Scheduling Inductions

renerian, BSN, RN · Oct 1, 2003

Actually my niece was induced yesterday at 9am and still to my knowledge has not had the baby. Kinda worried about that. AT the hospital she is at all their inductions have to report to the hospital at 6am to get ready and they said usually by 9am they are in good to go.

renerian

webbiedebbie · Oct 1, 2003

L&D at my hospital is a money maker. They bend over backwards to get the inductions done even if they have to call in extra staff to cover them. Our inductions come in the night before and in the morning. They don't preop scheduled sections. Those are done on PP. If PP is full (19 beds), then overflow to Peds for deliveries and preop scheduled sections. It is rare for a scheduled induction to be rescheduled.

imenid37 · Oct 1, 2003

Our unit is very small 60 del/month. We have 6 LDRP's and 12 beds for gyn/c.sec, and overflow from the LDRP's when we're busy. THREE pit inductions is the most we have scheduled in one day. If we are too busy w/ walk-ins to accomodate the inductions, we have to start calling our dr's and asking to postpone until we are able to either get the rooms or staf or both available to cover. I f the dr. refuses, it is up to our manager and the chief of ob to make the call. Mostly, the dr's are understanding, much more so than the pt's, about this because they don't want a bad outcome either. Thankfully, there's usually a macrosomia or post-dates w/ a good BPP we can postpone until the afternoon when we have some discharges or extra staff. We usually have pt's arrive for inductions at 0700 or 0800. They get 30 min. of efm prior to the pit and while they're on the monitor we ask them the 30,00 or so admission questions we have to go through.

SmilingBluEyes · Oct 1, 2003

Where I work, we also will bend over backward to accomodate inductions on schedule. Yes, extra staff ARE called in to take care of the scheduled indx. This is expected as we are service-oriented unit.

Rarely are they re-scheduled unless we are full or the floor is dangerous. the doctors become VERY irate when we have to do this, but what can you do if no beds are available?

In the middle of trying to get them ready at 6 a.m. (when they are told to show for pit indx), we are also prepping moms for csections. It can get pretty hairy for the last 2 hours of nightshift, getting ready. Days comes in, as do our doctors, expecting the pit to be "up there" already and things in full-swing. Sometimes, we are lucky to get them admitted alone. If we are full, we have to make those unfortunate calls, telling parents they are on-hold. Our cytotec indx are generally asked to show up at roughly 9 p.m. to start then with pit to begin at 5 or 6 the next morning. ....but...

Everyone, especially our doctors, knows labor and delivery are by their nature unpredictible. I wish our doctors would TELL these moms that they MAY be on the books, but not always accomodated if we are too full or busy to do their inductions on time. Oh, we get some VERY angry parents, who cry on the phone when we tell them we are sorry but cannot accomodate them until the evening or next day...

sigh....

such is L and D!!!!

imenid37 · Oct 1, 2003

Deb, do you guys start the pit before the dr. is in the hospital? Ours have to be in the hospital (not the unit, they can be in the or for gyne or c/s) for the first 30 min. of pitocin and they are supposed to have personally done a ve on the pt. w/in 1 hour of the pit being started. I wasn't sure what you meant by "having the pit "up there" . If you meant "up there" as in hanging and ready to go or as in the dose having been uppped several times before they appear. Do you guys have dr/cnm in house all of the time?

SmilingBluEyes · Oct 1, 2003

yes we start pit AS SOON AS A reactive strip is obtained. NO they don't have to be in the hospital and generally we won't see them until lunchtime or when we have a csection. they expect our pit indx to be ROLLING by 6-7....

always in a hurray.

no we don't have a dr./cnm in house UNLESS VBAC going on. if an epidural is running, however, anesthesiologist remains inhouse til delivered.

hth!!!!

PegRNBSN · Oct 1, 2003

We do 250 deliveries per month. We schedule a maximum of three scheduled procedures per am (inductions/c-sections) We have scheduled times starting at 4:30 am. This helps to stagger admissions. We have an RN who starts at 5:00 for a 10 hr shift to help with am admits. We call in extra staff when able, but have to delay inductions a couple times a month. Cervidil inductions come in the anywhere from 6:00pm until9:00pm and are counted in the number for procedures for the morning

ceecel.dee, MSN, RN · Oct 1, 2003

Are Pit inductions still one-on-ones in your bigger hospitals? If not, one nurse to how many inductees?

fourbirds4me · Oct 3, 2003

Our problem with inductions is not the staffing.... it is the room we average about 100 deliveries/month and usually over 300 outpatients/month. We have 4 big LDR rooms and 2 VERY small ones (they barely hold a bed and a chair.....we usually use these for our scheduled sections....labor checks etc.), A treatment/triage room and a NST room that has 2 recliners w/monitors. We only have 3 sheduled deliveries/day (section or induction). When we walked on the floor yesterday every room was full! We had to send one of the inductions home.... and a woman come in complete that ended up with a high forceps delivery in the treatment room!... it was crazy. Sometimes we have people waiting.... and I think that is dangerous.

Anyway.... cervidil patients come in about 5:30 the night before and orders are to start pit at 6:00am. Pit inductions are supposed to show up between 5-6am and the doc expect to AROM during morning rounds.