OK....I have to vent and would LOVE some opinions...
I work on a small low risk L/D, M/B, Pediatric and GYN unit. We are occasionally faced with the dilemma of no patients or one couplet and such at a time (not too often however it does happen). With the low census on our unit and the high census on Med/Surg, they are wanting one nurse to float while the other nurse stays on the floor alone. We are a locked unit on a different floor then any other unit in the hospital. Last night, we had one freshly delivered couplet with a heavier blood loss then average but not quite a hemorrhage (worth watching). They made the other nurse float. My issue is I think it is a huge safety concern and NOT in the best interest of the patient for there to only be one nurse on the unit. If we have a mom up to the bathroom and she passes out...how are we going to get help quickly? Tell the mom that is passed out on the toilet...."Hey hang on a sec....I have to go all the way to the desk to get the number to call up stairs to get the other nurse back on the unit"?!?!?!? Then ten minutes later help arrives!?!? I don't know....I am just very leery about this newer procedure with floating. AWHONN guidelines do not support this. What do you all think?
Jbneal, you might work where I do! We are currently trying to make a realistic set of guidelines as to what we can and will do safely when we have to float. This doesn't include anything neuro, ortho, cardiac or any patients that get more meds than simple antibiotics or pain meds.Nurses who float to it I it, get the obgyn surgeries, post op csections, and stable vag deliveries. They do not take ca of the babies, triage or labor patients. We pamper them.
Be careful what you ask for. Are you ALONE on the unit- no other staff at all- you have a complaint, but what if the solution is moving the mom/baby to a med/surg floor and floating both nurses as will as insisting you take a med-surg assignment with the mother/baby. Can you care for the mother baby better alone but on the unit designed for this care, or with more staff around, but no-one who knows what to do with this patient population and you have additional patients you don't know what to do with. All I'm saying is consider the options open to the hospital before you start making too much of a fuss.
I find that it is the same at all hospitals in the USA when it comes to OB and the pompus attitudes of nurses from med surg and any other nurse that that has never worked OB. They think the reason we want to have two nurses on OB at all times is because we are "primadonna's and " oh we can take 7 med surg. patient and you whine because you dont want to take care of one patient by yourself. These are the same nurses that would not ever step foot in OB to take care of a labor patient, but think because we went to nursing school we should be able to take care of any type of med surg patient on OB when they are full and we have overflow. We actually had an patient from ER to OB with DX of unstable atrial fib and was on telemetry. The consensus from the med surg unit director and the CCO is you went to nursing school, you are all ACLS Certified so you should be able to take care of these types of patients.BS. We wouldnt expect a med surg nurse to come to OB and take a newly delivered patient or a preterm labor patient. I would never say to them " you had oB rotation in nursing school didnt you?" I wouldnt expect a med surg nurse to come to OB and take care of this because we were having an overflow of OB patients. I am sick and tired of the predudice against OB nurses. Any one else out there feel the same.
YES, YES, a thousand times YES! I no longer work OB, but at the last hospital I worked at from 2008-2010 we were expected to float when our census was down. We would sometimes have to float to mother-baby (no problems there), but we would also have to float to Med-Surg, or ICU. Yes, ICU. This was a military hospital where there very sick/injured folks in the ICU. I was a civilian nurse who had only worked L&D. The military nurses all had a year of Med-Surg under their belt prior to becoming L&D nurses. I was floated to ICU one time and was expected to take a patient assignment. A fresh admit from the ED, no less. I told the charge nurse that I would be more than happy to enter orders, run to get meds, labs etc. for other nurses. However, I was NOT going to take a patient assignment. She balked and asked me if I was nurse. I told her, I was an L&D nurse and she was more than welcome to come down to L&D and take a patient assignment when our unit is busy. She got my point and called to house sup to find an RN that would take an assignment.
Kind of OT, when we had moms with cardiac issues and needed to be on tele during labor we would have an ICU nurse to come watch the monitor only and the first time that happened, the nurse was so nervous she would have to assume L&D nurse duties. She was mighty relieved when I told her that her responsibility ended with the cardiac monitor and I would take care of everything else.
Our L&D unit has RNs for Labor & LPNs for NSY. We have 6 beds. We are floated constantly. When our census is low, we have our RN man the floor alone and the LPNs or other RNs are floated. I have worked out med/surg unit and its nothing for us to take 10-12 patients, then when something comes in there is noone to give report to on these med/surg patients. Funny thing is we follow AWOHNN guidelines to a T when it comes to paperwork, but not patient ratios! Our new CNO came in and changed the floors patient ratio! 1 RN, 1 LPN, 1 CNA to ten patients or 1 RN, 2 LPNs to 16 patients.!
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A fresh admit from the ED, no less. I told the charge nurse that I would be more than happy to enter orders, run to get meds, labs etc. for other nurses. However, I was NOT going to take a patient assignment. She balked and asked me if I was nurse. I told her, I was an L&D nurse and she was more than welcome to come down to L&D and take a patient assignment when our unit is busy. She got my point and called to house sup to find an RN that would take an assignment. 
tntrn, ASN, RN
1,340 Posts
Jbneal, you might work where I do! We are currently trying to make a realistic set of guidelines as to what we can and will do safely when we have to float. This doesn't include anything neuro, ortho, cardiac or any patients that get more meds than simple antibiotics or pain meds.Nurses who float to it I it, get the obgyn surgeries, post op csections, and stable vag deliveries. They do not take ca of the babies, triage or labor patients. We pamper them.