L&D/NICU hostility!!!!

Specialties Ob/Gyn

Published

Just wondering if this unfortunate situation is unique to the facility where i work or if it is everywhere! whenever the NICU gets very busy, the nurses become very hostile and rude to L&D nurses. Last night I walked into the NICU and overheard a conversation between 2 nurses. There was a 36 wk baby on a vent, was induced because mom had severe PIH. 2 NICU nurses were complaining because "the ob docs think that 36 weeks is full term. they even had pit on her!!!" When i tried to explain to them that it was necessary to deliver due to severe pih, they said "well they had mag on her and just decided to turn it off and induce her. why would they start pit if she wasn't contracting anymore." i had to explain that the MgSO4 was for pih, not ptl. they had no clue, just thought that we induced for the fun of it!! but what is even worse is that they frequently convey these feelings to the parents. " well, your baby probably wouldn't be on a vent if your doctor didn't induce you" and parents have no idea, they think that ob's are doing something wrong!!!

then, after that conversation, had a 32 week pt come in, 8 cm, bulging membranes come in, called nicu to alert them and was told "well you better stop her." I explained that we were going to try but no promises. I was asked "well what are you going to do, pit her?" I again explained that we were going to try to stop her but what are the odds at 8 cm and bulging membranes? they were so rude. So, back to the original question, is it everywhere or just here???

sorry about venting. i am just so frustated. We do all that we can for our pts and are treated like we are tring to harm babies and the nicu is there to save their lives when we try to kill them.

Specializes in cardiac, diabetes, OB/GYN.

I was in the nursery the other night and reporting off actually had a day nurse tell me we have it easier because they have babies in the nursery all day. Hello, where do you think most of them are at night? Why couldn't you do a hearing screen, I ask. Well, its noisy in the day time because the babies cry. Hello, again I ask, What do you think they do at night? I need some help in here because I have 10 babies, she fairly shouts. Hello, I had the same ten babies AND managed to get things done. More patients talk at night to the nurses, usually get better and more involved care and we always have less staffing. We also work better and quicker between pp, delivery and the nursery because we have to. We are more assertive and interactive with docs and the rest of the hospital, and if we have to float or be forced to work on the day shift, we are done before 10 am with things they can't do their entire shift. NO ONE had better EVER say to me that we have less staff because we have less to do. We actually have more to do because there is our stuff and the stuff the other shifts either can't or won't do....I respect the differences in the activity between shifts, but until you have worked nights for awhile in a hands on capacity, do not wrongly assume it is easier, or in any way a slower pace. Babies don't check with shift change angels to show up.....Babies could care less about staffing...Apparently, neither does management......

Specializes in cardiac, diabetes, OB/GYN.

You know, just about everyone is short staffed. Those pf you who don't circulate through all three areas to actually experience what each other is going through, should consider asking your NM to have you meet together and try it. And, as for assisting and circulating as the only nurse in a lady partsl delivery, you don't need sterile gloves for that. The doc does, but you don't necessarily. You need clean ones. And, we sometimes have to do epidurals alone if the other nurse is with another patient. You can't scrub and assist at a c/s alone, but, though you would rather have someone else there, drawing up pit, adjusting the light, helping the pt push or anything else you would do in a delivery is no big deal. You get the coaches involved and you go back and forth. If the baby is not good, that is a whole other can of worms.....

Specializes in OB, Post Partum, Home Health.

WOW, what a huge response. I guess I feel a little better, and a little worse that it is the same everywhere. Thanks for the input!!!

Specializes in cardiac, diabetes, OB/GYN.

The only areas in our facility that are staffed for the what ifs are the emergency room and ICU....WE are the ones who staff them and it is hilarious to me that they send us everywhere (since maternity in any facet is NOT a specialty area) but cannot function when a pregnant woman comes through the door. I have been called up to delivery to retrieve a fetone to go to the ER or ICU to do an FH because THEY either can't or won't do one....And if I get another call from some ER nurse or doc who actually cannot understand or refuses NOT to understand that I will more than likely NOT find an FH on their barely 5 weeks pregnant pt....Just blows my mind....

Specializes in OB, Post Partum, Home Health.

