Is it legal..

Nurses General Nursing

Published

So I am a labor and delivery nurse at a hospital with something like 220 beds in the facility, and on labor we do 5 deliveries a day just to give you a background.

The pediatric unit at my hospital has been moved to the OB/labor floor due to them rarely having more than 1 patient and whatnot. Well this caused a ton of peds nurses to leave because they were having to work mom baby. And now peds has to legally move back to their own floor we've been told.

now that they lost almost all their staff, we are being forced to orientate to pediatrics (postpartum and labor nurses) for a 12 hour shift then are going to have to take full loads of peds patients when needed.

First of all, I feel this isn't safe as someone who has only worked Ob for many years. Peds is a distant memory from nursing school years ago, so after 12 hours of orientation would I be a safe practicing nurse to do this? And is it legal? To be forced to work a job that you didn't apply for or be properly trained for?

Any thoughts appreciated! I only have worked at this hospital so idk what other hospitals are like, if this is completely normal and I'm just crazy or what. Thanks

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
You should insist that there be a paid formal cross-training program (not just a couple of floats and "Good to go!"), with objectives and measurable outcomes, both for your peace of mind and the hospital risk manager's.

And TJC requirements.

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
I'm with the side on infection control issues. An above poster pointed out that hospitalized kids are usually the sick ones with RSV, Pegs, breathing issues and other assorted nastiness. Mother/baby generally is a fairly healthy population. I gather if this is a small enough facility that merging 2 units is considered, than i also suspect that the laboring moms are fairly standard risk and their babies are reasonably healthy. It seems common sense to keep these two units as far away from each other as possible (that includes with staff.)

THat's a good point that I didn't think about. Your L&D has a policy (or it SHOULD) that if you take other patients onto your unit, they must be infection-free, as L&D/nursery is considered an immunocompromised population. That will severely limit the types of peds patients you would be able to take.

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Specializes in Med-Surg.

I work on a med/surg and pediatric floor. We don't have a lot of peds patients at our hospital either. Approximately 1-2 a week during the Winter season. And less the rest of year. On our floor, we have med/surg RNs who have additional training of approximately 8 shifts specifically with pediatric pts. One shift of training doesn't seem to be the safest option. When advocating for a change, it's always a good point to bring up. We all want to safely care for our patients. When it comes to peds, they're not little adults! Good luck

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The internet is not the appropriate place to answer a question on legalities. No one here can actually give you an accurate answer, only anecdotal ones. Find an attorney that specializes in nursing issues in your state and make an appointment.

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No, it's not illegal. It is called cross training and happens in every hospital.

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Specializes in NICU, PICU, PACU.

We, including L/D, used to whole house float. We were sent to all the ICU's, peds, nursery and L/D. Imagine the poor Surgical ICU or CCU charge nurses horror when a NICU nurse showed up. We freaked if someone had a HR of 60 and didn't think twice about a HR of 150. Blood sugar of 40, didn't phase us. Scary stuff. We had NO cross training. It took a new CNO to change all this. We now have a closed L/D unit, they have to take call to cover, and we only float to postpartum/nursery/peds and PICU. We don it take dirty kids if we know we are going back. If we happen to get one that turns positive we have to change scrubs and mask when we go back to the unit.

Talk to your legal department and director of nursing. Also talk with your ID director and see what guidelines can be set. It isn't illegal, but if you are uncomfortable with an assignment you need to speak up. The peds nurses are probably as frustrated as you are.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

The term legal. We as nurses use that term freely.

Surprisingly, there are very few "legal" restrictions on nursing. There are ethical and standards of practice that we as nurses must follow and of course if we use our nursing skills to end someones life that would be called murder. Laws that govern shifts is actually federal labor laws. Some states have staffing regulated by law and most states have acknowledged minimal safe standards...but most hospitals are just obligated to provide breaks and Overtime pay.

(1)Every hospital shall implement a written hospital-wide staffing plan, recommended by a nursing care committee or committees, that provides for minimum direct care professional registered nurse-to-patient staffing needs for each inpatient care unit.

(2) In order to provide staffing flexibility to meet patient needs, every hospital shall identify an acuity for each inpatient care unit

But most of the staffing legislation is that hospitals have a minimal plan and follow that minimal plan.

https://www.ena.org/government/State/Documents/SafeNurseStaffingLaws.pdf

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Specializes in Pedi.

The law has absolutely nothing to do with this situation. For something to become illegal, the legislature, either at the state or local level, has to sit down and consider a bill on the subject, vote on it and then the Governor or President has to sign said law. Or the court has to evaluate said practice and find that it violates existing law or the constitution. Does anyone really think the legislature or the judiciary is going to concern itself with staffing at XYZ Hospital? The law applies very little to private employers in the United States. The law pretty much only requires that they pay minimum wage, pay time and a half for non-exempt employees that work over 40 hours/week, provide health insurance if they have more than 50 employees (though this could go away soon) and don't discriminate against protected classes of people. The law does not concern itself with individual employees' duties at specific places of work.

As a pediatric nurse of nearly 10 years, I imagine that if your pediatric unit is so tiny that it doesn't have the census to maintain its own staff, the patient population is not the really sick kids. You're presumably not getting pediatric heart disease patients, pediatric oncology patients, patients with complex congenital anomalies, etc. because said patients would need to be in a specialized pediatric hospital. I'm imagining the pediatric population at this hospital is babies with respiratory illnesses, uncomplicated appys and the like?

Does your floor include the newborn nursery? There are many hospitals out there that have L&D, post-partum, the newborn nursery and pediatrics in the same unit because, again, the pediatric population is so minuscule that it doesn't warrant its own unit.

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Specializes in Transitional Nursing.

Of course it's legal, you were hired as an employee and you're still an employee. They could make you count paperclips if they wanted.

It's probably not the greatest idea for them to not orient you properly, but that's not exactly anything we've not heard before, unfortunately.

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