FleurDeLisRN

The whole point of a specialized unit is for focused care. Pediatric units exist because pediatric patients can have medical issues unique to their population, can respond differently to changes in health, need ped sized equipment., etc. If a facility has specialized units then they should staff and have appropriate backup. In the end, not only is the patient at risk but your professional license is at risk. You have a duty to respond as a prudent professional. If the doc stops returning your calls, use your chain of command. Charge nurse -> House Supervisor -> then depending on your structure...Chief of Pediatrics for your facility. And, chart, chart, chart and then chart some more. I can only use my experience on L&D for examples. It took almost a year before a provider answering my middle of the night call stopped asking, “who else are you working with?”, then talking with them to get confirmation that my info is correct. It did not offend me because I was new and they did not know me. Ultimately, the MD is responsible so they have to trust that the information I am giving them is accurate. The flip side is, when I call an MD in the middle of the night and inform them they need to come now, the act on my request. I have also protected my license by saying ‘no’ to an assignment at the start of a staffing agency shift. I was scheduled to work a staffing agency night shift at a new hospital. When I signed in and met with the charge nurse, I was assigned couplet care. Well, I don’t take care of newborns. I can care for them at delivery and immediately after and even cover for nursery nurse in a delivery in rare circumstances. But a shift of newborns, I said no. The moms were not an issue. Newborns can go bad fast and I don’t have that experience (I have worked nursery and step down NICU at my home hospital paired with a strong RN in the unit). At my staffing shift, they were not happy but changed the assignments to traditional L&D and nursery. It all worked out for them because soon after the change, I was assigned to assess a new rule out labor of a mom who only spoke Spanish.....I’m fluent. Win/win.

I have been a RN for 27+ years. I trained in a diploma program at the second busiest public hospital in the US. It takes a few years to feel like you have your ‘sea legs’ as a nurse. Working on a specialty unit magnifies this. Since you are such a new nurse, perhaps you can regroup with your preceptor or shadow a day nurse for a day or two so you can see it from their perspective. I was a L&D nurse for 15 years, most of that time working night 12’s. Those nurses were some of the finest nurses I have ever had the privilege to work with. Many, many, weekday mornings I would sit patiently and wait for day shift to get their coffee, catch up chatting and THEN sit down to take report from the night nurses who are tired and want to go home. My last few years on L&D I switched to days to meet the needs of my family. Not only do you take a BIG pay-cut (no evening/night shift diffs), weekdays can be busy on any unit. Doctors want to round before office hours or surgeries, patients have procedures, labs, etc. Work on your concerns BEFORE you burnout. Obviously you are well thought of as an RN if you work on a Ped. Cardiac unit just 2 years out of school.