Floating...vent

we are a "closed unit" where I work. This has both advantages and disadvantages. What it means, is , when times of low census occur, we must take turns being "cut back" and either using PTO to get paid for the time lost (for FTE) or lose the full 12 hours in pay (for perdiems). But it also means no one is "pulled" involuntarily to other units with which he/she is unfamiliar. I have done it both ways and frankly, prefer NOT being involuntarily floated to other units. I just make sure when the census is high, to work "extra" to offset the "low census" times. I plan ahead for rough times.

The other disavantage is to being "closed" is NO ONE is forced to float to us, either, so when it does get busy, we may have to just "suck it up" and deal with it as we cannot expect help from other floors.

However, We are fortunate in that there are nurses from other floors who do like to float up to OB and will, if they can. It can work against us also, in that we are perceived as "prima donna's" by the other floors. SO when someone DOES graciously agree to float up, I treat her/him like GOLD. I make them welcome and never ever give them the tough assignments, cause I do want them back. Many will choose not to float to OB due to the prima donna perception. Can't say I blame them a bit.

I don't like the sound of how your place is run, frankly. Being alone in an OB unit is NEVER GOOD as you have NO idea what comes through those doors. 30 minutes is FAR too long if a true emergency like prolapsed cord or abruption is throw your way. You always want another labor-qualified nurse RIGHT THERE to help out, if an emergency comes in. I would strongly give some serious consideration to moving on, if you can't convince your management how dangerous this really is. Are you an AWHONN member? If not, seriously consider membership as you are kept abreast of current staffing requirements/ratios and standards of care (which by the way,. you are held LIABLE to uphold). Check http://www.awhonn.org for info on AWHONN membership and information.

I repeat, 30 minutes' response time is NOT good enough if an emergency arises.

I wish you well. I appreciate the predicament you are in...been there myself in the rural setting, and it's dangerous, period. HUGs!

Do invite your CNO to visit AWHONN standards as well. remember that is the standard of care to which we are held, period. Ignorance is no excuse on his/her part.

that is UNSAFE. Run, don't walk away from this job. I don't care how much you love L&D. There are facilities out there that actually care about malpractice issues. This just can't be one of them.

Agree with Deb & jeepgirl in that your unit is being staffed very unsafely! They've both addressed it well so I won't beat a dead horse. In answer to your question re: low census:

when our census is down, if no one has requested it (we have a calendar in our time book, if we want to be called off on a certain day if census is down we can request it) then per diem nurses are called off first, then it goes by hours & seniority. We keep track of how many hours we have been put on call for low census, and whoever has the fewest hours is called off first. If there is a tie, the person with the least seniority gets it first. And skill mix has to be addressed: we always staff with at least 3 nurses, and that includes at least 2 "very experienced" nurses, and since on night shift we have fewer experienced nurses those of us who are less experienced do get called off more, because we have to be staffed SAFELY at all times- as Deb said, you never know what's going to come through the door in L&D!

We're also a closed unit, although if we are called off and don't want to be, we have the option of calling the nursing supervisor and requesting to be floated. If our census is down for more than a couple days, we will take GYN surgicals and occasionally, stable general surgicals like a s/p lap appy or lap chole.

Hello OB nurses,

I am curious as to what your departments do when census is low. I was on-call all weekend long we had no pts but had an agency nurse who was contract so she was in the department getting paid and I the FT nurse was sitting at home on call ($1.50 hr) :angryfire . The weekend before I was told to float to Med/Surg to be a CNA all weekend long we had no pts (in OB) needless to say I busted my butt while the nurses sat on theirs and treated me like garb. You know I don't mind helping out but not when no one else is doing anything but me and the other CNAs. I am so fed up with this place. I have requested time off and not received it (because I am being punished for taking time off for my brother's death). I am new to this place and don't have time banked to cover my check for times that I am on-call. I would look for another job, but there just isn't anything available. I still don't have my competencies signed off on to L/D because the nurse that was my preceptor is now on maternity leave. For the most part I am the only RN on, with an LPN who is a strong nursery nurse but not L/D, and if census is low then I am by myself with her on-call 30 min away :angryfire ! I wish I could get change in this place. The director quit in Feb they hired a new one she just started two weeks ago I have not met her yet. They have not been able to keep a director for more than a year, the staff basically runs the place with guidance from the CNO which has no L/D experience. Please help me...

GET OUT WHILE YOU STILL HAVE YOUR LICENSE! The fact that you can't keep a director is a bad sign in and of itself.

To answer your other questions, agency nurses cant be cancelled: per contract. Your hospital knows that when they hire them. We only have a traveller on occasion and it is always necessary.

Our unit does not float. We on occasion have a med-surg nurse to help us with PP's/Nsy if we are drowning.

During times of low census, we all take our turns being on call. WE get poinst for being on call and the peson with low points takes the next cancel/call. It's a great system adn we are always happy with it.

It depends on agency; agency nurses CAN be cancelled, depending on their binding contract.