Quote from niquern
My hospital just closed our Level II NICU and converted us to a Level I Nursery. They also fired our Neonatalogist of 25 years and bought in a new on-call neonatlogist. We are in the inner city and a very high risk neigborhood where most of the mothers don't have pre-natal care. Do any of you with a Level I Nursery and no NICU have just on-call doctors and no one in house. We have already had two incidents in the pass six days since they took over. One baby was mec-stained and no neonatalogist to intubate and visualize the cords. Prayerfully the baby didn't have any resp. distress but I feel that is a very dangerous situation. The nursery nurses are still required to attend all high-risk deliveries in L&D and any outside deliveies that come in the ER without a neonatalogist, pediatrican, resident, intern or NP. We have no doctors in house except the OB-GYN. I am getting ready to resign because I don't feel that this is a safe situation.
I am a L&D RN in Waimea, Hawaii and we have a level I nursery. If the OB-GYN knows it is a high risk patient they are sent and delivered at the tertiary care center on another island.
If the patient comes in labor and high risk such as your case(which they sometimes do as we all know very well) they are delivered with RT and Peds present. Both of them, in addition to the OB-GYN or CNM, can intubate. We have an AWESOME group of Docs that are very dedicated to their craft and
to their patients we have no problem having them in attendance. By the time the transport team from Oahu where the tertiary care center is, the babe is usually stabilized---usually! The transport team is awesome as well and the PEDs and OB are in constant communication by phone in anticipation of any problems during or after the delivery.
Our RN team averages 20+ years experience with an NICU RN of greater than 20 years on staff. All RNs are NRP certified as you are. I am only the second RN with experience under 5 years.
Sounds like you all have restructuring you all are adjusting to. I feel for you. Hang in there---find strength in your staff. Do you have Respiratory Therapy on staff readily available and experienced to intubate? What about your OB?