Help on Med Surg from OB dept.

Nurses Safety

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I work in a 30 bed hospital. We also have a 4 bed OB unit. Many times we are running all shift to care for 5 to 9 pts. per nurse. The OB nurses may have 1 mom or no pts. at all but come in because they need the pay. They refuse to come and take pts on M/S because of the possibility of a mom coming in and they don't want to give them an infection they picked up on the floor. So they are being paid to read a book while we run our b--- off. Does this happen any where else in the world? I know in the good old days we changed into scrubs and then scrubed and went to do OB. I'm looking for feedback on how other small hospitals handle this.

I don't work yest as I'm stull a student, but my sister works in a 34 bed hospital and there is only 1 Maternity nurse there at a time! They don't have c/s there, so they only really need one. And the business can go both ways...either she's helping everyone else around the hospital, or if they have more than 1 person in labor, it can get pretty busy! That's when all the other nurses come to help here. They work very well together too...

Amanda :)

The threat of carrying an infection back to a mom or baby is very real, but unfortunately, many med/surg nurses do not take this seriously. Of course, many do not take L&D seriously, anyway. This is typical of the "all you do is rock babies and hang out" feelings about OB that I have heard for years. What got me was the time I was on call from OB--low census--and got called in in the middle of the night to take patients in ICU! When I politely refused, stating that obviously ICU nurses had special skills since they got a speciality diff and OB did not, the supervisor was incensed, but there was little she could do.After all, she was management, and part of the group who decided that OB should not get speciality diff. So if I'm not specialized enough, then I am not qualified to work ICU. You can't have it both ways!

It would be helpful if we could all learn to respect the jobs that all of us do, without spending so much energy whining and playing the "I;m busier than they are" game. Try to understand your collegues, and value their skills as you want them to value yours. Until we can do this, we will never get the respect we deserve, because we look like silly, shallow women to those who observe us.

Specializes in Hospice, Critical Care.

I work ICU. We frequently feel the same way as you L&D nurses do--we can go to most places in the hospital (NOT L&D!) but no one can come to us...so we can send help out but don't get any back. It does create hard feelings. We cover our own staff shortages too...we are not under the staffing office's 'jurisdiction.'

Or they have a patient in the ER but no bed for them anywhere in the hospital except ICU...so we get it even though it does not meet ICU criteria because "ICU can take anything" regardless of our staffing or the acuity of the patients on the unit.

We have the same problem at our hospital with OB. We have a 5 bed LDRP unit that is suppose to be staffed with 2 nurses on each 12 hour shift. If OB is closed they will not come to Med-

Surg unless absolutely threatened by the supervisor. If the OB nurses could just come and take vitals in rooms of the patients who aren't infectious and help make clean beds that would be a tremendous help to us. The excuse we usually get from OB is there is a patient out there who may be in labor. Duh!! The other situation we run into is when the med-surg nurse who is suppose to be the house float gets pulled to the floor and we ask OB to float (if their unit is closed). Usually, if their unit is closed they place one nurse on call for their unit and the other one comes in. They will not float if they are the only nurse. Their reason is if someone comes in with an immenient delivery they do not have a back up person to assist. Well, if we don't have a float nurse and there is an immenient delivery they still don't have anyone to assist. The subject of OB nurses and med-surg nurses has been going on for years at our hospital. I don't think it will ever change. About cross-training, almost all of our OB nurses started out in med-surg, so crosstraining wouldn't be that difficult. At least the med-surg nurses will go to OB and take vitals, pass meal trays, and enter orders in the computer. I have no idea what the solution may be to all of this. I think the only way it would ever possibly be solved is to cross train everyone and give them the chance to keep up their skills. Anyone have any suggestions? :eek:

I don't know if they would want to be crosstrained for med-surg. I wouldn't. No offense meant, I am just not the type of person for med sug. Doing tasks only is the only way I will go to a floor. If they object to that too, I have no idea what would work.

