Closing the unit

  1. We are stuggling with management in our small hospital about "closing our unit" when it is slow. "Closing" would mean no nurse (or any other staff) would be on the unit. A unit, by the way, which cannot be locked. Our department, along with our OB NM feel that there should always be someone on the unit even if there are no patients here because you never know what's going to walk through the door. (Also, to answer phones, complete the tasks that need to be done since we have no unit clerk or aids.)

    The other managers are fighting this, saying we can go up to another unit and put a sign on the OB telling patients to go to said unit.

    Anyway, I am trying to find out if there are any laws against closing a hospital unit. Do you know of any? (I live in Michigan) Do you know where I might find out such info?

    Thanks so much!
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  2. 21 Comments

  3. by   Jolie
    Wow, what some administrators won't do to save a buck!

    Check with your State licensing authority. Having a Level II designation (if you have one) carries obligations to maintain certain minimal staffing levels, although I don't know specifically what those requirements are. I don't know if the same holds true for Level I facilities.

    Next, go to your OBs and Peds physicians and let them know that administration is planning to leave your unit vacant at times. I'm quite certain they won't allow that to happen. Get your risk manager involved. If none of that works, tell every pregnant lady you know that you hope she will arrive on the unit when it is staffed. A few phone calls from frantic potential patients threatening to deliver elsewhere may do the trick!
  4. by   Quickbeam
    I'm not aware of any laws. I worked on a very small rehab unit almost identical to the situation you describe. No aides, no clerks. The manager made a decision when we opened that no matter the census, we had to have an RN there. It ended up there were only 5 nights in 5 years we had a zero census with an RN there. There were always projects to do, paperwork, stocking. I think it is foolish to have a unit go dark (especially in OB) when the cost savings would seem to be very small/zero.

    Best wishes to you.
  5. by   ElvishDNP
    Quote from Quickbeam
    . I think it is foolish to have a unit go dark (especially in OB) when the cost savings would seem to be very small/zero.
    :yeahthat:
  6. by   nurturing_angel
    Our OB unit does this. It is frightening to be the only OB nurse in the entire building and also to be up on med surg helping out and praying that no one comes in in advanced labor or with some sort of complication occurring.
  7. by   gitterbug
    I do not agree with closing the unit for any reason but it has been done here so many times I lose count. Always seem to have problems when they do, but administration turns a blind eye and continues to close. Doctors did not see importance of supporting nurses over closing of unit, now, too late, after a bad experience or several, they do but are stuck until new plan is developed. That will never happen.
  8. by   NicoleRN07
    I am not an OB nurse, but I do know that the OB and Pedi floor in our hospital kind of work as one. We don't have many pedi admissions, so when there are no patients on pedi, the nurses help staff OB and L&D....so they are usually overstaffed. In the event that a pedi patient is admitted, they simply pull a nurse from staffing to the pediatric wing, that way you don't have to say that the unit is closed.
  9. by   JenTheRN
    Also, how do I find out what 'level' we are?
  10. by   JenTheRN
    If it helps, I know we are a Critical Access Hospital.
  11. by   tvccrn
    I used to work in a small rural hospital and our OB unit was eventually closed after about 5 years of only have 70 births a year. It would not have paid to keep and RN on the unit when there wasn't anyone in labor or post-partum.

    It was a hard decision for them to completely close the unit as most of the patients in the area were so used to having these doctors for their OB care, but it simply ended up to be too costly to keep it open.

    tvccrn
    Last edit by tvccrn on Feb 7, '07 : Reason: spelling
  12. by   JenTheRN
    We would rarely need to do this...we have 200+ deliveries a year plus we see non-complicated antepartum, NSTs, and we also have post-op GYN patients.

    Plus our numbers are coming up.

    In my opinion this just leads to waaaaay to many problems. Most of them stemming from the fact that we can't lock the unit. If we are closed, anyone could come in and steal equipment/drugs/computers/whatever.

    Oh also We are getting a new hospital in the near future. This one WILL have a locked OB unit.
    Last edit by JenTheRN on Feb 7, '07 : Reason: 'cause I type too fast
  13. by   jannrn
    the hosp I work at has a maternity side and a med/surg side. we do close the med/surg side on occasion but never the maternity. I don't know if there are ever times when OB has no pt. We have mostly elective surgeries and none on weekends so when we close it is because on Friday, the surgeries were simple and the pt went home on Sat or Sunday and therefore there were none on sunday pm or nights. there is a procedure for closing the unit, all supplies are locked (except desk stuff), the phone is transfrerred to the OB unit, someone is always on-call if there were an unexpected admission. This probably happens a couple times a year.

    The unit re-opens before the first pt is expected back from surgery on Monday morning.
  14. by   nrsang97
    Jen

    I also live in MI. I am curious as to where you work. If you want to PM me and let me know.

    I would think that closing an OB unit would be a HUGE mistake. I cannot understand how the administration even came to that thought. Seems like a lawsuit waiting to happen. Could they leave at least 2 nurses on at all times since I cannot imagine OB being with a zero census. The OB units at all previous hospitals I have worked have always have been busy. I also suggest that a few calls from expected parents in the area would change their minds when they suggest they may deliver elsewhere.

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