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Discussion

For those of you who work LDRP

I recently changed hospitals and am now working at a facility that is LDRP, rather than just L&D which is what I am used to. Our dept. is also classified as a Level 2 nursery; we generally keep 34 weeks and up, CPAP for 24 hours. Anything more critical we stabilize, vent, place UAC/UVC, ect. then ship. All nurses are expected to be able to function in all of the areas, including special care nsy. I was wondering how your facilities managed to crosstrain the OB nurses in all of the areas. I have not had any training in special care nsy., my background is strictly L&D. I am very concerned that we will have one of these early or very sick babies delivered on my shift, there will be no one else working that has experience, and I won't know how to assist with stabilizing these babies but still be held liable. How do your facilities crosstrain and what are their expectations? Also- any ideas on what I could do independently to prepare would be greatly appreciated.

Thanks!

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You could try working with nurses who have NICU experience....and see what nuggets of wisdom and experience they can share with you. Or hope you always have an experienced baby nurse on staff who can take care of these babies when they enter the nursery.......there is no really good solution from what I have learned after working 4 places where there are level-2 nurseries and LDRP units combined.

I will say it can tough and I hate that about where I work. If we get a 35 weeker who has problems, it's a trick having enough staffing because we staff with a core of 3 nurses/nights, and 4 nurses/days. If a baby goes to the nursery, staffing gets really tight cause a nurse is now tied up in the nursery and that leaves limited help on the floor. And USUALLY the experienced nurses, are in the nursery, so that may leave only 1 or 2 experienced labor nurses on the floor, tops.

This a problem that never seems to be resolved to much satisfaction. We can't (rather won't) staff for "what if's" so we usually end up "sucking it up" while the baby in the nursery, scrambling to find a nurse on-call or for the floor, if need be. ANY time there is a baby in our nursery, it becomes a real problem, particularly on night and weekend shifts......

You could ask the manager/charge nurses what happens in the case of a baby being admitted in the nursery as to how it affects staffing on the unit. Do they have a back-up nurse on call for this contingency? If so, that helps a lot. If not, then do your best to learn how to care for SCN babies----and be prepared to work a bit short-staffed in these times. It's like this everywhere I go where there is an LDRP with a level-2 nursery. And it is frustrating.

One more suggestion:

ask about being formally oriented to the nursery, that is, working a bunch of strictly orientation shifts IN THE NURSERY with nursery nurses, so you can learn from the experts and be able to do this when the time comes you have to. Just a suggestion that may help set your mind at ease and prepare for being the nursery nurse.

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