ob to med surg

  1. I am currently doing my preceptorship for nursing school on the ob floor at the local hospital. Recently I have been hearing about ob nurses who have never been oriented to the med surg units and haven't worked in the area for several years being floated there. I realize as nurses we should be able to care for all of our patients. I still wonder if this is a safe practice and what should you do if you are asked to float to an area that you are not familiar with?
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    About tmf1202

    Joined: Apr '02; Posts: 5


  3. by   Q.
    This can be a very sore subject.

    I never worked Med-Surg in my life and went right into obstetrics as a new grad. My particular unit had a closed unit policy, where we didn't float to other units and they didn't float to us. The policy was instituted because, while the Medical floors were complaining that we wouldn't float there, THEY also realized that they can not help US either by taking a labor patient. When obstetrics gets busy, it's not with post-partum. We need help with LABOR, and unfortunately, Med-Surg nurses can't do a thing for us in that regard.

    Frankly, if asked to float, I would refuse. I don't have experience in Med-Surg and would be as helpful as an Aid perhaps, maybe even less. And, like I said, Medical nurses can't help us with labor patients so it's really not a give and take.
  4. by   fergus51
    We are not allowed to refuse to float to med-surg, but we cannot be made to do anything we don't feel comptent to do. So for me, when I float I do tasks only (IVs, minibags, analgesia, catheters, I&Os, BR, phoning docs, etc.). I do not take a patient assignment or do the real assessments. The med-surg nurses NEVER float to OB (L&D or PP) in my hospital, so they usually are pretty good about understanding why I won't take a patient assignment (plus if laboring women come in I need to leave!). I did work a few months on med-surg as a enw grad, but I don't feel competent there after a few years on L&D, and I will not risk my liscence or a patient's safety by working the floor.
    I am "core" past partum/nursery. The only units I'm required to float to are gyn/antepartum, NICU, and Peds. In NICU and Peds, we are not required to take an assignment, just do task oriented things as mentioned by previous posters. I do take an assignment on gyn, and feel comfortable taking stable antepartums, but that unit is usually fairly full of our overflow post partums.

    People from these same units are the only people that float to us. Peds and NICU people usually help in the nursery and are runners for us on the floor. The antepartum/gyn nurses do take assignments on post partum, but we are cross trained to each other.

    We NEVER float to med/surg, and they NEVER float to us. The differences in the specialties are just too significant (and I believe med/surg is it's own specialty!)

    "Refusal" is a sticky word. There isn't really a place in the hospital I wouldn't float to, but you can bet the farm that when I walk in the door I say, "Hi, I'm Heather, this is what I'm comfortable doing..."

  6. by   thisnurse
    suzzy...why couldnt we help you with labor patients?
  7. by   Q.

    Labor patients require alot of monitoring that most Medical nurses aren't skilled or familiar with - ie EFM interpretation. Most obstetric nurses take at least a year to become competent to recognize subtle signs of distress. Labor patient often times are on pitocin drips that we as obstetric nurses titrate, again, based on EFM interpretation. In addition, titrating the pitocin, titrating the epidural (in my facility we are taught to do this) is all done based on EFM interpretation and vaginal exams; recognizing the presenting part, station, effacement, etc and how all that inter-relates. In addition, the nurse present at a delivery needs to be NALS certified or at least familiar with coding an neonate. I wouldn't expect any Medical nurse to be able to take a labor patient based on this.

    Even if a Medical nurse took a labor patient "to watch", every time something needed to be done or acted upon, an obstetric nurse would have to come and evaluate anyway, so she might as well take the patient herself.

    As a charge nurse, I want a nurse that can take a labor patient independently and safely.
  8. by   thisnurse
    ok...i wasnt following what you were saying...we could HELP YOU with a patient in labor but we are not qualified to care for a patient in labor.
    i was kinda confused
  9. by   Q.
    No biggie. Confused is ok. I'm always confused - haven't ya noticed?
  10. by   mother/babyRN
    We are required to float everywhere in the hospital but not required to take assignments, not only from the standpoint that we might be rusty on new procedure, or because some nurses don't have that med surg background, but because delivery can get busy so quickly and without warning. We float in turn and feel that we are used inappropriately because it is easier to float people in house than it is to actually hire them for the other units (and us too, on some nights.) People in other areas, such as med surg, are never required to go anywhere else other than an occasional aide being briefly floated up to assist with feeding babies or the like. No one EVER is floated to assist or help out in delivery and the supervisors are aware and sympathetic of their feelings on this. Their logic, OB is a specialty area! Hello? Interesting that point of view only applies compartmentally....However, when our census is down and there is adequate support on OB, I am not happy to float, but I am glad I can help out when I can....
  11. by   RNforLongTime
    As far as I know, at the hospital that I work at now, the OB nurses do not float to the med-surg areas UNLESS they have been cross-trained to those units, and they don't have to be cross oriented unless they WANT to be.

    At my old hospital, they floated the Post-partum RN's and Med-Surg RN's to each others units. When an OB nurse came to my floor--she never took an assignment and basically functioned as an aide--answered call lights, got vitals, did blood sugars, etc. What made me upset was that when I was floated to the post-partum unit, I was expected to take a full assignment, no objections allowed. I really enjoyed getting floated there, unfortunatley, each time that happened, I only got to stay for 4 hours and then had to go back to my unit
  12. by   ShandyLynnRN
    At the hospital that I work at, we OB nurses do L&D, postpartum, and nursery. We are also required to float to other areas, ie med-surg, ER, PEDS, But we only take patient assignments if we have been oriented in those departments. Otherwise, we just do runner/gopher work. Nurses and especially aides from other floors do float to our unit, and do runner/gopher work for us, and take patients if they feel competent to do so on postpartum. We also in addition to OB patients, have clean med-surg patients female, ie TAH c BSO, back pain, etc. So we get med-surg experience anyway. I personally feel that most nurses from this and other floors are fair, although just because of the way our census goes, we tend to float much more than the other floors.
  13. by   NicuGal
    We don't float to OB...no one does...they are closed. But that is a double edged sword...they get no floats when they are swamped also The rest of maternal-child and pediatrics float to each other. The only exception to that is that the postpartum and nursery nurses don't go to PICU. Med surg is separate and is critical care. Before this was implemented we went everywhere...I went to CCU and those girls were appalled that they would send a NICU nurse to them...I was of NO help to them...I answered the phone all day
  14. by   whipping girl in 07
    At my facility, we are required to float to any floor except women's and children's services. We are given the option to float to these areas but not required. I work in ICU and so far have not had to float yet. The floors in our hospital that are the most short-staffed are telemetry and ICU. I would probably take the pull to peds, post-partum, or well-baby nursery, but I would not feel comfortable going to PICU, NICU, or L&D. Thank God they can't make me.

    If our ICU is not full and we have one extra person, that person tasks and it counts as a pull, so you drop to the bottom of the pull list. I tasked a couple of weeks ago, so I don't have to worry about being pulled anytime soon. I just got out of orientation and I don't feel like I'm ready to be pulled to another floor. I'm afraid I'd drown!:uhoh21: