My poor co-worker!

janetrnc · Mar 20, 2007

For the posters who wonder why the OB nurse must shower and change before going back to work since the Med-surg nurses don't change between different types of patients, those nurses are going back to work with NEWBORNS... would you really want them taking care of MRSA, infected wounds, etc? Even if they use universal precautions would you really want to take a chance of carrying anything into the newborn area? Again, its not us against them, its about advocating for safe practice for nurses and for patients.

Thanks

SmilingBluEyes · Mar 20, 2007

Pregnant women and newborns can have unique susceptibility to infectious disease others don't. That is why many places require L/D nurses scrub and shower prior to returning to L/D from M/S.

Also, why send a woman with say, a broken ankle to L/D unless her complaint is pregnancy-related? I have seen countless pg women up on L/D only to find out theirs was a complaint completely unrelated to pregnancy. We have wasted time and maybe had a patient in needless pain for longer due to such things happening. If there is a doubt as to the health/security of the pregnancy, clearly, OB is where the pg pregnant goes first. But if there is no pregnancy-related complaint, she has no need to go to L/D.

htrn · Mar 21, 2007

We have had issues with our staff being floated out to 'dirty' rooms in med/surg recently ourselves. Bottom line, it is a VIOLATION OF STATE CODE for a maternity nurse to take care of an infectous/contageous patient if there is a possibility of her being recalled to the OB unit that shift.

Now, as far as coming back and taking a shower and then going to work. That's all well and good if you have some time, but when we float anyone (RN, LPN, CNA) out to MS, we have to plan for them to be able to run through the doors and grab a baby out of someones arms, do a delivery, etc... without taking the time to change clothes, shower, etc.... Ideally, she should be grabbing hand gel as she is running down the hall.

Things happen soooooo fast in OB sometimes. We all love it because of the unpredictability and excitement of the job - but because it is unpredictable, we always have to be ready to care for the most vunerable patients in our population.

CRNI-ICU20 · Mar 21, 2007

Under state law, at least in most states, the charge of abandonment of patients assumes you have accepted the assignment and have established a patient nurse relationship with each of them, ie established with the patient that you are the nurse caring for each of them....that did not happen here....the hospital and their flying monkeys are in complete breach of the law here....she should sue them for unlawful dismissal....

You can't abandon what you never had!! DUH! getting report on two of the five or so patients she was expected to take does not constitute her nurse/patient relationship....if that were the case, then when one nurse gets pulled to another section of ICU after just getting report on a patient, under their erred assumption, she could technically be considered to have 'abandoned her patient' eventhough she never set foot in their room...

This hospital should be reported.....this is abusive and out of line....

Where's the nursing association in her state? Why are they sitting back and collecting dues without support? if it was me, I'd get a lawyer....and sue their little curly tails off...this will taint her career forever!

Shame on them for ramming this nurse like this....to save a few bucks, instead of doing it right...

Staffing issues are not the bedside nurse's problem....if they are short that day, it's the management's responsibility to fill in the gaps and make the patient care safe....if this nurse did not feel safe in taking that big of a load, it's the management's responsibility to fix it...firing her for this and charging her falsely is so wrong....so completely wrong...

tell her to get a pit bull labor attny....spome will work on contingency....

this place needs a good butt whoopin'

CRNI-ICU20 · Mar 21, 2007

Just for grins and giggles....does this facility have a WRITTEN float policy?

It would be a lawyer's dream if they don't....or even if they do....either way....the first thing any legal team is going to ask for is "what is your policy, and where is it located?"....It would be interesting to note whether or not any of that policy was followed, (if it exists)...because, not following their own policy is a shoo-in lawsuit...If it was altered before or after this incident in any way....that would be another thing to look at....

Any and all memos pretaining to floating....any and all dates, times, and supervisors involved and what they said...will be looked at...

Hope they have good insurance....they are going to need it...you cannot fire someone under false pretenses....

If they contact the BON, and make this claim with them, that is REALLY IN HER FAVOR...because it puts all of it in writing....and lawyers love a good paper trail...with signatures...ahem.

You can't accuse someone of abandoning patients that were YET TO BE ASSIGNED AND REPORTED ON TO HER....

They are in deep doo doo....Tell her to get an attny....right away...

You might look into what written policies exist on her behalf...betcha a cup of coffee they don't even have one...and that isn't how you run a hospital...or a human resources department...

Sabby_NC · Mar 21, 2007

they would have a snow balls chance in hades making me work under those conditions. they are actually opening themselves up to legal issues if they are not going to take the time to give a proper orientation and just expect you to get on with the work..

yes i agree runnnnnnnn away as fast as you can. yikes!

i also agree about getting some legal representation too.

caroladybelle, BSN, RN · Mar 21, 2007

Pregnant women and newborns can have unique susceptibility to infectious disease others don't. That is why many places require L/D nurses scrub and shower prior to returning to L/D from M/S.
Also, why send a woman with say, a broken ankle to L/D unless her complaint is pregnancy-related? I have seen countless pg women up on L/D only to find out theirs was a complaint completely unrelated to pregnancy. We have wasted time and maybe had a patient in needless pain for longer due to such things happening. If there is a doubt as to the health/security of the pregnancy, clearly, OB is where the pg pregnant goes first. But if there is no pregnancy-related complaint, she has no need to go to L/D.

And a patient with an ANC of less than 50 for over 60 days(along with acute anemia and a platelet count less than 20) is probably much more susceptibile to IDs than pregnant women or newborns. We still don't shower between them and are still expected to carry both types of patients.

