Forced to Assist in C-Sections

[Promacta]

I work in the operating room as a circulating nurse of a smaller rural hospital (5 ORs). We are on call throughout the week and on weekends. Currently, when we are on call we are also on call for the OB department to assist in C-Sections. However, as a nurse that doesn't scrub I have no experience, skills, or adequate training related to anything occurring during a C-section. Despite myself and others giving pushback regarding this issue the director is hard set on forcing us to be on call for another department and to be in the room during a C-section. How can one go about fixing this issue? Our associate managers have tried to fight the issue as well with no head way made. My current plan of action is to talk with HR during my next shift. Along with this, I have made it explicitly known that I will be refusing. There are currently no repercussions and the director has mentioned that it will be addressed when the time comes.

[toomuchbaloney]

Promacta said:

So you're saying L&D nurses can also come down to the OR and circulate any case? OB has their own call team and we have been told time and time again that they are adequately staffed. However, they still call us. I even heard recently that their call person was able to refuse the call and then we got called in. Of course L&D nurses have less OR experience but they have substantially more experience with C-sections as it is the only case they have to do. In the end, I am not trained or competent to be apart of a C-section. 

That's a strawman argument. The discussion isn't about OB nurses covering the OR, its about an on-call circulating nurse refusing to circulate in certain cases.  

[Promacta]

toomuchbaloney said:

That's a strawman argument. The discussion isn't about OB nurses covering the OR, its about an on-call circulating nurse refusing to circulate in certain cases.  

LOL I don't know what your deal is at this point. The principal argument is still the same regardless of how you are trying to spin it. Management has not provided a solution to becoming trained and competent in C-sections. How can you say that's okay? How can  appropriate care be given without necessary training and skills? 

[toomuchbaloney]

Promacta said:

LOL I don't know what your deal is at this point. The principal argument is still the same regardless of how you are trying to spin it. Management has not provided a solution to becoming trained and competent in C-sections. How can you say that's okay? How can  appropriate care be given without necessary training and skills? 

I think I'm not getting the whole story.  

[offlabel]

I can do a hysterectomy, but I can't do a c-section...that's not OK....

[Promacta]

offlabel said:

I can do a hysterectomy, but I can't do a c-section...that's not OK....

Not the same thing LOL. I don't know medications to give a pregnant/postpartum patient. I don't hemorrhage medications for c-sections. I don't know education to provide to a postpartum patient. I don't know how to do fundal checks. I don't know how to provide breastfeeding education. I don't know how to provide care to a newborn. I don't konw how to do tones via doppler. I am not PALS or ACLS certified. etc etc etc... Just a few examples why I am unable to fulfill the role.... OB is a specialty for a reason... 

[toomuchbaloney]

Promacta said:

Not the same thing LOL. I don't know medications to give a pregnant/postpartum patient. I don't hemorrhage medications for c-sections. I don't know education to provide to a postpartum patient. I don't know how to do fundal checks. I don't know how to provide breastfeeding education. I don't know how to provide care to a newborn. I don't konw how to do tones via doppler. I am not PALS or ACLS certified. etc etc etc... Just a few examples why I am unable to fulfill the role.... OB is a specialty for a reason... 

They aren't asking you to recover the patient or the newborn. They are asking you to circulate in the surgery.  Surgery is the specialty that they are asking you to assist with.  

It sounds like your are still looking for excuses rather than a solution. 

[Promacta]

toomuchbaloney said:

They aren't asking you to recover the patient or the newborn. They are asking you to circulate in the surgery.  Surgery is the specialty that they are asking you to assist with.  

It sounds like your are still looking for excuses rather than a solution. 

Not excuses. Yet again, legitimate reasons. You're lack of knowledge regarding the role is apparent. As the circulator you are responsible for all of those aspects and many more especially when its a critical situation. If I am not responsible for any of those aspects, which is apparent in your eyes, who is going to do all of those things? Maybe it works differently at your facility but not mine.

[Promacta]

toomuchbaloney said:

They aren't asking you to recover the patient or the newborn. They are asking you to circulate in the surgery.  Surgery is the specialty that they are asking you to assist with.  

It sounds like your are still looking for excuses rather than a solution. 

Furthermore, if surgery is surgery than pediatric, neurosurgery, cardiothoracic surgery, etc are all the same and don't require specific training for those specialties? No... that`s not how it works. Each specialty requires specific training for that surgery role. To think a circulator can just jump into anyone without the training is mind blowing and a massive patient safety issue. 

[Promacta]

toomuchbaloney said:

They aren't asking you to recover the patient or the newborn. They are asking you to circulate in the surgery.  Surgery is the specialty that they are asking you to assist with.  

It sounds like your are still looking for excuses rather than a solution. 

I have also stated the solution numerous times which you think isn't the solution apparently. Adequate training and competency. But apparently you would rather keep accusing me of "just making excuses".  

[toomuchbaloney]

Promacta said:

Not excuses. Yet again, legitimate reasons. You're lack of knowledge regarding the role is apparent. As the circulator you are responsible for all of those aspects and many more especially when its a critical situation. If I am not responsible for any of those aspects, which is apparent in your eyes, who is going to do all of those things? Maybe it works differently at your facility but not mine.

I've circulated on many c-sections. 

You've only offered your belief that you will be required to do those things in addition to circulating.  

 

Promacta said:

I have also stated the solution numerous times which you think isn't the solution apparently. Adequate training and competency. But apparently you would rather keep accusing me of "just making excuses".  

So stop whining about not wanting to do it and get yourself trained.  Professionals know how to get training for themselves.  

[toomuchbaloney]

Promacta said:

Furthermore, if surgery is surgery than pediatric, neurosurgery, cardiothoracic surgery, etc are all the same and don't require specific training for those specialties? No... that`s not how it works. Each specialty requires specific training for that surgery role. To think a circulator can just jump into anyone without the training is mind blowing and a massive patient safety issue. 

I've maintained from the beginning that you should get yourself some additional training.  Suggesting otherwise is dishonest and suggests that dishonesty might come easily to you as you try to make your case.  What other little details are not exactly accurate in your telling of this tale? 

[Promacta]

toomuchbaloney said:

I've circulated on many c-sections. 

Then from your perspective you can circulate any other surgery now if asked and if there is a lack of training you should obtain it on your own time. 

You've only offered your belief that you will be required to do those things in addition to circulating.  

How are simple facts a belief? This is the responsibility of that role in my facility.

So stop whining about not wanting to do it and get yourself trained.  Professionals know how to get training for themselves.  

Whining? I never said I didn't want to do it. I said I need adequate training and competency which the hospital should provide at the very least if they want someone to take on a new responsibility that was never required and mentioned before. 

 

toomuchbaloney said:

I've circulated on many c-sections. 

You've only offered your belief that you will be required to do those things in addition to circulating.  

 

So stop whining about not wanting to do it and get yourself trained.  Professionals know how to get training for themselves.  

 

toomuchbaloney said:

I've maintained from the beginning that you should get yourself some additional training.  Suggesting otherwise is dishonest and suggests that dishonesty might come easily to you as you try to make your case.  What other little details are not exactly accurate in your telling of this tale? 

No, you keep calling simple facts, statements, and the way things work at my facility as "excuses". A "tale"? You`re being comical at this point.