Need help from OB and PACU nurses

[amk7223]

I've been a PACU nurse for almost two years. My previous background is ER for 6 plus years. Our PACU nurses are required to go down to OB and care for post c section patients. Usually its when it's emergent and the patient needs sedation/anesthesia but they have us in charge of the entire recovery including the OB assessment. They let me shadow one recovery and then said I was cross trained (oh wait I did a scavenger hunt too). It was over a year until I got called in for OB and I was more of a hinderance than a help as I made the OB nurses check everything I did because I was so worried about doing something wrong. I don't know fundal checks, how much bleeding is normal, how to adjust pitossin, etc. In the ER we ran OB patients to the OB unit and that's my only previous experience.

I wrote an email to my managers and now have to have a meeting about what to do from here. I stated it wasn't fair to the patient to have me as a nurse. I also fear loosing my nursing license due to a mistake. If I went to court I would say I shouldn't be taking care of this patient.

I need some input into what I can say to not be taking care of theses patients. I don't think its the norm anywhere else that pacu takes care of c-sections with little to no training. Plus no offense to you OB nurses, but I never wanted to do OB. I give you guys all the credit but it's not the type of nursing I'm into :-) Please tell this is outrageous that they think this is ok?!

[Jory, MSN, APRN, CNM]

You have asked a very valid question and I would absolutely support you fully because it is ridiculous that you were asked to come do a post c-section patient after a check-offs a year ago.

This is what I would present: Either the PACU nurses do all of the c-sections or none of them. If they are going to do one here, one there, they need to keep an OB nurse down with you in order to assess bleeding, perform fundal checks, etc. The rest should be the same as any other surgery and most hospitals are keeping Mom and Baby together anyway if it can be safety done.

At our hospital, if the mother is in the main OR, the OB nurse stays with the mother until stabilization is over along with the PACU nurse. Our birth unit also has our own OR and our own OB staff does the recovery if she is in our unit.