does research support cross-training?

  1. 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.
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