Help on Med Surg from OB dept. - page 4
I work in a 30 bed hospital. We also have a 4 bed OB unit. Many times we are running all shift to care for 5 to 9 pts. per nurse. The OB nurses may have 1 mom or no pts. at all but come in because... Read More
Apr 23, '02Motherbaby have you ever just said no and seen what happens? Or filled out the "assignment despite objection" form and given it to your nurse manager? I think it is DEFINITELY inapropriate to be floating if that doesn't leave at least three nurses in L&D.
Our policy is to have at least 3 in L&D (no matter what census is) and we can be floated to med-surg where we have the right to refuse anything we don't feel competent doing (because when I float it is MY liscense on the line and I am not risking it by getting in over my head). I do tasks only (prn meds, dressings, vitals, toiletting, etc). Can't you all do something similar at your hospital?
Apr 26, '02Saying no to floating anywhere in the facility earns a threat of termination....Besides, although I would prefer to remain on my unit (as I am certain the med/surg nurses would), I am happy to be educated enough and available if the need is a true one. The other night a supervisor called and begged me to please go to the progressive cardiac care unit and function as the 2nd RN. She was in tears. Only when I arrived did I learn they chose NOT to mandate the evening nurse...So, in the case where there IS staff available and I am inappropriately asked to float, I do protest...If our census is high and dangerous and they float us anyway, we DO fill out unsafe staffing reports...THAT is an inappropriate float. In the case of our census being low, our LPN does (much to her chagrin) get floated over us, but that took years of insistance..
I know that we are happy to assist anyone who comes up to post partum, but that rarely, if ever happens. And, beyond a fundal check, a csection patient IS a surgical patient, after all. Breast feeding issues and the like ARE the staff's responsibility. Approaching them to say so is the floatees responsibility and it isn't fair to blame the entire staff for the bad judgement of one, when ANY unit is involved. When I float, I mention to the harried younger (usually) nurses, that while I will be happy to assist in any way as far as assessments go ( and most of them think OB is only good enough to do a routine set), and go through the assessments inclusive of the vs, breath sounds, bowel sounds, skin color, vascular system, i/o, iv, psychosocial, etc on every patient (because the assignment to "just do vs" is always on every one of their patients, since we "know" nothing.) They are always shocked...It shouldn't be an us against them sort of thing. We are all nurses. We should ALL function as same, gaining confidence in appropriately refusing things when we should. We will not take assignments because a delivery or pre term patient can come through the door at any time. They are not scheduled through the night. We would love other nurses to come up and help us and see what we actually have to go through. I know it is a tough place to work ANYWHERE in the hospital. But, I have done my time (and thats a good argument for those wanting to get into a specialty area-DO YOUR TIME IN MED SURG). I am an OB nurse. YOU are a med surg nurse...We either work together somehow or figure out how to deal with each other. I am not against floating totally. After all, patients deserve to have good treatment. I AM opposed to the inappropriate ways hospitals utilize staff to "fix" the alleged nursing shortage that big business has created, by using OB as alternative staff to other units that don't staff well or appropriately. THEN they laud themselves by claiming to care how to figure out how to keep and recruit nurses...Anyone coming up to my unit to help gets the best of treatment from me...And anyone NOT intending to either give OR treat an OB nurse (who had better be prepared to deliver the same sort of respect back to him/her), had better remember that your sister, mother, aunt, friend, someone will probably eventually need the distinct, skilled and unique services we provide....I personally like the break every once in awhile, because although I work every bit as hard as them (and often harder since, though having no assignment, I am doing tasks for every patient), I get to interact with different staff and patients while having an opportunity to teach newer nurses and learn from more experienced ones. And THEY begin to know who they can trust in maternity while we know who to trust and rely on throughout the units. For me it doesn't get any more complicated than that....Last edit by mother/babyRN on Apr 26, '02