Help on Med Surg from OB dept.

Jolie, BSN · Oct 28, 2001

To Panda,

How can your hospital offer OB services without doing C/Sections? What do you do with emergency cases?

JennieBSN · Oct 28, 2001

Jolie, BSN · Oct 29, 2001

Sorry about the double post. I am such a computer idiot. I didn't realize that this thread had more than one page!

Irishys · Nov 5, 2001

I am an OB nurse for a mid sized hospital (500) beds. We used to get pulled to any floor in the hospital. We were sent to ICU, Med-Surg, Ortho, etc. The nurses throughout the hospital raised a rukus because of this dangerous practice. We were told "a nurse is a nurse is a nurse". When mistakes were made - the hospital started using "complex based staffing". We are now part of the Maternal/Child Complex...which includes L&D, NICU, Peds and Postpartum (mother/baby). We were not given any orientation to these units. I work part-time and have been pulled to all of the above units. Pediatrics makes me the most nervous as we are taking care of children and the mistakes on this unit can be devestating. I get extremely nervous at the thought of getting hauled into court and not having a leg to stand on...because in truth...I am not trained and have no business on that unit. I believe each unit should staff itself. Nurses are not interchangable and the med/surg I did in school 20 years ago is no help to me now. The practice of "pulling" is dangerous...and I believe patients are entitiled to competant nursing care...how can this happen when nurses are taken from one unit and placed on another. :

ninaldunn · Nov 6, 2001

In our hospital the OB nurse manager is a Saint. She has schedules posted 8 weeks in advance, it's real nice to work there. I know tons of nurses who transferred to OB, maybe half of them stay. It's not for every one.

Anyway, usually post-partum is better staffed than the med-surg floors. OB takes lap choles all the time. At least 75% of the OB nurses have come from med-surg floors - it's like old times. The group who gets most upset is the doctors. Med-surg floats to PP, and hopefully one of their PP can go to L&D.

The funny thing is not all the regular OB nurses are trained in L&D. About 50% of the OB staff is cross trained to L&D. Is that normal? Some are newer nurses, but some have been on OB for 5 years, they are part-time, can only work PM's and have never been crossed trained.

fergus51 · Nov 8, 2001

That's normal for our hospital because we actually have to take a year of part time courses and a practicum to get hired in L&D on top of our RN school. PP only requires one extra course so a lot of them take the one course and stay on that side.

sherrie_rn · Nov 27, 2001

My first post here and thought I'd jump in on this topic. I've worked med/surg and NICU during my career so I've seen both sides. When I worked NICU I saw nights the L & D nurses had very little to do .... but there were MANY nights I saw those girls almost in tears with the patient load. It seemed you never had just "one" emergency C-section a shift. Same thing with med/surg ... some days are beyond what anyone should be expected to do and some are slow. In the facility I worked at, the L&D nurses were very rarely ever pulled to another floor ... mainly due to the fear of infection if they had to be pulled back. I agree with that philosophy. Pointing fingers at different units is exactly why managment has the upper hand. We're all nurses but we're all good at different things. We should embrace the knowledge that each of us and be willing to help each other when one of us has to work on a different unit. As a med/surg nurse I got pulled all over the hospital. There were some units I never minded going to ... simply because I knew the nurses there were very helpful. I worked in a very large facility and another thing to keep in my mind is the patients on the med/surg floor are much sicker ..... I see patients on the floor now that even 5 to 7 years ago would have at least qualified for the step down unit. Just as a laboring mom would be overwhelming to me, so are these patients to an OB nurse. We need to be united and recognize and appreciate what each of us has to offer in our field or speciality .... if we don't think we're special, how can we expect anyone else to? Just my thoughts........:)

sherrie_rn

debbieburch · Feb 4, 2002

I too am an OB nurse and this is an ongoing problem at my hosp. I have been in situations that would make anybodys hair stand on end and when an emergency comes up in ob you don't see anybody coming from the other floors to help, why...because it is such a high risk area that no one wants involved, their scared of ob and know nothing about this area because its a specialty area even though we are not paid as such....as far as calling help back from the floor that means precious time when your the only one and you have no help and no ob doc in the house and you have a FHR down and while you are trying to get the heart rate up you are suppose to get help back to the floor and get the doc beeped to come in...like I said precious secs can mean alot. When code blue is called and I'm not tied up I go and help but I never get the help in return....When we are not busy I go and relieve and help in other areas......This is by choice and I have learned alot by going to other areas....the other nurses are great about showing me things......even so they never come to the ob area.....I do have to admit I feel guilty when we are not busy and I will go help in other areas ......but the areas I keep going back to are the ones that treat me with respect and work togeather as a team and not to just do their dirty work.......for those that think we sit and do nothing let them come to ob and work and then see what they have to say when there is no help and your losing an innocent baby because there is no help and no doc inhouse and you feel like any minute the heart rate is going to be gone and then you get it up and get some intrauterine resusitation going on and get a doc there and then you worry if theres any neuro damage to the baby....you not only have the mom as a patient but you have a fetus and it can go bad with a blink of the eye....I know because it has happened

mcl4 · Feb 4, 2002

Originally posted by aila
I work in a 28 bed hospital. The OB nurses float to m/s when there is no patient. They can be low censused, but no one is allowed to clock in and just sit.

This has been my experience and when our census is low on a surgical floor we are expected to float to a medical, telemetary or OB station. It works well since the staff on these floors appreciate the float staff member and will help them out with any question they may have. On the OB station, we work along side with an experience OB nurse in the nursery and occasionally take vitals on PP mothers. I believe the OB nurses did complain about floating last summer, but that is reality when there are few or no patients. This seems to be rare since generally OB census is running high in this community with many young families.

Hardknox · Feb 5, 2002

We used to feel like the float pool for the hospital. We would be floated to med-surg to act as a pt. care tech and would be assigned to 5 pts. to do tasks. One of our nurses called the Board of Registration and was told that we were RN's and would be held to the job discription of an RN, not an aid. So if I was in the ICU giving baths and totalling I's and O's and there was some screw up I would be held liable:eek: Now the hospital has decided that we get GYN cases assigned to our Mother Baby rooms during downtime and we take them as an assignment. We work as an RN and if the floor fills up they are tranferred back to med/surg.

nursecathy40 · Feb 10, 2002

HMM like most of you all I worked in a 20 bed unit m/s in Maine-small town hospital where the OB nurse floated to m/s where she transcribed orders if any admits, fingersticks, lab draws, resp treatments, as well as take patients that do not have infection.

The only problem I encountered was with a Canadian RN who neglected to tell me she was leaving the floor and reassigned her patients to me . TALK ABOUT GETTING PEEVED!!!!!

Q. · Feb 13, 2002

What you have to remember is that OB is a speciality like any other floor. I don't think it would be safe to float me (I'm L&D) to another floor because I am not skilled in that area. Plus, no one can float to OB and take a labor patient and that is when L&D gets busy and needs help - with LABOR patients!

AWHONN guidelines are that a unit is staffed with at least 3 RNs, even with little or no census: for the reasons that another L&D nurse described - when things get bad in OB they do so very fast and without warning. A C-section, a prolapse, a previa, and abruption requires at least 2 nurses to manage, including a nursery nurse - now...whose gonna watch the floor? You think I am going to waste time CALLING a nurse from home to help me keep the cord in the lady partsl vault??? Ummm NO.

At my hospital we staff nursery, PP and L&D. If we get low census or are able to sit for a while - we deserve it. Honey, there are plenty of times when ICU or the floors have low census and we are drowing with critical patients - and you aint comin' to help. If you don't like your current situation, go to OB then.