Does your staff do C/S's or does OR team??

purplemania, BSN, RN · Sep 17, 2004

our L&D nurses assist with sections and tubals. We have two suites in L&D area. The CRNA is whoever is on call or scheduled. Our deliveries are about 100-150 per month.

MommyLauraRN · Sep 18, 2004

I think we do between approx 2500 deliveries per year. We have 2 ORs on L&D. Our own nurses scrub and circulate on all C/S.

fergus51 · Sep 18, 2004

I really don't know how that would be feasible when you do so few deliveries a month. What's your section rate?

Nurse_Educator · Sep 18, 2004

We are a larger hospital, 200+ deliveries a year. We do all our own c-sections on the unit. I recommend hiring / training a couple good scrub techs for your unit. You can teach them do to instruments on the c-sections, or they can help out on PP or Nursery if L&D is not busy. That way you have maybe only 6 staff that you have to competency for scrubbing on cases. You will have to teach the RN's to circulate, but that should not be a huge issue. Is Anesthesia there 24/7?

We are a small rural unit that does approximately 45 deliveries a month on average. Of course, we have crazy months that we do 65 and really slow months that we only do 35, but on average about 40-45. Anyway, we are constantly bombarded by the OR crew that the OB staff should be doing their own C/S's on the unit. Currently, if we have a stat C/S the OR team gets called in to do them.
I understand the reasoning that with a 30 minute from decision to incision time that it would be better for in-house staff to do them, but we do so few per year that our skills just wouldn't be up to par and we don't currently have the staff available for that. And the expenses involved in training all 30 of us to learn this skill would be incredible and to keep up the skill would also involve extensive training, not to mention more staff to fill the area also. Being a small unit, we would have to train everyone because of days off, on call, etc.
We confront this problem all the time and get frustrated. Mother and baby are of utmost priority and we do start opening the room and have the patient in the room sometimes prior to OR arriving, and then they take over and we concentrate on baby. (the labor nurse assists with the baby at this point).
Do any small hospitals our size staff their own C/S and how does it work?? Our experience is that only larger hospitals are doing this and it would not work in a small hospital. Thanks for your help. Sharon

bam_bam · Sep 18, 2004

250 deliveries a year here....we don't even have our own OR. We have to do C/s in the main OR. We go to catch the babe and that's it.

allnurses Guide · Sep 18, 2004

Well, we are sooooo rural that we don't really have regular OB staff. There are 8 nurses who have OB training but do med/surg on a regular basis or are the House Supervisor/ER nurse. (One nurse in a three bed ER and the supervisor - :uhoh21: . I do that part-time. Most of the time I'm just a regular floor nurse doing med/surg stuff. Our OR crew does the cesareans but we are the baby nurse.

It would not work for us to have our own crew . . we have too many other irons in the fire. :)

Our OR crew does a great job and I have never heard them say anything about wanting us to do our own cesareans. If we did it would sure cut down on some of their hours.

I'm talking really rural . . .. :)

steph

verock · Sep 18, 2004

I work in a small community hospital where we average about 60-75 deliveries a month. Our L&D nurses circulate and we usually have an OB tech who scrubs or a nurse that scrubs. We have a nursery nurse or a L &D nurse that catches the baby.

Sarah, RNBScN · Sep 18, 2004

We are small facility so the OR nurses do the c/s. Nursery nurse and Paed. are present during the c/s from OBS dept.

BETSRN · Sep 18, 2004

WE do about 830 deliveriesa year and it was a nightmare getting us all trained (for us and the regular OR staff). Our techs scrub and RN's have to circulate. I ahve to say, however, now thatw e are all trained it is very nice,for both us and the patient. I am not too sure it was cost effective spending the money to train us and now having to staff a bit differently. However, now we do not ahve to worry about the OR telling us they are too busy (even though a baby is a priority).

CA CoCoRN, RN · Sep 19, 2004

We have two regular ORs and a smaller one that we use for d&c or retained placenta's etc.

We've been so busy these last couple of months that we've even had to do regular vag deliveries in two of our ORs and save the other for emergent sections.

That said, we do our own sections. Due to CA law/ratios, etc. we even have a dedicated Circulating RN whose only job during the day is to circulate in the sections. Unless, of course, if we have both rooms going...then the regular L&D nurse circulates. And yes, we ALL circulate because before the law went into effect, we took our own sections back.

We have 24 hr inhouse Anesthesia and OB.

The scrub is either an LVN (that's the only way we use them in our OB) or a scrub tech. If it's an emergency though, some of us RNs scrub.

Last month, we did almost 600 deliveries.

Marie_LPN, RN, LPN, RN · Sep 19, 2004

L and D nurses assist in the regular deliveries.

There is a special team of maternity nurses that assist the OB with C-sections, not the OR staff. OR staff does all the other female-related surgeries.

I figure that they're either going to have to revamp the current system or get the OR staff in on the C-sections, the surgeons are complaining about the maternity nurses not knowing instruments, sutures, etc. But heck, they just started DOING it this way a month and a half ago!!