[LDRN697]

Hi every one- I am new to these boards and my department is having a problem and I need all the suggestions I can get. I work at a hospital that does approx. 100 deliveries/month. We staff L&D, nsy, and postpatum with a total of 6 nurses. (We've just started doing our own sections too.) We
are constantly being pulled to take pts. on med/surg and 95% of our nurses have never even worked there. We feel shorthanded as it is and really feel like we need another nurse to staff L&D (currently staff 2). None of us are comfortable staffing med/surg not to mention it is difficult to get our nurse back if we need her and she has a pt. load. We are currently without a nurse manager and are taking our concerns to the Director of Nursing. Has anyone ever been in this situation? Please give me some suggestions!!
Thanks, LDRN697

[pickledpepperRN]

Your management needs to know the JCAHO requires age appropriate as well as unit specific current competency. Even if you worked M/S before your competency is no longer current. Go to www.florenceproject.org
& download an Assignment Despite Objection. Try first to make a deal that you will help bu not be forced to take full responsibility based on lack of competence.
Your gut feeling that this is wrong is correct!

------------------

[timonrn]

I'm not sure that you can ever get out of floating to a med/surg floor but try these few suggestions--It works at our busy urban hospital: 1. Ask to be a "helper" when you float: 2. Ask for orientation to this floor and always ask for a resource person to work with you 3. Are you familiar with GYN patients? maybe you could request to only take care of these gals-most med/surg nurses will gladly give them to you. When you do get a Nurse Manager on board, start working towards a "closed unit" status--No one floats in or out because your unit is so specialized. However keep in mind your staff will have to be diligent in staffing the unit so that there are no holes. Try a maternal-child float pool like we have--They are utilized to fill our holes first and then are the first to float to the other units.

[AutumnMoonfire]

Can you decline to take a patient group or only take a reduced load? If you haven't worked M/S it isn't safe to take a patient assignment anyway. My unit is slightly smaller than yours and we always have 2 L&D nurses on the unit. If someone has to float and there are only 2 for L&D someone else will have to go. We too are working on a closed unit designantion.

[casirn]

This is a situation a lot of nurses are now dealing with due to the shortage in other areas and nursing in general. My facility has float areas. EX) L&D can float to NICU, Pediatrics. This is hard b/c we are NOT cross trained. Yes a lighter more appropriate assaignment is often given; however, the responsibility is overwhelming b/c of your lack of training in these areas. Our hospital skirts around the JACHO age appropriate mandates by requiring all nursing staff to take test for age appropriated test. (This needs only to be taken once) This is an issue that must not be taken lightly and i feel will only worsen as shortage grows. Perhaps we should use the shortage to our advantage - Not put our license in jeporady and refuse unsafe/inappropriate assignments.