Drills?

[ragingmomster, BSN, MSN, RN]

Our hospital does not automatically give raises or promotion to higher clinical levels, we have to "ladder" our way up.

Since I have been here for just over a year, I am now eligible for laddering.

I am thinking of trying to put together a drill for say a stat c/s or delivery in the lobby or at the curb.

Anyone using a drill program in their facility?

I am off now to make a web search....

[SmilingBluEyes]

suggestions:

dystocia

uterine rupture

out of hospital (or in the ED, etc) delivery of high risk newborns, e.g. preemies, drug-addicted moms etc

cord prolapse

NRP routines

you can drill on these situations based upon what your hospital policies and procedures say to do....

[midwife2b]

A shoulder dystocia drill is a great idea and I would let you "ladder up"!

Emergency C birth drill would be good also, unless you have a lot of staff and get the patient to the OR in just a few minutes. Sometimes too many people is as bad as not enough, though.

[ragingmomster, BSN, MSN, RN]

our most recent stat c/s was on a 28 weeker. the pt had left ama the previous week with pre-e because she had to work to support her other 2 kids. she arrived unable to tolerate the pain of labor and we had the resident check her cervix before we moved her off the stretcher, "bag in the lady parts" was the report. another resident arrived with a sonosite to check fetal presentation as i and 2 other nurses cut her clothes off, shaved her, started an iv and poured bicitra down her throat. resident 2 says "definitely breech lets go". anaesthesia and an attending were in the OR as we rolled down the hall and handed her off. baby was out in less than 3 minutes from room - in.

dead baby, had been for days.

seems the 2nd resident checked only presentation, not fht's.

attending comes back at the nurses for not checking fht's and we all stood together and told him where to get off.

resident was spoken to later and apologized individually to all of us.

But had we been drilling, I think we could have avoided the whole mess by having assigned roles.

Like an incident commander to be sure that all the pieces of the puzzle were put together before we went down the hall.

Maybe the second nurse in the door could be reviewing a mental list or cheat sheet to be sure it all got done before heading to the OR? We were perfect for the c/s, except the fht's being missed.

Any thoughts?