I think that is hilarious when they call us to er for a fhr when they are only 5 weeks. I have started asking when they call how far along the pt is because I went down to er one night for a fhr, I was unable to find one, I asked the pt how far along she was, she said that she didn't know, she thinks that she may have missed her last period. She was in the er for back pain!!! As professionally as I could, I suggested to the doctor that if wanted to find out if she was pregnant or not, a urine pregnancy test is much more reliable than calling L&D down to try to find fht's.

Originally posted by at your cervix

I think that is hilarious when they call us to er for a fhr when they are only 5 weeks. I have started asking when they call how far along the pt is because I went down to er one night for a fhr, I was unable to find one, I asked the pt how far along she was, she said that she didn't know, she thinks that she may have missed her last period. She was in the er for back pain!!! As professionally as I could, I suggested to the doctor that if wanted to find out if she was pregnant or not, a urine pregnancy test is much more reliable than calling L&D down to try to find fht's.

:rolleyes: :chuckle LOSER!! I would have paid good money to be a fly on the wall when you said that to that doc. :roll

I like your post Mother/Baby, I often wonder why it is that dayshift is always slammed and night shift is supposed to be so slow. I have worked both and did not find days any busier personally in relation to the volume of work each nurse has to do. yes there is more activity on day shift but there are a lot more nurses also. just a few days ago I worked a night shift was the only labor nurses on had rn in nursery, and 2 LPN postpatum nurses that were not IV certified, one had no experience in LD,PP or nursery. we were relieved by a dayshift that consisted of 2 experienced LPN's one was IV certified, 7 RN's, 1 OB tech and the nurse manager. for the same number of patients. not to mention in the morning i had 4 patients to admit which consisted of 1 c/s patient and 3 inductions. had them all admitted and on 12 mu of pit by 7 am. the small crew i had to work with had time to complete everything including the nightly chore list. the 3 inductions all delivered before 1400 still when i got back none of the instuments were clean,2 observation beds were dirty. someone explain to me how 11 people could not handle that work load when 4 people did it at night. next night we had a full house Again I was only labor nurse and We had a rn for PP and an RN for nursery, saw 6 triage patients labor 2 patients and delivered one. again was relieved by staff of 6 people to do what 3 had done. I also wonder why people think patients and babies sleep at night! just recently had a dayshift employee suggest that night shift start doing discharge teaching on patients because dayshift just does not have time. I guess i will need to squeezze that in my "slow" night time schedule. Maybe i will just give up my night shift nap:):):)

We are lucky not to have any hostility between our NICU staff and L/D staff. We try to warn them when we have things brewing for them.

Mark- we also have difficulty between our dayshift and nightshift. Dayshift doesn't think anything wrong with leaving a patient in their delivery bed for 4+ hours sometimes. "Mom and baby was bonding"(mom hasn't even held baby), "Baby was cold" (temp 99.0). "Moms legs were still numb" (she practicly runs to BR from full bladder). We here all the excuses, including we were too buzy.

So today I went in on my day off to visit a friend who just had a baby. I got there about 4 o'clock. She delivered at 10 o'clock. They were just getting the baby out of the warmer and just moving her to her knew room. She had not even fed the baby yet. Now mind you this is SIX hours after she delivered. When I first walked in there were 4 nurses sitting at the desk. Now I feel embarressed because this is my place of work and my co-workers who did this to someone I know. This would not have happened on nightshift. We try not to let mom's stay in their delivery beds for more than 2 hours. And baby's our out and fed by 2 hours max (unless probs.)

I have no problems with L&D. We all work in a high stress enviroment and relate well. I think maybe the ding dongs in the first post do not handle their stress well?

We do however butt heads with the newborn nursery. We often get babies that are "tachypenic and cyanotic" (RR 40 POX 100%)

"Blood sugar 40 and will not feed" (On arrival to unit BS 70, took 30cc of formula PO) We do get legitamate admits, but sometimes.....

And if you send a baby over there to finish out some antibiotics or bili light therapy.. Oh boy! You'd think you asked them to take all our vent patients! Sorry, we need the room! There are 2 24 weekers brewing downstaires and we NEVER close!

