I am in a similar situation to maxibelle. We deliver 1100-1200 per year. At night there is no OB in house. Anesthesia is only in house if there is a running epidural. We scrub, circulate and and assist our own c/s. OR back up is on call. We have LPN's as well as RN's. LPN's are limited in scope of practice but in our facility tend to do everything except VE and SSE.
Our protocol is currently 3 licensed personnel trained in L&D in facility at all times. Our night shift has been in a staffing crunch for a while and dr's were complaining about lack of experience on night shift esp. related to c/s. In an effort to relieve this a scrub tech with CNA experienced was hired. The problem is that because of staffing limitations the scrub tech is counted as a staff on many nights.
This can get really hairy at times. We had a situation a few weeks ago where there was an RN (me), an LPN, and the ST. We had a labor/SROM on pit augment with huge variables progressing quickly and an induction for non-reassuring FHT that was delivering. After delivery we had retained placenta and subsequent hemorrhage that we had to do a D&C on. She ended up losing >1800cc of blood and getting 3 units of blood (2 on a pressure bag/ 1 uncrossed). While I was tending to that. The LPN was trying to deal with the labor and subsequent delivery by herself. I felt this was an unsafe situation all around and I felt helpless in the situation. The house supervisor was of little help.
I love our scrub tech but I feel that he is often out of his element. We were short staffed one night and our manager was called in to work. She had him do the hourly vitals on a PIH mag pt.; while she audited charges and the rest of us had 2-3 pt apiece.
I love my job, I love my hospital, I hate this situation! They know they are violating policy but are talking about changing policy to fit practice and NO ONE is happy about it. We are losing more nurses because of it.
I know the answer is to refuse to work/be in charge of an unsafe situation. But I would like to help fix the situation instead of leave it..... any ideas?
The only thing I have thought of is having a nurse on-call... but I know that would not go over with our current staff.
May 2, '05
All I can say is that I'm glad that I don't work at your hospital!!!!
I know that people aren't happy having to take call, but it sure has gotten us out of some tight situations for sure!
May 5, '05
I am glad I am not in your shoes. Just hang in there and hope that your management sees the light soon. Have you brought to attention the latest ACOG standards. Mabye it could help.