Charge and Resus --How does your facility do it?

[HopefulRN2010]

Hello Everyone!

I work in a local level III NICU at a delivery hospital. Our current system is for our charge nurse not to have an assignment, or if she does, she usually only has one baby. And the charge is responsible for also attending deliveries (resus). Our manager wants to change it so more of the staff attends deliveries not just charge. Which I agree with, but the way she is going about it doesn't really make sense to any of us!

I was just curious what method other hospitals use? And do you like? Any suggestions appreciated. Thanks!

[vandermom]

We are a small rural hospital with only a level one nursery. All of the OB nurses are NRP certified and there is an RN dedicated to each delivery vag or C/S. If there are any risk factors present (meconium, gest diabetes, prematurity etc) then a pediatrician is present.

[SteveNNP, MSN, NP]

I work at a Level IIIc ECMO/cardiac unit with an ADC of 65-75. Our charge nurses do not take assignments. We also do not have a "first admit, second admit" setup either. We have a dedicated 4 bed admission/stabilization unit, which has 2 nurses assigned to it. A fellow, resident or NP will attend the delivery and bring the baby to the unit for stabilization/admission. The nurses downstairs on the main unit then take over once the baby is transferred down with lines/tubes/meds, etc done and ordered. There should be relatively no admission-type work once the baby actually is transferred to the main NICU.

[NicuGal, MSN, RN]

I think I love your set up! We are looking at, hopefully, a 5 year timeline to a new OB/ NICU wing. I am going to suggest something like this!

[Nurse Connie]

We are a small Level III 30 bed unit. We don't attend births, since we do have residents and the OB nurses are NRP certified. The charge nurse takes an assignment and we are assigned admissions.

[NICURN29]

We usually have a charge nurse with a lighter patient assignment (but plenty of other stuff to do), as well as a designated first admit nurse. We have a 23-bed level III NICU. We don't always get a baby on every shift, and there are shifts where we get more than one, but we flex accordingly. Usually, if you are getting a smaller baby, someone is going to pick up part of your assignment, which frees the first admit nurse up to go to the delivery (we have an attending and an NNP/PA, but no residents or fellows), and we do have an RT with us. For late preterms, it's usually just the NNP/PA who goes, maybe with an RT. If it's especially busy, the charge nurse might be the nurse who goes to any deliveries where a nurse is needed. In a c/s, we are in an outer resuscitation room, and someone brings us the baby, which is also what happens in a lady partsl delivery. We don't have to scrub up and go into the OR.

[muircv]

We're a 65 bed unit, the only level III in the state, no where up here does echmo. Our charge doesn't take an assignment unless we're in a bind. We are chronically short-staffed, so it does happen, but we have a resource nurse who does all our PICC line dressing changes, goes on transport, and is just over all "resourceful" who ideally doesn't have an assignment either. We don't always have a first admit assignment, sometimes we know it will go to resource, but if we know we will be getting babies they staff and make the assignments accordingly.

[HopefulRN2010]

Thanks again for all your responses! You all have given me several ideas to take back to my manager.