I just started working part time for OB float pool for a hospital organization that has several hospitals. I float around to a handful of hospitals. The first shift at any new hospital is strictly orientation. This was my second shift at this particular hospital, so only my FIRST shift on my own, taking my own patient assignment. I was assigned to M/B, along with one or two of their regular staff nurses.
Along with a couple couplets, the charge nurse assigned me a postpartum IUFD. 95% of the paperwork involved was already completed, and she was on day 2 of a NSVD.
However, to me that just seemed like really poor judgment. I've taken care of plenty of IUFDs, both during labor and PP. But as a regular staff nurse, where the charge knows me, knows my abilities and my temperament.
As a charge nurse, I would NEVER give a float pool nurse, on her first shift off orientation, an IUFD. IMO, that's just wrong for so many reasons.
Am I way off base or blowing this out of proportion?
I don't mean to be insensitive at all, and perhaps I'm way out of line here, as this is not my area of expertise at all...but as a float/traveler, I think that you should be willing to take on any type of assignment. On the floor that I worked on, our float/travelers got anything and everything, and most often it was "the leftovers" if for no other reason because our nurses normally worked consecutive days and wanted their patient assignment back. We normally found that the float/travel nurses had more advanced skills or more experience and thats why they were in the position they were in, because they were more comfortable flying solo or jumping right in and going with the flow, even after only having one day of orientation. Either way--if this was an assignment that you are/were uncomfortable about, perhaps you should have voiced your opinion?
Recently worked a Oncology/Hematology unit in another facility (for those of you that know where I currently work).
Said facility was supposed to put overflow Gyn/Onc pts on our floor. What did we actually get: Fetal demise cases, postpartum readmits for fever, Hyperemesis cases, PID/pylenephritis case with preterm labor, etc. Virtually none of the nurses had OB training whatsoever. And in the last 6 monthes before quiting, virtually no training was forthcoming. We also had a very poor nurse to pt ratio.
While it would be nice to put a regular staffer on a fetal demise case, I personally don't see in lack of safety in doing so. And quite frankly in most places that have agency and floats, this would be accepted practice. And I also do not see the problem with a nurse recently off orientation getting this pt. Yes, they need compassionate care, something that hopefully does not require an unusual learning curve, and standard MS/PP care.
And given the staffing in many facilities using float/agency, on experience alone, you may have been the "best" choice.
And bluntly, I traveled for about 7 years and have had much worse/much more inappropriate assignments.
Ok..I haved taken care of this type pt(wrapped, dressed baby in special outfits, took photos, etc-and held a few mini-viewings for the same baby)...not to get too gory, but where is the fetus kept? In mom's room? Are this type of pt clearly identified to ancillary staff-message, flwer, bow on pt's door...it would be SO uncomfortable to all involved, if a staff member walked into the room, and wanted to see the baby-common request on a PP floor....
Specializes in Nurse Leader specializing in Labor & Delivery.
if this was an assignment that you are/were uncomfortable about, perhaps you should have voiced your opinion?
Sorry if I was unclear. As a nurse, it was not an assignment I was uncomfortable with. I was simply questioning the charge nurse's judgment as a former charge nurse. It's definitely not an assignment I would ever give to a float nurse, unless it was someone I knew really well and thought she was the best person to handle it. I was looking for feedback from other people from a charge nurse perspective.
Apparently I'm in the minority, and perhaps I'm just super sensitive and protective of IUFD moms and who takes care of them. I have worked with lots of other nurses that I would certainly never want taking care of an IUFD mom, and as a charge nurse, I was always very conscious of choosing the right nurse to take care of those patients. I guess I just assumed all units were that way.
Specializes in Nurse Leader specializing in Labor & Delivery.
Ok..I haved taken care of this type pt(wrapped, dressed baby in special outfits, took photos, etc-and held a few mini-viewings for the same baby)...not to get too gory, but where is the fetus kept? In mom's room? Are this type of pt clearly identified to ancillary staff-message, flwer, bow on pt's door...it would be SO uncomfortable to all involved, if a staff member walked into the room, and wanted to see the baby-common request on a PP floor....
The baby is kept wherever the family want the baby kept. Maybe in the room, maybe in another room on the unit until they feel they're ready to release the baby to the morgue.
Tradition is to tape a white flower on the door (or a photo of a white flower). That signifies "infant death" to anyone who would be on the unit.
I think you just have to let it go... As you said, you felt comfortable taking this assignment, you took good care of the patient and that's what matters. If, in the future, you find a certain pattern with this particular charge nurse, perhaps it should be addressed, but I don't think you need to question this charge nurses' judgement based on one experience. It is always hard to be the "new" person and it is normal to compare new places/practices to more familiar places/practices.
That being said, I certainly understand being protective of demise patients since they do require extra sensitive care.
Ha ha--this is why I don't post on here much. Someone has a valid question about something, and everyone wants to come on here and blast you about their VAST knowledge while belittling you at the same time, and half of them are either students or don't work in the field.
Honestly hon, as a charge nurse myself, NO I would NOT have assigned a floater an IUFD on her 2nd day off orientation, UNLESS they felt comfortable with that assignment--and I would have ASKED them if it was okay first. If the floater said no, I would have rearranged the assignment. No big deal.
There may be a situation with the acuity that this particular assignment needed to be made, and if that were the case I would have made myself VERY available to the floater so she would feel comfortable.
I have been new places before and been thrown to the wolves and muddled my way through it. It's not fun, and I sure don't do it to staff I am working with.
Part of being a GOOD charge nurse is knowing the strenghts and limitations of all the people working with you, and assigning patients appropriately.
nicole109
147 Posts
I don't mean to be insensitive at all, and perhaps I'm way out of line here, as this is not my area of expertise at all...but as a float/traveler, I think that you should be willing to take on any type of assignment. On the floor that I worked on, our float/travelers got anything and everything, and most often it was "the leftovers" if for no other reason because our nurses normally worked consecutive days and wanted their patient assignment back. We normally found that the float/travel nurses had more advanced skills or more experience and thats why they were in the position they were in, because they were more comfortable flying solo or jumping right in and going with the flow, even after only having one day of orientation. Either way--if this was an assignment that you are/were uncomfortable about, perhaps you should have voiced your opinion?