[pebbles1977]

A couple of years ago we had a grand new Women's Hospital built onto our hospital. They took away PP beds and added them to L&D. At the time I was working on GYN and there was a lot more PP overflow to that unit.
Well fast forward to my experience on L&D. The MDs keep adding pts, but we don't have the room. It is a daily occurance that we are keeping pts PP until the 4 hr checks for lack of rooms, which would be ok but we've had pts deliver in triage when the triage RN was tied up with another pt (like severe preeclampsia, etc).
We've had several seasoned RN's quit saying they will not be in charge of situations where pts are unsafe. i don't blame them. And now, I've had less than 1 yr of experience here and they're asking me to do charge and precept. I have no real problem w/charge (I did it for 4 yrs on GYN) except that I know the promises of excellent orientation for it will not come to fruition.
So do you guys see similar things on your units? I know L&D is a primo place that usually has few vacancies, but we've been short staffed since I started there (and we're on our 3rd manager!).
BTW, DH and I are moving soon to another part of the state, so I'm hoping to hear better things.

[Jolie]

When you see an exodus of seasoned nurses from ANY unit, there is a reason for it. They are experienced enough to understand the legal and moral implications of providing care and being responsible for a unit (charge) or the education of a fellow RN (precepting), and are unwilling to do these things without the proper support from administration. Having had so many managers in such a short period of time is further indication that administration is either choosing poor leadership for your unit, or is unwillling to support the managers they hire. Either is unacceptable.

Accepting charge of a L&D unit with less than 1 year of experience is absured, despite your previous charge experience. Would you be able to assist another staff nurse in managing an emergency (prolapsed cord, for example), while coordinating admissions, making staffing adjustments, communicating with other departments, and addressing a disgruntled family member? That is typical of a shift in the life of a charge nurse.

Equally troublesome is having an inexperienced L&D nurse precept a new staff member. That indicates that there are no experienced nurses left to do the job.

I was once offered a M-F position on a birthing unit 5 minutes from my home. The pay and benefits were outstanding. At that time, I had about 6mos. L&D experience. When I realized that I would be the most experienced RN on the shift, I declined the job, and took another 30 miles away with weekend requirements and lower pay. I value my license too much to do otherwise. I think you do, too.

[SmilingBluEyes]

Originally Posted by Jolie

When you see an exodus of seasoned nurses from ANY unit, there is a reason for it. They are experienced enough to understand the legal and moral implications of providing care and being responsible for a unit (charge) or the education of a fellow RN (precepting), and are unwilling to do these things without the proper support from administration. Having had so many managers in such a short period of time is further indication that administration is either choosing poor leadership for your unit, or is unwillling to support the managers they hire. Either is unacceptable.

Accepting charge of a L&D unit with less than 1 year of experience is absured, despite your previous charge experience. Would you be able to assist another staff nurse in managing an emergency (prolapsed cord, for example), while coordinating admissions, making staffing adjustments, communicating with other departments, and addressing a disgruntled family member? That is typical of a shift in the life of a charge nurse.

Equally troublesome is having an inexperienced L&D nurse precept a new staff member. That indicates that there are no experienced nurses left to do the job.

I was once offered a M-F position on a birthing unit 5 minutes from my home. The pay and benefits were outstanding. At that time, I had about 6mos. L&D experience. When I realized that I would be the most experienced RN on the shift, I declined the job, and took another 30 miles away with weekend requirements and lower pay. I value my license too much to do otherwise. I think you do, too.

This is a wise, well-advised post. I would take heed. Watch the climate of any unit and you will have a really good idea what the job will entail.

[Mermaid4]

I second that....Big time...

[StealthyQ]

Thirded. Nothing much to add, except I'm familiar with all your described situations, including the mass exodus of nurses. Nurses are supposed to develop instincts and learn to trust them, and it sounds like you have.