Does this seem unfair to you???? Please advise.

[lovemyguys]

Hi, I'm new here and I certainly don't mean to gripe but...for the past month or so I've been coming home increasingly frustrated with work. Don't get me wrong- I love my job in L&D. I work in a busy Family Birth Center and have been nursing for about 1 1/2 years, so I'm still pretty new.

The problem is, I'm noticing that I keep getting stuck with what I feel is a disproportionate amount of work compared to my coworkers. For example, at work yesterday I ended up with a fresh admit SROM, orders for high dose Pitocin, all that good stuff. Got her all set, she was spanish speaking only so did all the admit stuff via interpreter phone, etc. Go back out to the desk to turn in her labs and another pt presents at the desk, obviously hurting. I glance at the board, there's one nurse with NO pt, and another who has an OB check for decreased FM. Considering I"m still working with my admit. The unit secretary calls into the pt's room that I'm in, and says, "Hey I need you to come take this Pt" so being the nice nurse that I am, I do. My mistake, I guess.

She's in active labor, arrives at 6/100/-1, granted she is a prime but she's huffing and puffing. So...I'm figuring this other nurse will assume care of one of my pts considering they're both active (plenty of times we take 2 active pts but that's when there's not staff to do anything but, but I digress...)

So..I see my shift coordinator who's mosied back in from break and I glance up at the board, (my second pt is now 8 cm, mind you and going quick) and I'm running like a chicken with it's head cut off. Shift coordinator says, "Calm down. You know technically by the law until the pt is complete, you can legally assume care of them both". What was this- a threat or what?

So here's the breakdown at this point: Me with one pt 8cm/0 station wanting an epidural, plus my SROM pt 3-4 cm/high dose pit (about 30 mu at this point). One nurse has an NST, one nurse has an OB check who ends up going home. The anesthesiologist comes in to do my epidural and says, "What do you have 3 pts or something?Are you the only one working today or what?" and I say, "No, I have two" and he says, "Well there's a bunch of people sitting on their butts out there. Is it favoritism or what?" I explain I'm too busy to even worry about it.

Anyway, thank you for reading this far if you're still with me, but the shift ended that way as well, with me with 2 active pts, and one nurse with none, one with an OB check. Night shift comes on and again (this is happening frequently lately) says, are you going to let her do all the work or what?

I'm getting frustrated. My legs are literally cramping up on the way home from work. I'm tired beyond belief and it feels like I'm being taken advantage of. The problem is, I'm reluctant to say anything because I do have a reputation as a hard worker, but plus I do have to work with these same people week after week.

Any suggestions, please please please????

[mother/babyRN, RN]

No proble, but hey fergus, I was also and mainly addressing St. Nurses post...Either way, I have been stopped by police officers in the past for speeding ( yes I did...lol) and had them attempt to intimidate me..It just doesn't work. On labor and delivery, intimidation is something you routinely encounter and learn to deal with quickly....You just have to find a way to incorporate your personality and knowledge into a way to let others know what you will and won't take...Respect is earned, right? However much we wish others knew that without all the testing it entails, it just happens sometimes.....And it takes awhile....

[RMH]

I didn't read everyone's posts, but aren't Pitocin inductions 1:1 nursing care?? And especially at that high of a rate. Seems unfair AND unsafe to me

[layna]

The AWHONN standards (which are guidelines) state that an RN can care for up to 2 uncomplicated labor patients with or without Pitocin until they reach the second stage of labor which requires 1:1 care. This is the ideal. You may need your manger's help in determining what is or isn't a safe workload. It sounds like the others on this board have been doing a good job in educating you on how to stand up for yourself but the reality is that you are also standing up for your PATIENTS. If you willingly accept an unsafe workload when there is another RN available to take patients and you do not stand up for yourself or call your manager, then YOU may be liable if there is a bad outcome.

Good luck!

[Burr]

Sounds like my life 7 years ago. New on L&D and had the following: 1 Mag, Pit, Epidural, +SROM; 1 Pit, +SROM, Abx, fever 103+; 1 Pit, intact; 1 New admit in LDR who delivered within 1 hour of arrival. There were 3 civilian L&D nurses working that night with me. One had an NST - went home. One had a labor, stable, not delivered until late morning on day shift. One with no one. After 10 hours of hell - I went to the dest and stated that this !!!! had to stop. It was unsafe for our patients. I was told that they were just waiting for me to tell them that I needed help. Shift charge of course was the nurse without a patient, talking with her husband on the phone all night and handing out the work. Things never got any better with that one, but I did gain the others confidence. Later that year, now shift charge - made the one who would not work at all - take patients. In the long run though we all had to cover for her - due to her phone calls. When you go up the chain - and you do not get help - that is when I was ready to give in the cloth.

The last night I worked there - there were 6 labors when the night shift arrived - 12 delivered on us - and 6 were laboring when we left in the morning. Scrubs are charts in that type of setting. Write on the strip - make a checkerboard on your scrub pants and chart while going from room to room. At the end of the shift - it takes 2-3 hours of charting to cover what you did that night. I would change out of the scrubs - and chart from them. I am enjoying where I am now - 250-300 deliveries per year. Nice pace - but I can say that I existed for 3 years of the above insanity and no one on my watch died, or was hurt by my care.