labor nurse circulating for C-sections


  1. Now if we labor a pt and she becomes a CS, we prepare the pt for OR, take care of the infant in the OR and recover the mother and baby . Our 1000+/yr LDRP hospital says we should also circulate in the OR for continuity of care. We are told all the hospitals are now doing that. Please tell me if your laboring nurse circulates and if that is workable.
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  2. 17 Comments

  3. by   nsgsup
    Glad, at our hospital, the surgery dept comes for the c-section and they do the circulating. We are there to receive the baby and like you, we care for mom pre and post op.
  4. by   KIRKLAND
    Wow, I work in a small hospital. We do about 650 deliveries a year and we do our own C/S.
    When I was hired 8 years ago, the unit was starting to train staff to circulate, recover and scrub in. Now I can do all three skills and after 8 years, its old hat.
    There are problems, such as old staff members not wanting to learn the new skills.
    Solution, they were told, you do not have a job in this unit unless you learn what is now required. (We orient 3 every 6 months, now) It use to be... whenever the need arised.
    The older nurses were afraid to learn, but once they did, the transition went smoother.
    Out of 26 R.N.s, All circulate and recover C/S patients, our OR is next to the L&D suites. The LPNs are the scrub nurses.
    11 RNs can do all three.
    The nurses here would not have it any other way.
    Now I try to teach the nurses these skills, and I work closely with our OR to make sure we are doing the same things.
    It really is nice. See ya Kirkland
  5. by   Booth
    We Circulate for our labor patient's and a second nurse does the baby care. We then recover the patient in her room. We also do our own C-S's on our floor.
  6. by   NancyPC
    Glad, we do 2400 del/year...we c/s on our unit, but the OR sends a crew. The L&D nurse is responsible for the infant w/ peds at the del {depending on circumstances}. We simply don't have the nursing staff to circulate, although we can do it under "splash & cut" circumstances. We've all been trained in the OR. The pt recovers in PACU for approx 1 hr, then goes to our PP unit.

    [This message has been edited by NancyPC (edited 02-03-99).]
  7. by   misstvlgirl
    We are a large hospital with 300+ deliveries per month. We circulate in our own OR for CS with NICU coming to take care of baby. We are responsible for taking care of mom during her recovery as well.
  8. by   CMCRN
    We are 500-600 deliveries and if your pt goes to c section you become the circulator. Nicu comes for the baby though. We recover. Try to get baby back with mom in recovery. Most of us also can be the scrub nurse.
  9. by   MissBrittanyRN
    We deliver about 5500 babies per year. We have our own ORs and PACU. Monday-Friday day shift, we have an "OR team" that is made up of all labor and delivery nurses and labor and delivery surgical techs. There are a few l&d nurses that are always part of the OR team, but all labor and delivery nurses are trained to circulate (and all of the OR team are trained for vag delivery and labor pts.) Up until a year or two ago, if your labor patient went for c/s, you went with them, circulated, and recovered. Depending on the reason for the c/s, either NICU or another L&D nurse would catch the baby. This still holds true if the OR team is not there. If the OR team is there, they have a circulating nurse, baby-catcher, and a PACU nurse. It is almost like an assembly line (can be good and bad) monday-friday because there are so many scheduled c/s.
  10. by   LDRNMOMMY
    Small military L&D unit 60-100 deliveries per month, about 70 average. We circulate and recover our own c-sections when it's a labor patient and the section is called. For scheduled c/s we try to have a circulator and a separate recovery nurse. Usually nurse who recovers will be the baby nurse in the OR. Mom recovers in the LDR and baby transitions with mom when staffing allows and baby is in no distress.
  11. by   L&Dnurse13
    At our hospital we do around 500 deliveries a month. The pt's RN will circulate during the c/s and recover mom. Nicu does the initial assessment of baby then if stable we weigh baby and let mom see him/her. Then baby is taken to nursery and mom is moved to OBRR. Mom stays an hour and when dc criteria is met is transferred to PP and reunited with baby.
  12. by   tewdles
    My experience was in a high risk L&D, we did 3500 to 5000 births/yr. The L&D nurse circulated, we employed our own scrub techs, the OB surgical suites were part of our department, NICU provided the infant care, mom and baby went to recovery together accompanied by the labor nurse, although there was an RN assigned to the recovery room as well and the labor nurse would return to the unit when her documentation was completed (she often would have some loose ends to tie up with unscheduled CS). After the post op recovery the mom and baby would return to the OB room where they would complete their post delivery care in their original room with their original nurse (when possible) until discharge. That hospital moved away from the concept of seperate nurses and units for labor and postpartum back in the 80s and built a completely new facility to accomodate the "one room" philosophy for care of the OB patient. It was a huge community success and the nurses learned to enjoy it as well. Scheduled CS had dedicated circulating and scrub staff...that was their job for the day...just OR...that was also why there was a dedicated RN for OB PACU. Post op the scheduled moms and babies were sent to rooms which were designed just for routine PP care...no labor or delivery amenities. All labor nurses were trained in PP care...some nurses were trained only in PP but the majority were cross trained. The labor and delivery trained nurses also cared for the "high risk" prenatal women...they were housed on an adjacent unit with quick access to the delivery and surgical suites.
  13. by   FLOBRN
    where I am in Florida we do about 1700 deliveries a year. We circulate our own c/s and recover them as well. HOWEVER, we follow the NRP guidelines and have one person JUST for the baby. Perhaps this could be implemented in your facility. So for a vaginal delivery we have the labor nurse and a nurse for the baby at delivery. For all c/s we have the circulator, an RT, a nurse for the baby (always a nursery nurse) and the neonatologist. It is still sometimes difficult to have been the labor nurse, circulator and recovery nurse. Usually this isn't necessary but at times it is. The last thing is in Recovery we follow the OR standards and have two staff in recovery when recovering a patient.
  14. by   jenrninmi
    We do, but we also have our own OR.

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