Things to Think about When Choosing an Obstetrician

Recently I was doing a Non-Stress Test (NST) on a patient in our antepartum testing center. Her amniotic fluid level was below 5cm, so I was waiting for the physician to call back with orders to send her to labor and delivery. Turns out her physician was not available, and the "on call" MD was a physician that the patient didn't know.
Cindy(not her real name) looked at me and remarked, "I thought MY doctor would always be the one to deliver me."
This was not the first time a patient had this reaction. Which prompted me to write this blog.

Things to think about:

1. If your OB is a single practioner:  Does he/she do all their own deliveries?
    ( Meaning being available 24 hours, 7 days a week.)
    My experience tells that this is RARELY the case.
    Some OB's have very small practices ( less than 10 pts/month)
    so this may be possible.

2. If your OB is a single practioner and does share call with other MD's,
    who are they?
    How does the call schedule work?
    Do they share your doctor's standard of care?
    How does your OB communicate with them ?
    Since the "on call"  MD is not physically affiliated with the
    private practioner, most rely on the "Prenatal Records"
    to provide the information. 
    If you have a birth plan, special requests,etc.,
    ask physician to attach a copy to your prenatal forms.
    This information is then delivered to the hospital L & D Unit
    where you plan to give birth.
   
    A good idea is to ask for your own copy of the "prenatals" @ 36 weeks.
    If you are ever in a situation where you can't get to your
    planned hospital having this information in your purse
    will be valuable.

3. If your physician practices within a "group," you still need to ask
    how the call schedule works.
    Usually your MD will deliver your baby if you give birth
    during the business day.( 8am-6pm )
    Then the "on call" doctor takes over.
    Some OB/GYN groups share call with other OB/GYN groups.
    That means you may know the doctors in your group,
     but may have to spin the roulette wheel on the others.


    The hospital I work at has several group practices
    and single practitioners. Poor MD/Patient communication continues
    to be an issue.

    My recommendation: Never Assume Anything! Always Ask!
    It is your right to know.

Fear, Hope and God's Grace- My "Shawshank Redemption"

As I sit here today, I can't help but feel blessed.
I've been on a journey for what seems like my lifetime.
My parents divorced when I was a 7-8 year old child. My memories of my biological family are few.
Whatever "photographic" evidence my mother had was destroyed. I remember looking at pics where my father's face was torn out.  Eventually those pictures disappeared altogether. I don't blame my mom. It is what she needed to do to move forward. I know she felt she was protecting not only me, but my sisters. To this day, she just says that I have no idea how awful her marriage was.
For me, it left a void in my life. Mom remarried and we were adopted by the man I consider my father. (Though not right away.) My paternal biological family was "those whose name shall not be mentioned."
And for many years that was the case. However, mom would tell my sisters and me that our biological father "never loved" us.
As I grew into adulthood and became a mother myself I sought "therapy." I couldn't fathom a parent not loving their child. I found it difficult to trust my men in my relationships. I thought that one day they would leave me. I felt I was "unlovable" no matter what evidence/reality was right in front of me. My greatest fears were/are abandonment and rejection. In fact, those fears propelled me in many life decisions.

I decided to reach out to my paternal biological family. Thanks to the internet and social websites, I  connected with them. I was fearful that no one would answer my e-mails. I thought I had accepted that possibility. What I couldn't admit was my buried yet palpable fear of rejection. I remained so cool/cavalier on the outside but internally there was a knot in my stomach. I prayed & gave it up to God and  then "Let it Be." All I could do was hope.

Through God's grace, the family responded. It wasn't until this morning that I realized how relieved I feel. The little girl in me feared rejection. That little girl cried this morning because indeed... "Fear CAN hold you prisoner...Hope can set you free!" God is Good!

National Nurses Week: May 6th-12th 2010

Today is National  Nurse's Day. My hospital will recognize nursing care with a Luncheon/Dinner.

"NURSING YESTERDAY, TODAY AND TOMORROW"

Driving transformation in our community's health care

A Cirque du Soleil Celebration especially for you!

