About 10 yrs ago my hospital decided to cross train the mother/baby staff to L&D, and vice versa. The unit in my opinion has not run smoothly since. We have an18 bed wing that is for c/s and gyn pts, also the sick AP pts. The next wing has 16 LDRP's, with the nursery at the far end. The next wing is the surgical/triage area-C/S and Gyn's done here. The last wing is the Spec Care Nursery. Despite cross-training, most nurses favor one type of nursing, and usually are put there. The hospital sited the continuity of care as one reason for this type of care delivery. That is a farce. In an 8hr shift you may change assignments/units many times. There is a big difference in caring for the 80+yr old gyn pt. and the complicated labor pt. Deciding how to place the staff is a constant issue. Sometimes too many "L/D" nurses and not enough for the C/S's, or not enough to cover the OR/RR. Realistically the staff is not "cross-trained". There are few nurses that have good skills in all areas. Now I hear I will have to cross-train to the NICU. It's a zoo! Staff is always miserable and the turnover is high. The new cross-trained staff feel overwhelmed and frequently quit as they are pulled around too much. I would like some hard results of how to best manage this unit. Would core staff for each area and a float team work? I am trying to find documentation so we can put together a proposal that will meet pt needs, budget restraints, and keep staff happy. Thanks for input, any research, or creative ideas.
Buggs
30 Posts
About 10 yrs ago my hospital decided to cross train the mother/baby staff to L&D, and vice versa. The unit in my opinion has not run smoothly since. We have an18 bed wing that is for c/s and gyn pts, also the sick AP pts. The next wing has 16 LDRP's, with the nursery at the far end. The next wing is the surgical/triage area-C/S and Gyn's done here. The last wing is the Spec Care Nursery. Despite cross-training, most nurses favor one type of nursing, and usually are put there. The hospital sited the continuity of care as one reason for this type of care delivery. That is a farce. In an 8hr shift you may change assignments/units many times. There is a big difference in caring for the 80+yr old gyn pt. and the complicated labor pt. Deciding how to place the staff is a constant issue. Sometimes too many "L/D" nurses and not enough for the C/S's, or not enough to cover the OR/RR. Realistically the staff is not "cross-trained". There are few nurses that have good skills in all areas. Now I hear I will have to cross-train to the NICU. It's a zoo! Staff is always miserable and the turnover is high. The new cross-trained staff feel overwhelmed and frequently quit as they are pulled around too much. I would like some hard results of how to best manage this unit. Would core staff for each area and a float team work? I am trying to find documentation so we can put together a proposal that will meet pt needs, budget restraints, and keep staff happy. Thanks for input, any research, or creative ideas.