Help on Med Surg from OB dept.

[Ekaye]

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.

[debbieburch]

Tell it like it is girl, its one of those situations that you have to be in to know what one is talking about and when it happens to you its like 'okay' why do I keep putting myself through this and you really have to have one of those heart to heart talks with yourself and it is always the same answer......you have a love for the OB dept. and your heart is truly into the job we perform, the care we give and the joy of bringing life into the world...... if this was not the way I felt I would be out of this high risk, heartstopping and understaffed area in a heartbeat

[canoehead, BSN, RN]

nursecathy

those gosh-darn Canadians...gotta ditch em

[mother/babyRN, RN]

Gosh, I would LOVE to work in a hospital where the OB department could refuse to inappropriately float to other areas and be the float unit of the hospital...In our facility we are better trained than everyone else since we have to be certified in critical care areas in order to care for our "easy" patients, you know, the ones with the c/sections, diabetics,cardiac patients, PIH, DIC,gyn surgery, DVT.......

There are two sides to this issue as rarely will anyone in Med surg float willingly to assist in delivery...My background is ICU and med surg...Scariest place I have EVER worked is delivery....Rarely do people sit on their butts....You can NEVER count on the fact that it will remain quiet. Babies go bad rapidly. Labor happens. The #@#@## hits the fan just as fast or quicker than it would in Med surg. People who think delivery nurses have it easy should work there a while...Not post partum...Not nursery...OR nursery with a baby going down the tubes. OR pp with a mother going down the tubes OR delivery with both mom and baby in trouble...

I am not saying people shouldn't go down and help out once in awhile, but until people float to delivery when THEY are busy (and not just to feed babies), don't make a judgement that it is either an easy or totally fun place to be....If a patient comes in with an abruption, which happened to us not long ago, and the delivery nurses are elsewhere in the hospital, valuable time is wasted and lives could be compromised...Think not...Go through it just once.....By the way, in order for each shift to be totally prepared, it takes about 2 hours of checks to make sure you have what you need when things do pick up...And, why aren't the ER or ICU people on that list of "sitting on their butts when its quiet" Why? Because they don't have to float since "someone might come in" How ( and not in the biblical sense) do you think babies get here?

Please tell me how to get on the list of not having to inappropriately float....Some weeks we are on other floors ( that we were not hired to staff as a cheap solution to a nursing shortage), more than we are in delivery. In my 13 years in labor and delivery I have often volunteered to go help out when I knew it was busy...I am not happy to go when the supervisor makes that inappropriate call, but I go....In all that time not ONCE has someone from any other floor either volunteered or consented to come up to delivery, and anyone who DOES come up to pp or the nursery "sits on their butts" because, as they say, WE DON:T KNOW WHAT TO DO!" Get over it and petition your manager or human resources to get more hours OR go to labor and delivery so you can relax . Nothing EVER happens there...SUCH a happy place! ( Tell that to the moms who have sick babies or lose one....)

[fergus51]

Motherbaby have you ever just said no and seen what happens? Or filled out the "assignment despite objection" form and given it to your nurse manager? I think it is DEFINITELY inapropriate to be floating if that doesn't leave at least three nurses in L&D.

Our policy is to have at least 3 in L&D (no matter what census is) and we can be floated to med-surg where we have the right to refuse anything we don't feel competent doing (because when I float it is MY liscense on the line and I am not risking it by getting in over my head). I do tasks only (prn meds, dressings, vitals, toiletting, etc). Can't you all do something similar at your hospital?

[mother/babyRN, RN]

Saying no to floating anywhere in the facility earns a threat of termination....Besides, although I would prefer to remain on my unit (as I am certain the med/surg nurses would), I am happy to be educated enough and available if the need is a true one. The other night a supervisor called and begged me to please go to the progressive cardiac care unit and function as the 2nd RN. She was in tears. Only when I arrived did I learn they chose NOT to mandate the evening nurse...So, in the case where there IS staff available and I am inappropriately asked to float, I do protest...If our census is high and dangerous and they float us anyway, we DO fill out unsafe staffing reports...THAT is an inappropriate float. In the case of our census being low, our LPN does (much to her chagrin) get floated over us, but that took years of insistance..

I know that we are happy to assist anyone who comes up to post partum, but that rarely, if ever happens. And, beyond a fundal check, a csection patient IS a surgical patient, after all. Breast feeding issues and the like ARE the staff's responsibility. Approaching them to say so is the floatees responsibility and it isn't fair to blame the entire staff for the bad judgement of one, when ANY unit is involved. When I float, I mention to the harried younger (usually) nurses, that while I will be happy to assist in any way as far as assessments go ( and most of them think OB is only good enough to do a routine set), and go through the assessments inclusive of the vs, breath sounds, bowel sounds, skin color, vascular system, i/o, iv, psychosocial, etc on every patient (because the assignment to "just do vs" is always on every one of their patients, since we "know" nothing.) They are always shocked...It shouldn't be an us against them sort of thing. We are all nurses. We should ALL function as same, gaining confidence in appropriately refusing things when we should. We will not take assignments because a delivery or pre term patient can come through the door at any time. They are not scheduled through the night. We would love other nurses to come up and help us and see what we actually have to go through. I know it is a tough place to work ANYWHERE in the hospital. But, I have done my time (and thats a good argument for those wanting to get into a specialty area-DO YOUR TIME IN MED SURG). I am an OB nurse. YOU are a med surg nurse...We either work together somehow or figure out how to deal with each other. I am not against floating totally. After all, patients deserve to have good treatment. I AM opposed to the inappropriate ways hospitals utilize staff to "fix" the alleged nursing shortage that big business has created, by using OB as alternative staff to other units that don't staff well or appropriately. THEN they laud themselves by claiming to care how to figure out how to keep and recruit nurses...Anyone coming up to my unit to help gets the best of treatment from me...And anyone NOT intending to either give OR treat an OB nurse (who had better be prepared to deliver the same sort of respect back to him/her), had better remember that your sister, mother, aunt, friend, someone will probably eventually need the distinct, skilled and unique services we provide....I personally like the break every once in awhile, because although I work every bit as hard as them (and often harder since, though having no assignment, I am doing tasks for every patient), I get to interact with different staff and patients while having an opportunity to teach newer nurses and learn from more experienced ones. And THEY begin to know who they can trust in maternity while we know who to trust and rely on throughout the units. For me it doesn't get any more complicated than that....