I didn't realize how funny that title was until I wrote it here. Sometimes being a nurse does feel like a "Cirque du Soleil."  I do find myself spinning, bending, juggling and flexing to provide excellent care for patients! Kuddos for the humor! But I digress. This Blog Post is about trying to celebrate Nurses', Mom's, Dads, Love, etc., for 1 day. Don't get me wrong, I do enjoy the yearly recognition, but what about the other 364/365 (leap year) days?

At the yearly party, nurses' are treated to great food, SUPERB desserts buffet 

(cookie, candy, cake with take home boxes) and a raffle. Unfortunately I can barely do this within my 1/2 hour lunch. Sometimes the unit is so busy other nurses bring back food to share. Each nurse used to get a little "gift." The gifts were pretty funny and mostly useless, so the nurses voted to donate the money spent on those gifts to a local charity.( Isn't that just like us?)

While I enjoy all of this fanfare, I would give it up for more consistency year round by the administration. I want to have more communication from management. Communication that treats me like the professional I am. Communication that promotes change. Honest Communication that speaks loudly to my value to the healthcare team. I believe management suffers from inertia. By that I mean that their focus appears to be on the "brick & mortar," & gaining certifications such as "MAGNET,"( I know those are the foundation for the hospital.)

but I believe the administration could do more to promote nursing " well-being " year-round.

However,even as I write this, I realize that the appreciation for nursing & change has to come from within the "rank and file."  Change begins/comes from within each nurse.

 In view of that I'd like to share the following piece by Donna Cardillo RN,MA, in NurseWeek.

The word “Zen” is often bandied about. Although many definitions of Zen exist, it’s simply the art of being present in everything you do, giving full attention to each action, each interaction, each task. Unfortunately, we often are mentally on to the next thing before we have finished what we’re currently doing, thus shortchanging the task at hand. How can you adopt a Zen philosophy in nursing? Here are seven suggestions:

Set your intention each day. Before going to work, decide what you wish to accomplish, not in terms of tasks or projects, but in terms of an overall philosophical goal. For example, your intention might be to be patient with everyone you encounter — staff, family members and clients — and consider that they all are carrying a heavy load. Your intention can be the same each day or take a different focus.



Ground yourself. Take at least five minutes before your workday (and during the shift as necessary) for meditation, prayer and contemplation to center yourself. Spending even a few minutes with your eyes closed or cast downward, focusing on your breathing, connecting with your spirit will help you stay in touch with your inner voice and wisdom. Grounding brings you into the present moment rather than projecting into the future or obsessing about the past. A racing mind that reacts sensitively to little things has lost its spiritual power. Meditation restores that.



Create good karma. The word “karma” is derived from the Sanskrit word kri, which means “action.” It is the universal law of cause and effect that says every thought, word and act carries energy into the world. Therefore, do not judge or criticize others. Absolve not to partake in gossip or negativity of any type. Look only to help, support and encourage. Your thoughts and actions directly impact your environment.

Affirm your path. Remind yourself daily of the sacredness of your work — your chosen life path. It is truly a privilege to walk the path of the healer. Although the road may be rocky and steep, the destination is worth the journey. You save lives. You help bring new life into the world. You are there to ease the transition when life departs the body, and are there for every other aspect of the life cycle. Your work has value and meaning.



Aspire to new heights. Each day, consider how you can become a better person and a better nurse. Always be moving forward in your career and life, looking for ways to improve, to bring new positive energy into your world. This might involve learning a new skill, taking a class, getting more organized, being more generous and so on.

Be mindful in everything you do. When you are with a patient, focus only on that patient for that time and be more aware of every aspect of him or her. To be mindful is to be truly alive and present with those around you and with what you are doing. Even routine tasks can become a meditation of sorts.



Tap into abundant energy. The universal life force, also known as chi, is present in every living thing. It flows freely in us when we eat healthy food, get proper exercise, breathe clean air, live and work in an uncluttered environment, and avoid negativity. Taking care of yourself, including using modalities such as Reiki and massage therapy in your self-care routine, will help to keep you energized and doing your work at the highest level.



http://news.nurse.com/article/20100503/DD01/105030020