L & D OR team?

[ragingmomster, BSN, MSN, RN]

Ok,

Does anyone work in a busy L & D unit that has a specified team of RN's to run all the scheduled c/s's?

We are trying to implement one at the end of the month (has been in the works since December) and I can't believe I didn't think to talk to you guys sooner!

They want 3 of us to work M-F, 7-3, no nights, weekends or holidays and they won't allow us to split a position between two part timers.

They are building a new recovery room and we will have a second room to work up our incoming section.

We have days with 3 sections scheduled and one and sometimes 2 add-ons. Most days have an average of 2 scheduled and some actually have none scheduled.

They plan for the 3 of us to handle all of the scheduled c/s's which I don't think will be a problem. On days when there are fewer c/s planned we would pick up add-on's and stats if we are available. If there is nothing happening we would assist staff on the floor, but would not pick up a patient load because we may have to drop it and run in case of a section.

Any thoughts? Anyone else doing anything similar?

We would also be expected to follow our MD's to the main OR if they have a case that needs to be closer to the large PACU or SICU, but only to provide newborn care as the main OR has it's own circulators and PACU.

So many thoughts, stuff whizzing through my head. HELP!

[suzanne4, RN]

If the C/S is done in the OR, then you usually see a nurse from the Nursery that is there, not Labor and Delivery. They are the ones that will be accepting the patient after the delivery.

If there are only three cases per day, why do you need three RNs? Is one going to be scrubbing, or is there going to be a scrub tech? Even in the OR, there would be just one crew that would be assigned to that room. Are you going to be doing the recoveries as well, or will they be going to a recovery room?

[Jolie, BSN]

I think it sounds like a dream in terms of staffing, and smooth running of cases. But, I have a few concerns. Will the OR always be staffed by the same 3 RNs? If so, do you have 3 nurses on your staff now that really want to do OR only? While the hours sound great, and would certainly be a plus, I think there is a risk that those 3 people will get burned out on OR cases, and lose some of their expertise in the other areas of LDRP care.

[suzanne4, RN]

And too dreamy I am sure for the people in the financial section of the hospital. You would never even see that amount of staffing in an OR for that number of cases. Definitely not enough money coming in to cover that.

[NITEOBRN]

We have LPNs and aides on 7-3 and 11-7 shifts who srcub. The day girls do the scheduled c/ss and of course on nights (if staffing on our unit allows) we try to do our own. If our unit is busy and the trained persons have a heavy assignment, then we call in an OR team. We have one RN so far that circulates she works nights also. We have run into some attitude problems when a called in OR nurse spots someone she knows can scrub on the floor. They kinda don't get it that if the floor is busy we can't send the whole nursing staff to a c/s. We send 1 RN to do baby, an aide to attend to the Dad (and read bands) and if we sent another RN to circulate and an LPN to crub that just about leaves 2RNs and maybe an LPN to cover the unit.However, when we can we do our own sections and it works out nicely.

[FLOBRN]

Hmm interesting concept. But...why not take that same money and cross train everyone to the OR? We do about 200 deliveries per month. Everyone is crosstrained to do scrub, circulate and recovery. It's not unusual for the circulator to circulate and recover the pt. If you have enough LPN's and aides to cover the scrubing, it wouldnt be such a big deal for everyone to circulate and learn to recover.

Just out of idle curiosity, why do you need an aide to "read bands"? In your lady partsl births, do you have an RN solely dedicated to the baby per NRP standard? Why doesn't the RN take care of the banding? Just wondering.