And having had 36 weekers I know that they are NOT term! And somone needs to tell pg women and some of these OBs that!I have also butt heads with preemie moms about this. It's not 26 weeks, but it is still not term!

Originally posted by at your cervix

I think that is hilarious when they call us to er for a fhr when they are only 5 weeks. I have started asking when they call how far along the pt is because I went down to er one night for a fhr, I was unable to find one, I asked the pt how far along she was, she said that she didn't know, she thinks that she may have missed her last period. She was in the er for back pain!!! As professionally as I could, I suggested to the doctor that if wanted to find out if she was pregnant or not, a urine pregnancy test is much more reliable than calling L&D down to try to find fht's.

Oh geez...they can't get their own FHTs? And then they try to get someone else to find them on someone who may not even be pregnant? :rolleyes: :imbar

And having had 36 weekers I know that they are NOT term! And somone needs to tell pg women and some of these OBs that!I have also butt heads with preemie moms about this. It's not 26 weeks, but it is still not term!
OH, DAWN....I THINK I LOVE YOU!!!!!

I totally agree!! It grates my nerves to the n'th degree to see these women who are so "tired of being pregnant" and their stupid OB's who oblige and do stupid stuff like STRIP THEIR MEMBRANES or worse, BREAK THEIR WATER!!! :eek:

I want to scream, 'HELOOOOOOOOO???!!! GET A CLUE!!!! LUNG DEVELOPMENT, ANYONE?????" I had a pt. last week who was 36 weeks pregnant with her first baby and TOOK CASTOR OIL!!! She of course came in contracting q2-3 minutes, but thank God was only a fingertip dilated. I told her, "I know you're tired of being pregnant, but your baby still needs time to grow! Those little lungs aren't working yet!!!" I begged her to please not do that again and let nature decide when it's time for her baby to come out. Then reassured her that pregnancy does not last forever. ;)

WHAT IS WRONG WITH THESE PEOPLE?????? :rolleyes:

Specializes in cardiac, diabetes, OB/GYN.

The day, night shift thing amazes me..AND, they seem to have some pull with the nursing supervisors.. Not too long ago, I was on pp and received a gyn pt who was bleeding lady partslly. All night long. I took her off bathroom privileges and put a commode at bedside ( hello, do you think that was something people should have thought of considering she was symptomatic AND had blood running. They had, as they more often than not do, floated my LPN. The 2 delivery people were busy with patients and nursery had only one RN, so there was no one to help or intervene if something went wrong. Doc didn't want to be bothered overnight so this lady was going to have a d&c in the morning..I was the only pp nurse and giving blood....2 units overall...THEN, they bring me a c/s and of course she is high risk and has frequent vs..Not to mention a whole host of other things that kept me busy throughout the night. Morning comes. Anesthesia calls and tells me they want the pt brought to the OR suite asap...I tell them that would be a neat trick but that I am not certified in teletransportation and if they want this pt, they are going to have to come get her themselves. They do.....(Wicked surprise to me, by the way.) Lady was in the OR by 7. Dayshift comes on. One nurse with a backup on call. Now that my lady is downstairs, she really will only have 3 other pts and 2 of them will be discharges, whom I have already done discharge teaching with. ( of course, the myth is that no teaching of any sort whatsoever gets done on nights). She is asking me about the blood policy and I just cannot get through to her that the pt is gone and isn't coming back to us. In fact, she will probably go home from pacu..

Didn't she not get right on the phone and demand one of the day delivery nurses to come over and listen to report...I couldn't believe it.. My pet peeve is floating and having them leave the night shift super short and then see them adding help to the day shift. And THEY have a secretary so they don't have to kill themselves doing pt care and running for the phone every minute...And why the hell do I have to do dayshift paperwork and put forms they use in the chart just "in case" THEY are busy....

I love those girls ( sorry Mark , we have no male nurses) , but on the odd occasion they are floated to our shift, they are amazed at our speed and ability to merge. No one complains what area we are in, we just pitch in and do it. They could argue about things like that for 10 minutes and I have actually had to call them over so I could go home...like the night shift has nothing better to do than hang around while they get situated...

And, how about that " You don't mind doing this or that before you leave, do you?" Yes, I DO mind......Hmmmm, apparently, I needed to vent......:)

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