nodi0603 665 Views
Joined: Mar 4, '06;
Posts: 7 (0% Liked)
I am the Director for a L&D/PP/Nursery unit and I tell my staff this:
When you start asking questions of these patients you are essentially performing an assessment and you can not assess over the phone. They are only allowed to instruct them to call their Physician or come in to be seen. Even if you document what you tell them (we do not keep a telephone call log) it is your word against theirs. I worked at another facility 6 years ago( i was not the Director at that time) and a patient called and said she thought her "water had broke". The nurse said she told the patient to come in to be seen. The patient did not come in for over 8 hours. This was a full term patient and when she arrived and was placed on the monitor, initially the heart rate was 140, but then it took a nose dive and failed to recover. The baby lived for 3 years but from birth until death he was on a ventilator with home care. The patient says she was told to shower, wait until contractions are 5 minutes apart and then come in. Of course it was her word against the nurses. The jury believed the patient and she was awarded an undisclosed amount of money. I tell this story to all my staff and I also insist they chart as if a lawyer will be reviewing their chart. We have an excellent labor flow record we use but I still insist they chart narrative notes. I realize it is "double charting" but in the long run it is what is best for them. It is hard to remember what happend 2 weeks ago, let alone 5 years from now.
What are some of the Quality Perfomance Improvement you might be looking at in your L&D/Nursery units? We look at transfers, C/S for CPD/FTP, Deliveries unattended by a Physician, just to name a few.
Here in the south they use:
FOB-Father of baby
JOOTBP-Just out of the bed pregnant
Complete and fully
PITA-pain in the --- (for docs also)
PP-OOP-presenting part out of pelvis
If we can't reach her cervix we will sometimes say "it's in her tonsils"
Of course they "mash" all kinds of buttons around here. I am originally from the Midwest and we always press buttons. If you are a native of the south then you are a "good 'ol boy"
I once heard a nurse tell the IC/EH nurse, who is very bow legged; "you are so bow legged you couldn't hem a hog in a ditch". LOL
I am in the process of writing a new policy for Emergency Cesarean Sections in the event all 4 main OR's are in use. We do not have a section room in our L&D unit and a minor procedure room in the OR has been designated as the "back up". Deos anyone have a policy of sorts or know where I can get one so I do not have to "re-invent the wheel." Would appreciate any and all suggestions or help.
Starting pay at a hospital in NC is $19.88. The weekend diff is $10.00 plus a 2nd and 3rd shift diff. Specialty areas also recieve an additional Premium pay $3.00 for L&D and Nursery.
AWHONN and ACOG have staffing guidelines that should be followed-Our hospital certainly does. You should involve your Chief of OB.
I am a nurse manager and I DO NOT fall into that category. I work side-by-side my staff EVERYDAY. There is NOT a time that my staff has called me in the hospital or at home that I did NOT help them. I am the first person the Nursing Supervisor calls when staffing is less than minimal, and I am always happy to help. I AM PART OF THE FRONT LINE STAFF THAT TOTALLY ENJOYS DIRECT PATIENT CARE. I am in the hospital EVERYDAY at 5:30 a.m. so I can talk to my night staff and very rarely leave before 6:00 pm. I feel sad for those staff members whose Manger is not visible to them. You are correct when you say-how can we evaluate you annually when we never see how you perform. Good luck in your endeavor.
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