Journal of obstetric, gynecologic, and neonatal nursing : JOGNN
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Advanced practice nursing has evolved during the last 25 years in important ways to become a central component of the new health care system. The quality of care and cost effectiveness of practice for various advanced practice roles has been well documented. New roles are being created as the demand-driven health care system presents opportunities for innovative practice models. It is incumbent on nursing to prove its ability to assume full accountability and responsibility so that full freedom to practice may be achieved.
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J Obstet Gynecol Neonatal Nurs · Jan 1997
ReviewThe nurse's role in the identification of risks and treatment of shoulder dystocia.
Shoulder dystocia is a clinical emergency that requires immediate recognition and prompt treatment to minimize maternal and neonatal sequelae. The nurse's role is to recognize and report associated risk factors for shoulder dystocia, respond with appropriate assistance, and monitor the woman and her newborn after delivery. The nurse's calm demeanor, knowledge of treatment modalities, and prepared response are valuable assets in this clinical dilemma.
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J Obstet Gynecol Neonatal Nurs · May 1996
ReviewEpidurals redefined in analgesia and anesthesia: a distinction with a difference.
Advances in our understanding of pain have created a new and meaningful distinction between epidural analgesia and anesthesia. The principles underlying this important difference are reviewed from a childbirth perspective and promote a reconsideration of the role of pain relief in labor versus the need for anesthesia at delivery. An epidural analgesic technique is presented with fresh implications for several old intrapartum practices. The analgesia/ anesthesia distinction in epidural therapy offers new opportunities and flexibility for safety and fulfillment in childbirth.
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One unique aspect of childbirth is the association of this physiologic process with pain and discomfort. However, the experience of pain during labor is not a simple reflection of the physiologic processes of parturition. Instead, labor pain is the result of a complex and subjective interaction of multiple physiologic and psychological factors on a woman's individual interpretation of labor stimuli. An understanding of labor pain in a multidimensional framework provides the basis for a woman-centered approach to labor pain management that includes a broad range of pharmacologic and nonpharmacologic intervention strategies.