door after you’ve worked a year or two, remember that you were there not long ago. Welcome them, mentor them, don’t talk about them when they leave the room. Be the positive example in your unit.

Welcome to the nursing profession! Best wishes on this exciting journey!

img006Lori is a NICU Staff Nurse  at Sahlgrenska University Hospital in Gothenburg, Sweden. After becoming a nurse, Lori traveled across the country to work a three-month travel contract in San Francisco, California.  Nearly five years later her journey continued to Gothenburg, Sweden, where she now lives and works.

5 Q&A about Inducing Labor from our CEO

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We asked moms what questions they had about inducing labor and Lynn Erdman our CEO answered back.

  1. My girlfriends told me that having labor induced is the safest, and certainly most convenient, way to have my baby, but my nurse is saying that waiting for labor to start on its own is the safest. Which is true?

Many people don’t realize that undergoing labor induction for any reason is associated with immediate and long-term health risks. Induced labor can lead to excessive postpartum bleeding (or hemorrhage), which in turn, can increase the risk for blood transfusion, longer hospital stays, hysterectomy, more hospital re-admissions and, in the worst cases, death. Induction is also associated with an increased risk for cesarean birth. Cesareans increase a woman’s  risk for infection, problems with how the placenta implants in future pregnancies, and life-long pain from abdominal adhesions.

AWHONN recommends against inducing labor at any time during pregnancy unless it is medically necessary, because a woman or her baby have problems. The medication used to induce labor is a manufactured hormone and a type of drug that bears an increased risk for causing serious patient harm when used in error. With the increasing use of labor induction and its resulting complications, it’s more apparent than ever that we must improve our understanding of the health consequences of administering artificial hormones, especially to vulnerable populations like pregnant women and infants. The short- and long-term health risks are just too serious to undergo labor induction when there is not  a medical need. Continue reading →