Unsafe staffing in OB dept - page 2
I've been a long time lurker on this site for nearly 4 years now and this is my 1st post! I changed from cardiac nursing to OB nursing back in June and have loved every minute of working with... Read More
Feb 3, '07Quote from SmilingBluEyesAbsolutely! I also work at a small hospital (about 550 babies/year) Fortunately, our P/P state that we must have 2 OB RNs in house at all times, and if we get floated to another dept we cannot be assigned pts or take care of any infectious pts. Our OB manager is also very staff-friendly, but some of our house supervisors are very pushy about trying to pull us from OB.The 2nd person needs to be a qualified nurse, not an aide.
To the original poster, STAND YOUR GROUND! I'm not saying be hateful when you are discussing it with your superiors, but be firm. Don't let them push you to do something unsafe. It's not only your license on the line, but the safety of the future patients of your unit. Fortunately, it sounds like the VP will be there for you. Best of luck!
Feb 3, '07I used to work at a small hospital OB dept, and often was the only nurse in house with NALS, and the only nurse in OB, no one else within shouting distance. We were told to hit the code blue button in the room, or have the SO hit it if we needed assistance. We also had a panic button in our pocket that rang at the sherriff's office. The panic button was useless cause the dispatcher would call the ER and tell them to go check on the OB nurse, and the ER would call us on the phone (can't get to a phone, that's why I hit the button, getit?).
Anyway with OB emergencies I got very good at delegating non OB staff. They say I got bossy, lol. But my advice is to hit that code blue button with emergencies. They will either show up and help every time, or they will get peer pressure to admin that this is NOT a safe practice.
Feb 3, '07All of these situations sound horrible, one of our docs who no longer practices used to demand that an L & D nurse and a nursery nurse be on the floor for that occasion when a mom gets off the elevator. Anyone who has been on OB for any length of time can tell of Moms getting off the elevator. I have literally pulled the pants down of one and her pants were the only thing holding the baby back. ( Funny tho, the ER doc I had summoned was hollering for me to start an IV ! ) Ok, and which set of hands should I use ?? Also have seen a Mom get off the elevator with blood-saturated bath towel between her legs. Everyone has tales of how things can turn sour quickly. We don't have a code button either, just phones which are not easy to reach. The bottom line with these places is money but like one poster said, millions are gone in a flash in a lawsuit.
Feb 3, '07Quote from SmilingBluEyesI agree that the second person SHOULD be a qualified nurse. However, you were alone, you were told you could not have another nurse and you did not get another nurse. I believe that in that particular situation, you would have been better off with a warm body sitting by the phone.I disagree. The 2nd person needs to be a qualified nurse, not an aide.
It's good that your VP is on your side. With her, lobby for what you SHOULD have. In the midst of a bad situation, try for whatever you can get at that time and then go thru channels (as you are now doing) so that that situation cannot repeat itself.Last edit by NurseNora on Feb 3, '07
Feb 3, '07But there *was* another nurse available in her situation. The house supe made a bad call, keeping that nurse away in another unit, (that apparently did not need her that badly) when there was an actively laboring patient---and then sending her home at 0600. This is wrong on every level. It was so beyond silly---the supe ended up admitting patient #2 when the other nurse assigned to the unit could/should have been doing that. Stupid use of resources, really, if you think about it.
And if an OB emergency happens, a warm body is not enough; I want an NRP-qualified nurse there with me, readily available to help out.Last edit by SmilingBluEyes on Feb 3, '07
Feb 3, '07Quote from SmilingBluEyesI think so too!I disagree. The 2nd person needs to be a qualified nurse, not an aide.
Feb 4, '07Quote from rntobe2005Good grief.She told me I was "crazy to be asking for help when we have 19 patients upstairs for 3 nurses and 1 aide."
I work NICU now, but in a previous life was on a (very busy) colorectal surgery floor.
We were lucky to have 4 RNs on at night - for 31 beds! And that was only on busy post-op days. Most nights were 3 RNs for 31 beds. And that's total staff - no LPNs, no CNAs, just us.
Now I know that's a bit excessive as far as workloads go, but surely they could have managed 19 patients with 3 staff.
That's what I reckon anyway, and that's coming from a med/surg point of view.
Feb 4, '07Quote from rntobe2005So I have question about documentation. Is it right to document in the patient's chart about the unsafe staffing and that the HS was notified, along with their response?? I wanted to include that in my labor notes, but didn't know if I'd get in huge trouble for doing so. I've never been faced with situation, so this is the 1st time this has come up.
I haven't filed a report with Risk Mgt, but I will now. At least then, maybe they'll realize just how serious I am on the matter.
I'm glad to know I'm not alone in my thoughts on this subject. Thanks for your reply!