Is it legal.. - page 2

So I am a labor and delivery nurse at a hospital with something like 220 beds in the facility, and on labor we do 5 deliveries a day just to give you a background. The pediatric unit at my... Read More

  1. by   HouTx
    Cross training is very common. Would you rather be sent home if the patient census drops? That's the only alternative.

    I would be more concerned about the infection control issues. The potential for inadvertently transmitting something from those little ambulatory Petri dishes (AKA, peds) to your Mom/baby population is very real.

    Most state nurse practice acts are very emphatic - it is the responsibility of each nurse to refuse to accept responsibilities for which he/she is not qualified. If that is the situation for you (with Peds), then can certainly understand your position. However, it is even more stressful if refusal may bring on the risk of termination. This is a classic example of "moral distress" in nursing.

    Rather than adopting an adversarial stance, have you thought about engaging both clinical groups to develop a more effective cross training & mutually acceptable staffing process?
  2. by   dharlow
    So if they float you to peds - have they ever pulled you back to OB for any reason? I ask this because if you are being floated to peds and take care of sick kiddos and then they pull you to OB, I have a problem with that due to infection control.
  3. by   dream'n
    For me, I guess it would depend on the pediatric population at your hospital. I could handle a 12 year old appy, but a 5 month old with sepsis, no way. I didn't like pediatrics way, way back during school clinical because of all the medication math calculations, everything is so weight based in little ones.
  4. by   AliNajaCat
    Your state nursing association can back you on the concept that you cannot be floated to an area where you do not feel competent, and you can get it in writing from them. However, you will not get any backing for the idea of resisting cross-training, because that's an institutional policy. You should insist that there be a paid formal cross-training program (not just a couple of floats and "Good to go!"), with objectives and measurable outcomes, both for your peace of mind and the hospital risk manager's.
  5. by   SierraMoon
    I think I'd rather have a med-surg nurse cover peds than a L&D nurse. I don't have kids or work with them but adult med-surg seems at least closer to peds type problems.
  6. by   heron
    Whether floating from L/D or adult med-surg, the thing management seems to be forgetting is that infants and children are not mini-adults. Definitely agitate for better cross-training.
  7. by   dharlow
    As a former Risk Manager, one of my first days in that role was shadowing my preceptor and she had a med error Incident Report she was following up on and the poor ED nurse had way overdosed a baby on Chloral Hydrate! No good!
  8. by   Here.I.Stand
    Quote from klone
    Yes, I agree with that. I saw that there was orientation; I missed that it was only one shift.
    I missed that the first time I read it too.
  9. by   Love2Sleep
    Check your state's standards of nursing conduct or practice.
  10. by   catsmeow1972
    I'm with the side on infection control issues. An above poster pointed out that hospitalized kids are usually the sick ones with RSV, Pegs, breathing issues and other assorted nastiness. Mother/baby generally is a fairly healthy population. I gather if this is a small enough facility that merging 2 units is considered, than i also suspect that the laboring moms are fairly standard risk and their babies are reasonably healthy. It seems common sense to keep these two units as far away from each other as possible (that includes with staff.)
    Considering the necessary amount of orientation? 12 hours...ummm no. I just transitioned to a General surgical floor position after 15 years in the OR. I've needed 4 weeks of orientation and I still lean heavily on my colleagues for support. The OR and post-op floor are very, very different. Just like Peds and OB, right?
  11. by   txbornnurse
    This sort of policy decision is why removing dedicated float pools was a bad idea. I can visualize the bean counters rubbing their hands in glee at the idea of removing all of those "overpaid" float nurses. Silly short sighted twits.
  12. by   klone
    Quote from AliNajaCat
    You should insist that there be a paid formal cross-training program (not just a couple of floats and "Good to go!"), with objectives and measurable outcomes, both for your peace of mind and the hospital risk manager's.
    And TJC requirements.
  13. by   klone
    Quote from catsmeow1972
    I'm with the side on infection control issues. An above poster pointed out that hospitalized kids are usually the sick ones with RSV, Pegs, breathing issues and other assorted nastiness. Mother/baby generally is a fairly healthy population. I gather if this is a small enough facility that merging 2 units is considered, than i also suspect that the laboring moms are fairly standard risk and their babies are reasonably healthy. It seems common sense to keep these two units as far away from each other as possible (that includes with staff.)
    THat's a good point that I didn't think about. Your L&D has a policy (or it SHOULD) that if you take other patients onto your unit, they must be infection-free, as L&D/nursery is considered an immunocompromised population. That will severely limit the types of peds patients you would be able to take.

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