[tryingtomakeit]

I would really like to hear from you guys on this one because I really don't want to jump from the skillet to the fire. Here goes ...

I am an RN in L&D. The hospital I work for is rural and very often I am the only L&D nurse working. I am not exhagerating when I say that EVERY day I have worked in the past month, I have been pulled to med-surg.

Let me be the first to say that I don't mind helping out when I am needed and when I am able, but the supervisors where I work start to stalk us when we come on duty wondering when we think we may be "cleaned out" so we can help out. As soon as the patients leave L&D for post partum, we are pulled. We never have time to stock and all the other little things that go along with patient care. The kicker is - half the time we go over there and the nurses tell us that they don't need us and are very rude to us! The other night I went over and did vital signs, cleared pumps, emptied catheters, did glucometer checks and gave insulin on 30 patients. When I had finished I asked if there was anything else I could do to help. The answer was a very short, "no", so I went back to L&D to stock only to learn later that they were griping because I wasn't back there with them.

I graduated in May and this is the first place I have worked as an RN. I love the people I work with and I love what I do, but is this normal? Are all hospitals this bad about pulling nurses to areas they aren't even really needed? We are having a staff meeting this Thursday and several of us are planning to bring this up.

Thanks!

[Q.]

I have never been pulled into a med/surg area from L&D. The rationale for this at our hospital was because we couldn't pull from med/surg FOR L&D - thus, we were on our own.

If you are the only RN on the L&D floor, and you are pulled to work med/surg, how would you know if there was an L&D admission? A cord prolapse or some other critical event? Not to mention, I'm not sure having one RN on L&D is even within AWHONN guidelines. I believe you should be staffed with at least 3 even if there are no patients.

I wouldn't be too happy with your current arrangement; not only would I not like staffing med/surg all the time without any help from THEM when you're in trouble, but not sure I'd like leaving the L&D floor without anyone there. Just not safe, imo.

[SmilingBluEyes]

Originally Posted by Q.

I have never been pulled into a med/surg area from L&D. The rationale for this at our hospital was because we couldn't pull from med/surg FOR L&D - thus, we were on our own.

If you are the only RN on the L&D floor, and you are pulled to work med/surg, how would you know if there was an L&D admission? A cord prolapse or some other critical event? Not to mention, I'm not sure having one RN on L&D is even within AWHONN guidelines. I believe you should be staffed with at least 3 even if there are no patients.

I wouldn't be too happy with your current arrangement; not only would I not like staffing med/surg all the time without any help from THEM when you're in trouble, but not sure I'd like leaving the L&D floor without anyone there. Just not safe, imo.

I agree w/Suzy. I think this totally violates AWHONN standards. I cannot say I would work in a place like this, at all. Rural hospitals are tricky. I have been there. The only thing you may have going for you to fight this is to get hold of AWHONN standards for staffing/practice and go from there. Suzy is right; it's just not safe.

[Q.]

Plus, I just thought of something. Who's going to answer phone calls from patients? When we discharged our moms, we gave them our unit phone # to call with questions on bleeding, breastfeeding, etc 24/7 (since we're open )

If a patient calls, who's going to answer the phone if you're off emptying foleys?

[TheCommuter]

I never realized how critical the nursing shortage is until you told your story. Perhaps your employer might wish to go to R.N./L.P.N. programs at local community colleges or state universities to recruit new employees. It seems that your job has a lower supply of nurses than needed. They need to hire more people to relieve you of your extra duties in the other departments.

[kc2004]

the hospital where i work keeps 3 people on the OB floor at all times.
if there are no patients, the OR tech can get pulled to help out with
sitting a suicide on psych or in the ED but she must remain available
in case of an emergency. in OB it is so important to have someone
available right away, you have 2 peoples lives at stake with your patients
and "GOD FORBID" someone comes in with a prolapsed cord and the
receptionist in the ED says to her "Oh, you can have a seat until we can
find the L&D nurse ."

[tryingtomakeit]

Originally Posted by TheCommuter

I never realized how critical the nursing shortage is until you told your story. Perhaps your employer might wish to go to R.N./L.P.N. programs at local community colleges or state universities to recruit new employees. It seems that your job has a lower supply of nurses than needed. They need to hire more people to relieve you of your extra duties in the other departments.

Ok, I feel better now ( I think, lol ) because you guys are coming up with the same concerns that I have. Also, Commuter, I wish it was that easy as far as staffing goes - you see, a CNA was actually called off the other night so I could have "something to do" on the med-surg floor. It isn't a matter of there not being any help, its a matter of a very small hospital not being very wise ... Thanks for your input, I just wanted to know I wasn't over reacting.

[JaneyW]

Originally Posted by tryingtomakeit

Ok, I feel better now ( I think, lol ) because you guys are coming up with the same concerns that I have. Also, Commuter, I wish it was that easy as far as staffing goes - you see, a CNA was actually called off the other night so I could have "something to do" on the med-surg floor. It isn't a matter of there not being any help, its a matter of a very small hospital not being very wise ... Thanks for your input, I just wanted to know I wasn't over reacting.

We ALWAYS have two nurses on in L&D even if there are no patients. I have had nights where we have NOTHING until 4am and then in walks a 29 weeker with twins ruptured with one a footling breech. We don't have a NICU and this is a true emergency for us making both nurses very busy instantly. I can't imagine if we had to be called in from another unit or home. I can't believe they pay you an RN wage to empty foleys!!

Yes, this needs to be addressed. If they want to play around with only having one person in L&D then at least that person should be there at all times for those that walk in or call in,etc. Good luck. And for the other posters, are the AWHONN guidelines available on their website??

Thanks!