My poor co-worker! - page 4

I really guess I would just like to hear some opinions about something that happened to one of my fellow nurses. I'll try to make it short. One of the 7a - 7P L&D nurses came onto her shift to be... Read More

  1. by   DEB52
    After many trials and nurses quitting , our OB department decided on a simple pulling plan. L&D and High Risk pregnancy would cover each other and NBICU and MBU(postpartum) would do the same. This is a simple pull plan for us because we have seen alot of different ways. Our hospital merged with two other hospitals. When this happen, we were getting pulled to the other hospitals without any orientation to equipment layout of the unit ,ect. They said that the paper work and policies were the same. This stopped after many nurses quit at all three hospitals. We are much happier with this way. I am happy to say that we don't get pulled off the OB unit. :spin:
  2. by   crissrn27
    We too do the "call-offs" for low census in the nursery and PP. In L and D all 5 of the RNs come in regardless of patient load. Last night we had no one all shift in L and D with 5 RNs back there doing nothing. That would drive me crazy. None of our nurses have to be pulled anywhere if they don't want to. As for this situation, I agree, tell your friend to get a good att. and sue their pants off....for loss of wages, etc. I know there has to be something she could do. I don't think the BON would actually do anything to her after they new the real story, but she better see whats to be done to protect herself from this also, just in case.
  3. by   Minou
    Unbelievable !. I work in a small Birthing Center that is actually in a separate building from the main hospital ( soon to be changed ). We are a closed unit so do not float ( that is nice !!!! ) The price of that is we take mandatory call twice a month for FT and once a month for PT.
    Personally I think floating should be illegal ...it is dangerous. Someone mentionned a rn is a rn is a rn.....that is the mentality indeed.....However, would anybody ever think of having heart surgery done by an orthopedic surgeon ? Every hospital unit has become so specialized with highly skilled RN's ( the professionals that we are ) that I dont understand how they can just throw a rn into a different environment and expect her/him to function normally. I'm glad I don't float but if I had to, I would expect to help out but not take a full load.
    This should never happen to anyone !
    Minou:
  4. by   oneillk1
    Quote from traumaRUs
    I'd be hitting the want ads. If you are expected to take a full med-surg load, then orientation is in order.
    Exactly, the same thing happens where I work, (I am in ICU and have never worked in my hospital before this, my only ward experience was as a new grad for three months in an elective orthopaedic ward, and for the last 3 years worked in OR!!). Fortunately I have not been sent yet but if I am sent and am put into a situation where I feel unsafe, I will be telling everyone about it then and there because at the end of the day I am not prepared to risk my registration because the hospital has staffing issues. I have never been oriented to any of the wards. If worst comes to the worst, I would go off sick. I know that sounds like a terrible attitude but at the end of the day you have to put yourself first because noone else will!
  5. by   janetrnc
    In our facility every nurse knows she might get floated but each department has a list of what their nurses are allowed to do when floating. L/D nurses don't take assignments or give meds. Saying they could give meds after looking them up is unreasonable, how many times do med/surg patients have pages and pages of medications? If that is true by the same token then why couldn't a med-surg nurse be expected to float to l/d and take a Mag patient? They can look that up in a drug book! It's all about patient safety. If you are put in that situation you need to say out loud to whomever is in charge "I do not feel safe working here and taking a full load of patients".
  6. by   caroladybelle
    Quote from Jolie
    Originally Posted by Bridget O'Malley
    Why these nurses can't...take care of an infected foot of a diabetic (as though everyone who delivers a baby and her multitude of visitors is 100% healthy);...is beyond me.

    If a nurse cares for patients with active infections, he/she must scrub, shower, and change clothes before returning to OB. This is not feasible, given that an emergency on OB would require the nurse's immediate return.
    First, I believe L&D should not be floated to MS without previous orientation. That is just inappropriate.

    Second, how come on most MS units, nurses must take care of BOTH infected and immunosuppressed patients in the same assignment?

    I recently spent 10 monthes on a hemo malignancies unit in a facility considered one of THE BENCHMARKS of care. These patients are among the severely immunocompromised patients you will see. Some will have ANCs of less than 50 for over 60 days after chemo. Yet on the same unit, and in the SAME assignment, a nurse may/will care for another patient with VRE/MRSA/C-Diff. That is why you adhere strictly to contact precautions, handwashing and universal precautions. Nobody obviously has us shower between patients.

    Interestingly, this unit screens all patients for Cdiff/MRSA/VRE. The rates of infection, even in those that come in healthy (new dx) and without histories of chronic disease, are incredibly high. There are a lot of people carrying this illnesses without symptoms.

    Yes, it would be nice and optimal to have a nurse only care for clean patients and another have the infected ones. But given the number of "hidden" infections out there, it is not going to happen.
  7. by   caroladybelle
    Quote from janetrnc
    In our facility every nurse knows she might get floated but each department has a list of what their nurses are allowed to do when floating. L/D nurses don't take assignments or give meds. Saying they could give meds after looking them up is unreasonable, how many times do med/surg patients have pages and pages of medications? If that is true by the same token then why couldn't a med-surg nurse be expected to float to l/d and take a Mag patient? They can look that up in a drug book! It's all about patient safety. If you are put in that situation you need to say out loud to whomever is in charge "I do not feel safe working here and taking a full load of patients".

    As an MS nurse, I have been floated to Postpartum and had to take a mag patients.

