More staffing issues

  1. Hi, What do you all think about having an assignment in the NICU where two babies are in one pod and two are in another, sometimes on the other side of the unit? The assumption being these are stable infants. I just feel very umcomfortable when this happens, but am told it is a standard practice.
    Also, what do you think about an assignment where you have two clean babies and one with VRE?
    Thanks ahead of time for your replies.
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  2. 8 Comments

  3. by   NICU_Nurse
    1) I HATE when they do this! In my opinion, this is simply unsafe. If I am all the way on the other side of the nursery, I cannot keep an eye on my patients while I am tending to others across the room. I cannot hear the alarms, cannot tell if they are correlating, cannot visualize my babies and see if they are in distress, vomiting, etc. I have to ask another nurse to keep an eye on or an ear out for my babies while I am across the room, and this is putting even more work on her- she has her OWN assignment to worry about. We do not have a rule against this, but our nurses try as much as possible to keep this from happening. If a baby is stable enough to move, sometimes we will move the entire Isolette or crib to the other side of the room to solve this problem. It is ridiculous to have to do this, but there is simply no safe way to care for babies so far away from each other. Our unit is open; we do not have pods, but this would make me especially uncomfortable. Don't pods have walls that surround part or all of the area around the cribs? I would never hesitate to be vocal about this. I may not be able to solve the problem, but when this happens to me I make sure it is noted by SOMEONE, even if only verbally, that I disagree with this and feel it is unsafe.

    2) When we have isolation babies, we never pair them with clean babies. The nurse assigned to those babies is considered 'dirty' all night long to reduce even the slimmest chance of cross-infection. Sometimes this requires a 1:1 staffing issue, if, for instance, we only have one Iso baby, or if there are 3 of them (they would need 2 nurses- nurse A has 2 dirty babies, and nurse B would have the third). I just think, even with strict precautions, this is an issue begging to occur and on our unit we don't pair them up.
  4. by   cindylouwho
    we often pod-hop as we call it...having 2 babies in one pod and 2 in another...we try not to do that with critical babies but the biggest problem we find is not being able to tend to the family when they visit if you're busy in another room with the others....they then expect the other nurse in the room to automatically answer all their questions and help them when she has 4 babies of her own and doesn't know all the details about this baby.....we have voiced our concern but it goes unheard....all that matters is numbers and budget......here's another good one....we float to pediatrics to help when they are busy and take 1 or 2 patients while our charge nurse gets a full assignment...covers deliverys and transports etc....isn't that nice?....once again....AND THEY WONDER WHY THERE'S A NURSING SHORTAGE????????????
  5. by   cindylouwho
    by the way..that floating and having our charge nurse taking a full assignment is a management problem I know.....no backbone to stand up for us
  6. by   NicuGal
    We do this frequently..we keep the person with the intubated kids and unstable one in the room and float the other person out. Actually, not many of us see this as a big deal. If we have one kid that is acting out a bit, we can pull that kids screen up on the monitor we are at. We tell the parents that we have babies in the other room and we will be back. Everyone is good about helping out when the other person is out of the room. We just tell the parents that we don't have their baby, but we will try to answer their questions. We also don't expect someone else to help a mom BF or give a bath, we work it out with the parents.

    Our unit has pods/rooms that have 5 bedspaces and 1 overflow (who ever designed that should be shot! LOL ). If the one person is out of the room and we need to go to another room, then the people in the next rooms will keep an ear. (our pods have open windows in between), but usually we work it out amongst ourselves so that one person is in the room all the time.

    For iso babies...it depends on the kids. If they are NEC and have been treated for 5 days we can float out and take a larger baby. If they are 3 stable kids (ie a vent and two NPO's) we will take all 3, or even if there is 2 stable vents and one nonvented. Never 3 vents. Anything viral is by itself.

    Our charge nurse doesn't usually get an assignment unless we are super busy. And we never float someone and give the charge nurse an assignment. If we get busy we call the float back.
  7. by   smbluthing
    Hi, Thanks all for your replies, I appreciate the time spent.
    I won't have to get used to this pod splitting snafu, I am counting the days until my contract expires...19 shifts to go.
    Thanks again.
  8. by   UTVOL3
    Hi.
    I know this thread is really old but if anyone knowledgeable is browsing around here, could you please post back and tell me how a baby gets VRE? As you can tell I am a nurse of adults right now. Are they born with it or do they pick it up at some point while in the hospital? And if so where is the source usually? Like equipment, other patients, workers who got to other units, etc. etc. I just never really thought about that before. Thanks.
  9. by   NICU_Nurse
    Aja,

    Here is a link that may answer some questions for you:

    http://www.slackinc.com/general/iche/stor1099/edit.htm

    If you have any more questions, you may want to re-post this inquiry as it's own independant thread (rather than leave it down at the bottom of an unrelated thread- you're much more likely to get more of a response if you post it under it's own heading). Let me know if you need any help with this. ;>)

    Kristi
  10. by   UTVOL3
    Thank you Kristi for your reply. This is the same as what happens to our adult patients, very unfortunate. We never have the option of isolating the VRE/MRSA patients to just one nurse. As a result many patients get colonized with the bugs and others get serious infections from them. Thanks again.

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