I have been working in a small facility for about a year. We do do about 65-80 deliveries a month.
Problem is our doc's are no shows for about 20% of our deliveries...we have had 12 RN deliveries in the last 8 weeks. We have a midwife and 4 docs who deliver with us. When we call them re: pt status, give report of pt arrival, etc. the doc's who tell us that she will get there "after she takes a shower, and gets her kids to school" (the pt was crowning), our midwife on many occasions, states "I don't want to get out of bed" takes her time on calling the covering docs for pt's in need of section (2 abruptions in 2 weeks). Our last abruption was a 31 weeker with heart tones in the 60's x 70 min before we sectioned her. Waiting on docs!
We have had several incidents like these. Our new manager is trying to implement change with the MD's, but not making any advances.
Then we have nurse situations where we are cross trained to mother baby, but have nurses who refuse to work L&D, but we have to depend on them in emergency situations. (We have 2 L&D nurses scheduled everyday, with a backup nurse either on call or in M/B, but our backup has no idea how to function with us) so we end up "in a barrel with our feet in the air" with no one to call or back us up.
I hate to give up on the unit, but I do not want to be responsible for a bad outcome, I don't think I could live with myself if I knew I could be a cause for a parents heartbreak due to circumstances that WERE in another person's (Doc's) control.
I was wondering if anyone had any ideas or suggestions? What would you do?? Am I imagining the danger, or is this happening everywhere?
I know doc's don't like to come in at night. I have worked in busier units and have never seen doc's like these. Please help!
As the legal nurse consultant said, just because you have sternly asked (and even strictly told) the doctor to come in RIGHT NOW, and he refuses, that does not mean that you are not liable in the situation. If something bad were to happpen, you could easily still be found liable- remember, charting is great, but it doesn't solve the immediate problem, and your job is to solve the immediate problem. Try calling other doctors in the same practice, saying "Your associate Dr. So-and-So is refusing to come in, can you come in?" If need be, do the same thing to the hospitalist present in the hospital- they are designed to be the eyes and ears of doctors who cannot get to the patient at that moment. Hopefully, you would prompt some peer pressure on these doctors, by other doctors (and even by one another) because they are tired of being bothered with issues other doctors need to take care of.
Also, get the risk manager involved right away- they should be aware of this problem from the getgo, and involved in every step of the process in adressing the problem. After your director, the risk manager is the absolute first person you should speak with. The risk manager should probably be your absolute best friend in this process- he/she is the one who will let you know how to help fix the problem and keep your job at the same time, which I assume is your ideal goal.
Be sure to take steps as a unit to reach out in kind ways toward the nurses on Mother Baby and towards the doctors- to let them know that you do appreciate them when they are on your unit. Increased and repeated cross-training on units may be one thing that could help with your unit-unit conflict (between MB & L&D)
Remeber that this could seriously affect your ability to get a job in the future. If you get fired, a future employer can see it as "you don't collaborate well with peers," and if you quit and explain this reason, a future employer could see it as "you run away from or avoid problems instead of fixing them." Also, I would gues that the sooner you bring the issue up with your risk manager, the less likely you are to be fired for reporting this, because the risk manager will know how that could backfire onto the hospital legally and give you the right to sue them for being a whistleblower.
I have to say, I am very surprised you have not gone all the way up the chain of command yet, as this seems to be an ongoing problem.
Good luck in whatever you decide to do, as this is a very sticky situation.
sunflrz321
64 Posts
Hi there,
As the legal nurse consultant said, just because you have sternly asked (and even strictly told) the doctor to come in RIGHT NOW, and he refuses, that does not mean that you are not liable in the situation. If something bad were to happpen, you could easily still be found liable- remember, charting is great, but it doesn't solve the immediate problem, and your job is to solve the immediate problem. Try calling other doctors in the same practice, saying "Your associate Dr. So-and-So is refusing to come in, can you come in?" If need be, do the same thing to the hospitalist present in the hospital- they are designed to be the eyes and ears of doctors who cannot get to the patient at that moment. Hopefully, you would prompt some peer pressure on these doctors, by other doctors (and even by one another) because they are tired of being bothered with issues other doctors need to take care of.
Also, get the risk manager involved right away- they should be aware of this problem from the getgo, and involved in every step of the process in adressing the problem. After your director, the risk manager is the absolute first person you should speak with. The risk manager should probably be your absolute best friend in this process- he/she is the one who will let you know how to help fix the problem and keep your job at the same time, which I assume is your ideal goal.
Be sure to take steps as a unit to reach out in kind ways toward the nurses on Mother Baby and towards the doctors- to let them know that you do appreciate them when they are on your unit. Increased and repeated cross-training on units may be one thing that could help with your unit-unit conflict (between MB & L&D)
Remeber that this could seriously affect your ability to get a job in the future. If you get fired, a future employer can see it as "you don't collaborate well with peers," and if you quit and explain this reason, a future employer could see it as "you run away from or avoid problems instead of fixing them." Also, I would gues that the sooner you bring the issue up with your risk manager, the less likely you are to be fired for reporting this, because the risk manager will know how that could backfire onto the hospital legally and give you the right to sue them for being a whistleblower.
I have to say, I am very surprised you have not gone all the way up the chain of command yet, as this seems to be an ongoing problem.
Good luck in whatever you decide to do, as this is a very sticky situation.