Community hospitals????

Specialties Ob/Gyn

Published

Ok, so I am considering a switch to a community hospital that is about 4 miles from my house, vs. the almost 50 that I'm driving one way right now. I love my job at the moment, like being at a teaching hospital, like having the NICU right down the hall. But the commute is killing me. I have an interview early next week w/ the manager @ this local hospital, doing essentially the same thing I'm doing right now, minus the highrisk antepartums. Would still be doing postpartum and/or nursery, and one part of the floor is gynies. I am not sure if I would be working NBN right now or not...that is one thing I am going to ask about. Unstable kids get shipped out for the moment, though they are working on level II certification.

But those of you who work OB/mother-baby/GYN in community hospitals, tell me about it. Tell me what you like, tell me what you don't like, what the challenges are. I have started a list of my own questions, but I would like to hear from you all....some of the best out there. :) Thanks.

Since a labor check must now be seen by a midwife or physician prior to discharge, often they are forced to spend the night til morning when the careproviders round as they don't want to leave their comfy homes to come in.

Why do they have to come in to see a labor check? I don't go in to see simple labor checks. I review the strip on my computer at home and dictate a note stating that serial exams by the RN showed no cervical change, the strip was reactive, and that she may be discharged to home. Any issues, sure, I'll go in. But the low risk primip at 38 weeks who's having some contractions? Probably not.

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Why do they have to come in to see a labor check? I don't go in to see simple labor checks. I review the strip on my computer at home and dictate a note stating that serial exams by the RN showed no cervical change, the strip was reactive, and that she may be discharged to home. Any issues, sure, I'll go in. But the low risk primip at 38 weeks who's having some contractions? Probably not.

We're lucky enough to get our MDs to come in to catch the babies, coming in to discharge labor checks would definitely set them over the edge.

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Specializes in LDRP.

Beckinben,

In the smaller community hospitals the only way to see a strip is to come in to the hospital itself. When I worked in one such hospital the family doc's would take our word on the reactivity of a strip and lady partsl exam and give a v/o for discharge without seeing the patient.

I am in a new hospital now and appreciate the fact the our doc's come in to review strips and see patients before they leave. Just my personal preference. I wish we had CNM who still did delivery's here but ours work in the office and have opted to no longer do actual deliveries.

Kay

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I can't remember what generated the new "rule" but about 2 years ago, it was mandated that the care provider come in and check the patient prior to discharge. Probably about the time they took our litmus paper and our amni check sticks away.......as we are not "qualified" to have them on the floor. As I said, the care providers are not happy and most of the triage patients end up spending the night. How cost effective is that ?? Obviously if they are in the hospital, we need to check VS and FH at least periodically. It could have been a patient complaint that caused the change......our facility SO over reacts to patient complaints. It would be comical if I weren't trapped in the middle.

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