(PS, severe neutropenia is an ANC less than 500. Standard "nonrefractory" leukemic induction puts them at that for 10-14 days) but only for less than 50 for 2-3 days).

And the patient admitted post accident WAS admitted for premature labor. The fractured ankle did not require admission and could have easily been cared for at home. As the major interventions/monitoring involved were OB, she clearly belonged on OB, especially since those interventions/monitoring were clearly not available on ortho.

Still the issue should be not to float L&D to MS when they can be pulled at any time. That is neither fair nor ethical to the receiving unit or the sending unit, or the nurse.

bubbyb · Mar 21, 2007

Get out of that job as quickly as possible. It is a set up for loosing your license that you worked so hard for. PLEASE GET OUT OF THAT JOB!!!!!!!!

SmilingBluEyes · Mar 22, 2007

And a patient with an ANC of less than 50 for over 60 days(along with acute anemia and a platelet count less than 20) is probably much more susceptibile to IDs than pregnant women or newborns. We still don't shower between them and are still expected to carry both types of patients.
(PS, severe neutropenia is an ANC less than 500. Standard "nonrefractory" leukemic induction puts them at that for 10-14 days) but only for less than 50 for 2-3 days).
And the patient admitted post accident WAS admitted for premature labor. The fractured ankle did not require admission and could have easily been cared for at home. As the major interventions/monitoring involved were OB, she clearly belonged on OB, especially since those interventions/monitoring were clearly not available on ortho.
Still the issue should be not to float L&D to MS when they can be pulled at any time. That is neither fair nor ethical to the receiving unit or the sending unit, or the nurse.

Well standard of care really is not to have L/D/newborn nurses working with "infected" patients on other units---I can't nor won't argue about what goes on in M/S units; I know as I floated plenty when I was in Oklahoma. And yes I agree L/D should not float to other units only to leave the M/S nurses "holding the bag" if they should be called back to OB. It's not fair to anyone, the patients, the M/S nurses, nor the OB nurses themselves. Floating is risky business (when the areas are unfamiliar to nurses anywhere). That is why I am glad some units are closed to floating for these reasons.

nurseynightnight · Mar 22, 2007

We have to float to other units sometimes and we (nurses) hate it!!!

We as OB nurses are not allowed to take patients so what has been happening is we are working as techs or CNA's. So we do all of the personal hygiene, q 2 hour turns, water, toileting, etc... So we can just go back to OB when/if we are needed without worrying about reporting off on our patients.

We would love to be a closed unit and not float. I can't remember the last time we had nurses float to our unit so why should we have to staff theirs???

-Not a fan of floating. I think it can be a VERY dangerous situation having a nurse work in a unit she isn't trained/oriented in.

GooeyRN, ADN, BSN, CNA, LPN, RN · Mar 22, 2007

I am not a fan of floating, especially when NO orientation was received. Its just not safe. Not even to take 2 easy patients. If the nurse was to return to OB, that would be a HUGE pita. She/He would have to report off, and do all of the charting before leaving. That could take an hour before they could return to their unit! Also... Should an OB nurse be around all of the nasty med/surg microbes and then share those microbes with the newborn babies? :bluecry1: I feel if floating is a mandatory thing, a few weeks of orientation is in order, and it should be for the entire shift, unless there is some sort of "real" emergency. (Not just a staffing emergency)

annie4747 · Mar 22, 2007

I really guess I would just like to hear some opinions about something that happened to one of my fellow nurses. I'll try to make it short.
One of the 7a - 7P L&D nurses came onto her shift to be floated to med-surg. Bear in mind that this young lady has never worked med-surg a day in her life.
We have been told recently that if we are floated, we may be asked to take a couple of low accuity patients so that if we are needed in our own area we can quickly hand then off to another nurse. None of us has had any orientation to med-surg, other than to occasionally help out as a "runner", and our L&D is staffed with a MAXIMUM of two nurses per shift. Only if there is a second nurse are we expected to take patients.
Back to my co-worker ... She came in at 7a and was to be floated. She was already upset that she would have to take patients because she had very rarely been over there to work at all, but she held her head up and went anyway. When she got there, she started taking report. After two patients, the offgoing nurse continued. The L&D nurse stated that she was only supposed to have two patients. The offgoing supervisor told her that she was going to take a full load - that the med-surg manager had approved it through the CNO.
My co-worker became upset and told the nurse supervisor that she had to go to the restroom (she didn't want anyone to see her crying). After coming out of the restroom, she told the supervisor that she would be right back, that she really needed to speak to the L&D nurse manager, who's office is just down the hall from med-surg.
When she got there, the NM wasn't in yet, and she ran into the CNO, who told her that she needed to wait for the L&D NM to get there so they could talk about the situation. The nurse was still visibly upset, so she thought they were just going to maybe work out a compromise of some sort.
When the L&D NM got there, she was taken into the CNO's office, told that she had abandoned her patients, and escorted off the property by security with the NM telling her that she was going to report her to the BON.
The other nurses were still taking report and hadn't even been on the floor to see their pt's yet, and she had told the supervisor that she would be right back, which she had every intention of doing.
That night, another L&D nurse was pulled and was given a full load also - without any form of orientation. I guess I'm just wondering if I have lost perspective of the whole incident and was wondering how you guys feel about it.
Thanks so much!

That sucks, do they sleep at night?