    But my favorite is the fact that many family care units will not take patients that clearly would be better cared for on their unit yet have a MS problem, that they will not care for.

    For example, patient that is 8 monthes pregnant gets into an auto accident. She is admitted to ......ortho w/premature labor and a fractured ankle. Why? The family care unit, several blocks down, does not know how to care for a fractured ankle. Patient is on antilabor meds and requires fetal heart tones to be assessed every two hours. MS section DOESN'T EVEN HAVE something to assess fetal heart tones with, much less anyone that could do so. We have to get family care nurse to come down every two hours to assess. But will they accept the patient? No, because of the fractured ankle.

    Which is of more ultimate concern to the patient's health? The baby. You can repair the problems w/ a mismanaged ankle much easier than a mismanaged birth.

    And, yes, the MS nurses had to look up and give alot drugs that we had no experience with.

    As an Onco nurse, there are lots of meds I give that are new to me, that I have to look up. Somehow, we are expected to just deal.
  8. by   General E. Speaking, RN
    Quote from caroladybelle
    First, I believe L&D should not be floated to MS without previous orientation. That is just inappropriate.

    Second, how come on most MS units, nurses must take care of BOTH infected and immunosuppressed patients in the same assignment?

    I recently spent 10 monthes on a hemo malignancies unit in a facility considered one of THE BENCHMARKS of care. These patients are among the severely immunocompromised patients you will see. Some will have ANCs of less than 50 for over 60 days after chemo. Yet on the same unit, and in the SAME assignment, a nurse may/will care for another patient with VRE/MRSA/C-Diff. That is why you adhere strictly to contact precautions, handwashing and universal precautions. Nobody obviously has us shower between patients.

    Interestingly, this unit screens all patients for Cdiff/MRSA/VRE. The rates of infection, even in those that come in healthy (new dx) and without histories of chronic disease, are incredibly high. There are a lot of people carrying this illnesses without symptoms.

    Yes, it would be nice and optimal to have a nurse only care for clean patients and another have the infected ones. But given the number of "hidden" infections out there, it is not going to happen.
    interesting point- so true!
  9. by   withasmilelpn
    My guess is that there is a bigger liability issue involved in L&D. Probably we shouldn't be taking care of mixed patient populations (known ones at any rate). Cost is probaly the deciding factor, not good care.
  10. by   janetrnc
    For the posters who wonder why the OB nurse must shower and change before going back to work since the Med-surg nurses don't change between different types of patients, those nurses are going back to work with NEWBORNS... would you really want them taking care of MRSA, infected wounds, etc? Even if they use universal precautions would you really want to take a chance of carrying anything into the newborn area? Again, its not us against them, its about advocating for safe practice for nurses and for patients.
    Thanks
  11. by   SmilingBluEyes
    Pregnant women and newborns can have unique susceptibility to infectious disease others don't. That is why many places require L/D nurses scrub and shower prior to returning to L/D from M/S.

    Also, why send a woman with say, a broken ankle to L/D unless her complaint is pregnancy-related? I have seen countless pg women up on L/D only to find out theirs was a complaint completely unrelated to pregnancy. We have wasted time and maybe had a patient in needless pain for longer due to such things happening. If there is a doubt as to the health/security of the pregnancy, clearly, OB is where the pg pregnant goes first. But if there is no pregnancy-related complaint, she has no need to go to L/D.
  12. by   htrn
    We have had issues with our staff being floated out to 'dirty' rooms in med/surg recently ourselves. Bottom line, it is a VIOLATION OF STATE CODE for a maternity nurse to take care of an infectous/contageous patient if there is a possibility of her being recalled to the OB unit that shift.

    Now, as far as coming back and taking a shower and then going to work. That's all well and good if you have some time, but when we float anyone (RN, LPN, CNA) out to MS, we have to plan for them to be able to run through the doors and grab a baby out of someones arms, do a delivery, etc... without taking the time to change clothes, shower, etc.... Ideally, she should be grabbing hand gel as she is running down the hall.

    Things happen soooooo fast in OB sometimes. We all love it because of the unpredictability and excitement of the job - but because it is unpredictable, we always have to be ready to care for the most vunerable patients in our population.
  13. by   CRNI-ICU20
    Under state law, at least in most states, the charge of abandonment of patients assumes you have accepted the assignment and have established a patient nurse relationship with each of them, ie established with the patient that you are the nurse caring for each of them....that did not happen here....the hospital and their flying monkeys are in complete breach of the law here....she should sue them for unlawful dismissal....
    You can't abandon what you never had!! DUH! getting report on two of the five or so patients she was expected to take does not constitute her nurse/patient relationship....if that were the case, then when one nurse gets pulled to another section of ICU after just getting report on a patient, under their erred assumption, she could technically be considered to have 'abandoned her patient' eventhough she never set foot in their room...
    This hospital should be reported.....this is abusive and out of line....
    Where's the nursing association in her state? Why are they sitting back and collecting dues without support? if it was me, I'd get a lawyer....and sue their little curly tails off...this will taint her career forever!
    Shame on them for ramming this nurse like this....to save a few bucks, instead of doing it right...
    Staffing issues are not the bedside nurse's problem....if they are short that day, it's the management's responsibility to fill in the gaps and make the patient care safe....if this nurse did not feel safe in taking that big of a load, it's the management's responsibility to fix it...firing her for this and charging her falsely is so wrong....so completely wrong...
    tell her to get a pit bull labor attny....spome will work on contingency....
    this place needs a good butt whoopin'

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