I don't understand what you are asking exactly. Is this a homework assignment, general interest or are you having a c-section?
The L&D nurse assists the doctors and anesthesiologist in the O.R., usually they scrub and prep the pt for surgery as well but sometimes the OR tech do that. They help count the instruments afterwards and do paperwork. The patient is sewn up by the doctors and the L&D nurse takes pt to recovery area for a few hours and monitors their vitals and general condition, administering meds and fluids as necessary (and paperwork of course)
I take care of moms after c-sections every day at work. Generally the mom is recovered for two hours in the O.R. until she is stable, then brought to postpartum where she is reunited with the baby (baby is bathed and assessed in the nursery). Mom has an IV running with fluids containing pitocin to help uterus contract, a foley catheter in to drain urine from the bladder, a pad applied to catch blood.
It is the nurse's job to: take vitals every half hour for first hour, then every two hours for four hours, then every four hours, give antibiotics if prescribed, change and maintain IV site/dressing/bags/tubings, assess the patient, make sure abdominal incision is dry, approximated, dressing is dry, treat patient with pain meds, antinausea medications, assist with breastfeeding, listen for bowel sounds, empty the catheter, chart accurate intake/output, change patient's bloody pad in bed when she cannot walk yet, ambulate patient within 12 hrs after delivery (minimum), discontinue IV fluids when tolerating oral fluids, discontinue catheter at 18-24, assist patient to breastfeed, assist patient to the bathroom, familiarize patient with hospital policies/procedures, basic infant care and feeding, self care, post-surgical care instructions, what to expect re: recovery (gas pains, incisional pain, four day hospital stay, don't drive for two weeks, no heavy lifting, appt with provider at 2 wks and 6 wk mark)
And this is assuming everything is going well. Things go wrong too: pt has pain control issues, very nauseated, is bleeding or hemorrhaging, infected incision, bowel obstruction, abdominal distension. trouble breastfeeding, mom may be a gestational diabetic and need blood sugars drawn, she may have PIH and be on mag sulfate so that needs to be hung and calibrated and now I need to pad the side rails in case of seizures, draw PIH and mag levels, assess reflexes and protein in urine. I may need to call the doctor if there are problems except it's the middle of the night and he's asleep or she's doing a delivery...so I call again.
I make referrals to lactation if you have issues I can't solve, referrals to social services if there are issues with depression, anxiety or anger issues, referrals to a dietician if you are overweight, underweight, under 16 yrs old or diabetic.
And of course I have to take care of the baby too because mom can't get out of bed for awhile and the new dads aren't too much help and need a lot of assistance. Sometimes babies have trouble breathing, or become jaundiced or septic. And oh, I must do their vitals every four hours and make sure you are feeding them and changing their diapers. Oh - and I have three other moms and three other babies just like you to take care of too, plus reams of paperwork and computer charting. And you ALL need help breastfeeding your babies every three hours except there is four of you and you all breastfeed at different times so basically someone is always calling for help latching the baby! Also people call for water, juice, help changing diapers, extra blankets and so on.
I must have all my charting complete, all the i's dotted and t's crossed by 6am before the doctors start rounding or they hunt me down bellowing "where is my chart? where are my vitals? where is my I&O? I must have all labs reviewed, make sure the CNA charted your vitals, I&O (or that's my fault too) read through the previous nurse's and doctor's notes and each patient's history in case I missed an order or they forgot to tell me something. If I miss something, it's ALWAYS the nurse's fault. Doctor's like to come in a 7am (just when it's time to go home) to do a circumcision, now I must set up and assist with that too. Then I have to give my last minute pain meds and bed checks, then give report to the oncoming nurse but invariably people will call at 7am when I'm in the middle of report complaining they didn't get what they ordered on their tray!
Did that answer your questions?
Answered By: BabyRN - 8/11/2006