Info on cross-trained staff

[ebby79]

Hey All,

I could use some help!! I am part of a group on our unit, trying to find out how the rest of the world is caring for their patients. We are a unit comprised of 18 LDRPs, 2 semi-private antepartum rooms, 2 c/s suites and a level 2 nursery licensed for 8 beds. We do about 1400 deliverys annually. The unit has been cross-trained since the mid 90's, but we are having some issues with the pediatricians wanting to go back to a core group of nursery nurses. All of the staff has been fully crosstrained, with the exception of some of the per diems, who were able to choose the areas they want to work. We are working on a concept that will allow for more specialization, without losing skill level that we currently have. Anyone who has a similar set up or ideas that seem to work well, please let me know.

Thanks!!

[NurseNora, BSN, RN]

At my hospital all the staff were cross trained to work nursery, L&D, and Post Partum. As we grew and began to get more and sicker babies (we're only a level 1, but since we're in the middle of nowhere, we can't always get the higher acuity babies out (the planes can't fly in to us in bad weather), the requirement was that everyone had to work two of the three areas. In practice, that means L&D and Couplet Care or Nursery and Couplet Care. There don't seem to be many nurses who want to combine L&D with Nursery, but there are a couple.

[ebby79]

Thanks for the input! Some of us would like to continue to work in all areas, however, there are some who would only like to do L&D/PP or nursery/PP. Actually, I would be willing to give up PP and just work L&D and nursery! Our concept actually is not so cut and dry. Admin would like us to be able to function in all 3 areas, so we are trying to come up with some guidelines for those who would like to lean toward one or the other! Not an easy task!!

[theamberdawns]

We have labor and delivery nurses that also help catch other labor and delivery nurse's babies (unless we expect complications then nursery is involved). Once the babe is assessed and stable then back to your own patients it is! Once mom is recovered they are moved to post partum/gyn. L&D nurses give report to nursery nurses once babe goes to nursery!

[RNBelle]

We are a small hospital so we do it all on our women's center. We are short on RNs and have quite a few LVNs. So the RNs will always be hanging out in L&D and our LVNs doing PP. What I don't get though is that our special care nursery nurses are all LVNs - they are very well trained and great nurses and we tend to have a low acuity level on our special care babies BUT I would love my boss to cross train me to special care, but that won't happen - I gotta catch the babies in L&D.

[beachmom]

We have about 60 babies/month. Everyone does couple care and GYN surgeries. A few part-time per diems just do those only. Most of us specialize in either nursery/NICU or labor. A few do everything. (I'm nursery/NICU)

When a baby's born, I leave my couples or surgeries, and help with delivery. If I'm busy, I just do drying, banding, first VS and charting. I stay until baby is stable, then I go back to my other pts, and the labor nurse finishes the admit as well as the mom. If I have time I do the whole baby admit, I will.

If baby is not stable, the other nurses help with my other pts until baby is stable. Bad NICU babies are shipped, but we take care of them for the hours it takes for the team to come get them.

Usually the charge nurse doesn't take pts. She does the triage (labor checks, phone calls, walk ins, etc.) She helps in a delivery if needed. We work together pretty well and help each other if busy.