How long will it take you to admit a new patient to L&D?

Hopefull nurse · Jan 31, 2010

Hi,

I just wanted to let you know that when I went to have my first daughter I went in at 8:00 pm. I started doing paperwork (which I think could have been completed during pre-registration). Then by the time the nurse had gotten me to my room, started my IV, asked a boat load of more questions, answered MY questions, and inserted pill downthere to help get things going (sorry, I can't remember what the tiny little pill was called) it was around 11:00pm.

I watched a little bit of Law and Order and by 12:00am, things were starting to get too exciting in my room (nurses kept coming in to check on my baby). All of a sudden I was in the OR and my daughter was delivered at 1:00 am. Her heartbeat kept dropping then rising, dropping then rising. They performed emergency C-Section.

Sorry to have given way to much info but my point was that I waited around 3 hours before the nurse finally left me alone w/ my husband.

For my second daughter delivered also my C-section at another local hospital, it was about 1 hour before the nurse left me alone. She was much faster and didn't ask me a million questions like the first time. She was quick w/ the IV (the first one thought it over and over before she inserted the needle).

Don't get stressed. You are a new grad and w/ experience I am sure you will get better at what you do. I am pre-nursing (applying to nursing school in May). Cant wait!

Good luck and don't let people get to you. You will do fine.

sahm02 · Jan 31, 2010

We try to team up admissions in my unit, so usually about 30min but if I have to do it myself 45-1hr depending on the pt, but I let them know up front what is going to happen so they are aware that this may take a while and most are understanding. Anything I can get off the prenatal I skip when asking admission questions... but if the doc comes in well that may add another 15min depending on if they are rupturing, IUPC. etc.. I just got off a 7mon orientation so I know how you feel, don't be afraid to ask for help..

tmulder · Jan 31, 2010

A full brand new admit? 45 minutes. If they have been here before that leaves off a few history questions so.........30 minutes. It does take time to get used to it but here is my advice: Get familiar with the admission questions and ask them while you are doing other things like placing fetal monitors or doing an SVE. This means you have the answers to your questions already and can whiz through them on the computer. It saves me ALOT of time to do this, and I was once very slow at admits

babyktchr, BSN, RN · Jan 31, 2010

I can fully admit a patient in 30 mins to an hour, depending on where she is in labor, but I have been doing it of 16 years. As with what the above poster said, you have to really know what you are wanting to know. You almost have to memorize the admission data and then while you are doing all of the physical work of admission: fetal montior, IV, etc, you can be having a conversation with the patient and gathering all of your information. The patient then does not think they are being interrogated by endless amounts of paper driven questions. If I forgot something, I just go back and ask.

One of the things about being new is learning your own way of doing things. You will find your groove...just give it time. I find that newbies are more anal about every question and it does seem more like you are grilling the patient instead of getting to know them. Just relax and try to make it more of a conversation. You will get more information out of the patient and you both will enjoy it more. Don't worry, it will come. Give yourself some time to learn.

Oh and as for the charge nurse assigning admissions at change of shift? Get what you can done, and pass the rest on the next shift. I would not expect anyone to get a full admission done at change of shift...it is unreasonable. Get the physical stuff done, and leave the paperwork or vice versa....or better yet, ask the charge nurse for help to admit the patient so it can be completed in a timely manner. Change of shift admissions are hard on anyone....doesn't mean you are incompetent in the least.

NurseNora, BSN, RN · Jan 31, 2010

It depends on how close to change of shift you get the patient-- 6, 6:30, 6:45? and how active she is. Get the monitor on and ask the most important questions: G, P, EDC, complications, PIH symptoms, ROM. If she seems active, examine her and if she is as active as she seems, tell everyone she's active and you need relief ASAP and you and the new nurse work together to get her admitted.

If she doesn't seem active and the baby looks good, you can ask the oncoming nurse if she wants to do the first exam since she will be doing all the other exams and may as well know just where she's starting from. The one who does the exam is probably the best one to call the doctor.

Unless the patient is bleeding or there seems to be a problem, the IV can wait. Women all over the world have babies without IVs and all is well. Consents are the last thing that really needs to be done. As a previous poster said, learn to do a few things at once. You can get a lot of the history and/or do a lot of teaching as you put on the monitor, get vital signs and whatnot.

Two hours is slow, but you'll get faster with experience; it's not especially slow for someone with your level of experience. Be patient with yourself, you'll learn and develop your own way of organizing yourself.

Jiayou · Jan 31, 2010

Thank you so much everyone for your wonderful comments and advice. I really appreciate that. I think I do need to find my way to speed up myself soon. I like L&D and like to take care of those women in labor, but I hate being blaming of being too slow although I already tried my best. Thanks everyone for your help.

LDRNMOMMY, BSN, RN · Jan 31, 2010

It usually takes me 20-30 minutes. But I work in a military hospital where the med techs start the IVs and send labs. It takes me about an hr if I don't have a tech available to start IV, etc. However if it is very close to change of shift I do what I can and let the other shift know. They usually take it from where I left off and we do the same. I would never expect a off going nurse to complete an admission if the patient walked through the door at say 1850 (we do report @7). All I ask is that she is on the monitor and if she looks like she may be in active labor, SVE. I can take care of the rest once I get report.

Don't worry you'll find your groove and your speed will pick up.

tewdles, RN · Jan 31, 2010

I am a new grad in L&D. After 10 weeks of orientation, I have been on my own for only one month. I realized that I was almost late every day for either paper work or charting. Our charge nurses always like to assign new admissions to me before the change of shift, which made me very stressful because I was not able to finish admission before the change of shift - So I was always blamed of being too slow. I am wondering how long will it take you guys to finish admitting a new patient, including putting pt on the fetal monitor, interviewing, SVE, calling the doctor, signing all the consents, IV, answering all questions patients and their families have, all paper work and computer charting? It almost spends me two hours finishing all those things. If patients are in active labor and need epidural, I will need more time... I feel very frustrated.... Does that mean I am still not competent? How can I speed up?

You are not incompetent...just inexperienced. You will get faster with practice and experience. Don't try to hurry, but do ask your more experienced peers for tips on ways to fit it all into a smaller time slot. Sometimes the order in which you accomplish things can either slow you down or quicken the process.

Good luck.

phlox · Jan 31, 2010

I worked L&D many years ago. You will get faster. You will learn to do serveral things at once. For instance, while you are putting in the IV and putting on the fetal moniter, you can be talking to the patient and answering questions. Bring all your stuff in at once and don't go back and forth a hundred times. Chart in the patient's room while you are listening to the moniter. Call the doctor only after you have gathered ALL pertinent information so you don't have to call him right back and feel like a dummy. It is like a dance, you learn the steps and streamline all of it to where there are no wasted steps.

ibambamama · Feb 3, 2010

Hi there-

I'm also new (12 wks orientation, 1 month on my own now). I've gotten faster at admissions, but it sounds like things run pretty differently at your hospital. For one thing, a lot of stuff is already done in triage (basic hx, IV started, labs sent) and nurses don't do SVE's where I work (in NYC - and I am curious actually, b.c. I'd really like to learn - do most nurses do them in other places?)

I agree w. the other posters though about trying to get questions answered while doing other things.

And most importantly- don't beat yourself up! We're new - these things take time!

good luck.

Jiayou · Feb 3, 2010

Thank you everybody again for your valuable suggestions. I really appreciate that. Tomorrow I will work my 12 hour night shift again after my one-week break. I will use methods you taught me, and try to speed up myself ASAP. Thanks again for all your help and support!