Published Apr 16, 2004
My hospital just closed our Level II NICU and converted us to a Level I Nursery. They also fired our Neonatalogist of 25 years and bought in a new on-call neonatlogist. We are in the inner city and a very high risk neigborhood where most of the mothers don't have pre-natal care. Do any of you with a Level I Nursery with no NICU or peds floor have just on-call doctors and no one in house. We have already had two incidents in the pass six days since they took over. One baby was mec-stained and no neonatalogist to intubate and visualize the cords. Prayerfully the baby didn't have any resp. distress but I feel that is a very dangerous situation. The nursery nurses are still required to attend all high-risk deliveries in L&D which most of them are and any outside deliveies that come in the ER without a neonatalogist, pediatrican, resident, intern or NP. We have no doctors in house except the OB-GYN. I am getting ready to resign because I don't feel that this is a safe situation. I have complained to the manager and VP of nursing and I am told that a Level I Nursery is not requried to a physician in-house.
BittyBabyGrower, MSN, RN
That is true I believe...a level one doesn't have to have an inhouse doc. Many private hospitals run this way and use anethes. to intubate and if there is a bad kid you stablize and send out. They have the peds on call for those kids.
Does your hospital offer the STABLE classes or NRP? I would feel better having those classes.
You also need to document all your concerns, and your co-workers too and present them. Also, have you called the legal department with your concerns? I would also, to cover my behind, make sure you have pathways set up for situations.
I wouldn't blame you if you had to quit! I hope you can resolve things!
I saw your posting on the OB/GYN thread. A level I nursery is not appropriate for your type of facility and therein lies the problem. You said you have many high risk patients who walk in off of the street. That's what happens when you have idiots in an office counting beans who know nothing about what needs to go on at the bedside. Someone thinks this is a good scheme to save $$$'s. So pt's and nurses take the hit. Go find another job now, before the unit closes and/or there is mass exodus and all of your co-workers are looking for a job too. Best of luck!
Aren't you NRP certified?
Just because a nurse has taken NRP, does that give them a license to intubate a neonate? NO . Just like in ACLS, you learn intubation, but does that give youa license to do so in your facility? NO.
If you are not covered, you should not be doing it.................... :uhoh21:
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