Communication
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Fetal Heart Rate Monitor Strip Readings
Early Decelerations: ***These are GOOD Decelerations*** They tell us that the baby's head is coming down and thus called head compression.
Variable Decelerations: Variables can tell us that there is a cord and the cord is being compressed with the contraction. These decels require some interventions. (i.e. re-positioning the patient, MD to be notified, Amnioinfusion)
Late Decelerations: These Decels tell us that there is placental insufficiency. ***NOT GOOD** These decels also require interventions and need to be monitored closely ( i.e. reposition, LR bolus, turning pitocin off, O2 being applied, MD to be notified)
Reading Fetal Monitor Strips only get easier with time. Practice, practice, practice!
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Pushing and Delivery
We have to adapt to the patient to identify which pushing style suits them. There are patients who go natural with no anesthesia and would like directed pushing (pushing in which the nurse directs them when to push and for how long), and/or they would like to push standing up at the side of the bed, lying on their side or on hands an knees. There are patients who do request anesthesia and can only push in the lying position and most often need guidance on when and where to push. As we communicate with our patients we learn which style suits them.
Once the pushing has been started and the delivery is near, it is always important to allow the patient to make as many decisions as possible. Such as : who will cut the cord, will baby go right to the mothers chest; would the patient like vaccines to be given. Once these have been made clear by the patient, the patient feels as though they are part of their care.
Delivery is an amazing experience and one which the family will remember forever. We as L&D nurses must make that experience as special as possible for them!!
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