MB15YRS

We actually have a couplet care committee, compromised of myself, staff nurses, Unit Secretaries, and PCA"s. We did 2 site visits, with staff, to Memphis Baptist, and Good Sam in Cincinnati. We thought during the "trial" runs, we could find the problems. We are well staffed, better than we ever have been in the past, but still hitting hurdles. I have those nurses that just don't want to give up the past and move into a new way of doing things. We are trying to move equipment in places where better needed, meeting with the Pediatricians in their offices to discuss their issues, and talking with the OB's. Some of our Docs are not helping, but instead feeding in with the staff with negativity. My biggest concern is safety in the nursery. My Director only wants us to staff one nurse in each nursery and figures couplet nurses will migrate in there during their shift. In the early morning, when Docs are moving through, she is the only one in there doing circs, helping with the Physicians, answering phones etc...This leave the baby's that are there in a nursery by themselves while the nursery nurse is assisting with the circs in a room next door. I want another PCA in there during this time, but keep hiting a wall. The couplet care nurses during this time are out doing assessments and not always available. Am I the one who is being stubborn here?

My unit has been making drastic changes to move from traditional post partum and newborn nursery nuring to couplet care. It has been a nightmare!! We have 3 floors, 3 nurseries, all the same staff rotate in these areas. We do 6000 deliveries a year. We trialed on one floor at a time to try to work out some of the bugs, and then added the next floor. Staff hate it, for the most part, and I am having questions regarding safety in the nursery. We staff each nursery with one nursery nurse, but during the daytime I feel we need another person there while MD's are coming through, circs, phones ringing etc...I am also afraid of infants being in the nursery room while the nurse is in the circ room assisting. Possibility of choking infant and no-one in the immediate area. Any ideas, suggestions? I need staff buy in, and running out of ideas on how to achieve this.

Does anyone do follow up phone calls after discharge?

My unit has about 145 employees and within the last year went to self scheduling. We post their weekends/holidays and they post the rest. We have a self scheduling committee that oversees this 6 week schedule. Once the schedule comes down, the committee counts each day and matches to the number that we need for average staffing for that day. It starts low for the beginning of the week, higher toward the end. If we have too many on a day, and not enough on the other, the committee takes the schedule back to those staff and make changes to better staff other days. It has worked very well in our area, staff are much happier and don't mind making the necessary changes. Our holidays are on a rotation. We have group A, and group B. You are assigned to a list, and your holidays are listed as headings. Example, group A holidays are July 4, Labor Day, Christmas, and New Year's Eve, and group B has Memorial Day, Thanksgiving, Christmas Eve, and New Year's Day. At the end of the year, you switch to the other group. This has also worked very well. The self scheduling committee oversee this list. Before posting new positions, I discuss with the self scheduling team. They have wonderful insight regarding scheduling needs/shift needs. My committee consists of RN's and PCA's. It has been a pleasure working with them. :wink2:

I have toyed with the idea myself, and you are right, it is a tough decision. With the stress of this position, how effective are you? Perhaps it will take a new pair of eyes to give the staff what they need. It is incredible what the stress of this job can do to staff, and to yourself. What will make you happy?