Critical Acess Hospitals and Labor nursing

[mustang_convt]

Hello fellow travelers! I am a nurse in Indiana who is trying to break into the travel nursing field. I applied for and was granted my Cali liscense as my original plan was to go out West. However, for personal reasons I'm now thinking of staying in the midwest-hopefully Indiana, applying for Illinois now.

My question invokes Critical Access hospitals. There aren't too many travel jobs in Indiana but there are a few at CCA hospitals. I'm used to 60-80 deliveries per year. These hospitals do 100/YEAR so I'm assuming I'f someone comes to deliver there it is probably an emergency. I'm not sure I'm comfortable with that liability. The. Again-I'm pretty confident in my skills but not knowing the docs or where things are at when I need to move QUICK concerns me. Has anyone travels to a critical access hospital? What was your experience?

[NedRN]

I did a bit of reading about critical access hospitals, and it appears that it is only a higher Medicare reimbursement scheme to help keep rural hospitals open. Otherwise, it should be like any other small hospital. I looked at the list of such hospitals and it turns out that I have traveled to two of them unbeknownst to me. So it doesn't have anything to do with the nature of the patients, in fact, your deliveries should be routine as high risk patients will have been flagged and told to go elsewhere for their last trimester - at least that is what happens at smaller hospitals I have been to, and even some larger ones.

As far as liability goes, you can ask in the interview how many deliveries are done without a midwife or physician in attendance. That seems like a reasonable question to ask at any small hospital.

[bagladyrn, RN]

I have done OB travel contracts in multiple critical access hospitals. You do need to have strong skills in all facets of OB - L&D, PP, NB as well as some antepartum experience.

While it is true that most high risk pts. are referred you still need to be able to deal with these patients when they present and until they can be stabilized for transfer, which can often be long distance and take some hours.

Since providers are often not in house, especially at night you will have to manage patients on your own, know when to call in the provider (and how long it takes them to arrive), and very occasionally manage a delivery that just won't wait.

I don't know that the liability is that much higher (it sort of balances out with the numbers and usual acuity) but malpractice insurance is always good for peace of mind.

If you have other specific questions about critical access hospitals let me know.