I agree with Kday. Why don't med-surg floors cover themselves with call like we do in OB? And yeah, why not float over to us to "keep your skills up"? What skills do you mean? As a high-risk OB nurse, I start IVs, do physical assessments, manage art lines, have patients on telemetry sometimes, pts with DIC, cardiac, neuro and ortho problems. We do lots of psych, and I don't mean informally, have pts with cancer, lupus, many diabetics. Which skills am I not "keeping up"?

When our ob is closed there is a nurse on call and one who

stays in house. The in house nurse floats and does tasks , usually

does not take patients. The nurses from other floors do float to

ob but only postpartum and nursery. We have floated to clean

delivery rooms after delivery. There is only 1 ob nurse that I've

worked with who seems to have a problem floating and functioning on the other floors but I've heard she has the same

trouble on her own floor . It isn't a matter of skills she just has

one of those attitudes.

Do any of you have both OB and Med/Surg patients at the same time. That is what our management is proposing as a solution to the fact that they want us to be more productive when we are working and only have 1 or 2 Mom's and baby's. I'd be interested to hear if any other facilites use this form of staffing and if so what the guidelines are for when you only have OB patients.

Specializes in Med/Surg, Geriatrics.

I have been pulled to work on OB to take care of C-sections and I didn't like it one bit. When I protested that I didn't feel qualified to take care of these patients I was told that they are to be treated as any surgical patients. Basically that's true but on the other hand they had issues and questions about breast-feeding, the baby and other OB-related questions. I didn't feel like I was able to give the best care to my patients. The OB nurses were absolutely NOT helpful and they had major attitude. If they had been the least bit understanding of my position I probably would have been glad to go back and perhaps I could have expanded on my skills. Now I don't care what happens to them. Coincidentally I have never, ever worked with an OB nurse on the med-surg floor in 10+ years of nursing. You are probably better off without them being pulled to your area since this would probably be a source of resentment on their part. Perhaps there could be one or two designated people who are cross-trained to work both areas and who could be assigned accordingly, i.e. we're fully staffed on OB these days so they could work med-surg on that day and vice-versa. Just a thought.

:rolleyes:

Specializes in Maternal - Child Health.

To Panda,

I don't mean to sound stupid, but how can your hospital have an OB service, but not do C-sections? Shat do you do with emergency cases?

I also work in OB and in my hospital we float to med-surg but they can't float to us. It seems to me that each unit should cover themselves, excluding emergencies, and that if everyone would stop keeping track of what other units were or weren't doing and just do their jobs everyone would be alot happier. I'm new to hospital nursing and I am willing to float to med-surg but to be honest I'm nervous about it. I think med-surg is a specialty area and I am not familiar with all of the meds, diseases, or procedures. Med-surg nurses are not familar with OB meds, conditions or procedures. I feel it is unsafe to have nurses cover areas they are not familar with just because they have RN behind their name.

Specializes in Med-Surg Nursing.

In the midst of the Severe Nursing shortage--my small hospital does not "float out" the OB nurses. Our OB unit is rather small and those nurses do it all--L&D, PP and Nursery. And as far as I know, they do not "float in" med/surg nurses of which I am one.

At the last hospital I worked at, I was floated to the post=partum unit. Talk about feeling like a fish out of water. I had one of the moms yell at me because I would not let her go over to NICU to see her baby---she was running a fever of like 102 degrees. She told me that if I didn't know what in the hell I was doing then I needed to go back to where I came from. See, she got mad that when I told her that she had to stay in her room and I had told her that I did not normally work on the mother/unit I would need to ask the charge nurse if she could go to the NICU with a fever----I didn't think that she would be allowed but wanted to double check with the regular staff.

Anyhow, I told the charge nurse about this situation and she went into the patients room and told the patient that she had better apologize to me for treating me that way. Next time I went into that patients room--she APOLOGIZED TO ME!!!! I thought I was gonna fall over. I graciously accepted her apology.

When we had an OB nurse on my med/surg unit at that last hospital, they did not take an assignment. They answered call lights, did chemstrips, took VS, etc. We were apprecitative of their help. Funny thing is---they expected us to take a full assignment when we were floated to OB yet the OB nurses refused to take an assignment whenever they were floated out the med/surg units. Go figure.

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