tryingtomakeit

I just wanted you guys to know how much I appreciate your support - you have no idea how much it means to me right now. I am very grateful that, at least for right now, we are all hanging in there together. There have been three people who have left in just the past week with this situation being their deciding factor. I really do love my job and it is sad to me that something like this is pushing me away from a place that I love so much. The Drs there are WONDERFUL - they are trying very hard to take up for us and my co-workers are second to none. I am looking at going PRN on a very limited basis until I can see if this is going to pass. I am hoping that with everyone leaving (there are more looking for jobs), that they will see the light and then maybe I can come back full time. I plan on telliing them why I am going PRN - I just can't handle the stress. Thanks again for all your support. I will keep you guys posted.

I can understand that being really frustrating, but this is the thing that is so frustrating to us where I work. We do go to med-surg from time to time. It just so happened that this girl had only ever been floated over there once before, and it was to clerk. She knew next to nothing and is a relatively new grad to boot! I have passed meds for the nurses over there, emptied foleys, hung IV's EVERYTHING. I am comfortable with that. I can do those things. I dont even mind taking a small patient load and still help the other nurses because I have been over there enough that I do feel as though I have had some form of orientation, but let me tell you what happened the last night I worked ... I was in L&D alone and my partner was helping out in post partum, we have no problems with this because we are just down the hall from each other and can still tell what is going on in our area. But, at any rate, I had a patient who came in, 31 weeks, bleeding like a stuck pig! All I had to do was yell down the hall to my partner and by the time the Dr got there, we had her IV started, labs drawn and ordered, had taken them to the lab, had her abd shaved, and the C/S room partially opened. As it was, by the time we were taking her off the monitor to go to the OR, her baby was having HUGE late decells. If I had been alone to call the Dr, take orders, and do all the other things I mentioned, that baby could have been dead. Not to mention if I had to wait for my partner to give report, then come to me - minus the time it would have taken us to contact med-surg, then have them find her down the hall. Believe me, I know your frustration, because we can't even get the same people we are being MADE to help give us the time of day when we need help. They say, "that is a specialty area and I can't be made to do that". When in reality we would never DREAM of giving them patients. All was ask is for help with call lights and answering phones, things like that. It can be very frustrating on both ends. Another thing that we are finding very frustrating is that when we are slow, they will pull us over there even when THEY are slow. The other night they were complaining that there were two of us in L&D with only two patients. They only had four patients each! Grrrrrrrrrrrrrrrrrrr! Please don't think for a minute that I am flaming you for your comment, because I'm not. I guess I just really wanted to say that sometimes I realize that it gets frustrating for ALL of us, no matter where we are.

I only wish for a union! We were told that we should have received enough orientation to med-surg in nursing school

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!

I HATE magging patients in OB! HATE HATE HATE IT!!!!

You bring the spoons - I'll bring the old coffee cans!

Too funny! I know what you mean. At Christmas we had a contest for decorating. The nightshift did EVERYTHING! Our unit won and the day shift got the prize! Does anyone else get tired of getting memos because ONE person screws up badly? Instead of talking to the person who messed up, they send blanket memos which sound like they were written for a first grader! Most of the time the person who screwed up doesn't even know that THEY are the one the memo is addressing! AAAAAAARRRRGGGGGGG!!!!!

Angie, I know exactly what you mean. I was a CNA for nearly twenty years before becoming a nurse. I miss it terribly sometimes.

..."I don't know nuthin' about birthin' no babies" If I had a dollar for every time I heard this ...

I don't really have any words of wisdom for you, but I will tell you that I have walked in your shoes many times. My co-workers and I have talked to management until we are blue in the faces, to no avail. I have nothing against med-sug, have worked it many times and admire those who work there greatly, but I have problems with getting my second nurse pulled there to take patients (not just be a runner) so they could have 3 or four patients a piece when I am left with a laboring pt, a recovering pt, and a triage who wound up being a mag pt. I think a lot of our problem comes from management who has never had OB experience. They don't grasp the concept that we are not responsible for one pt, but for two with each admission. They have never seen how quickly these pts can crash. For the most part they view L&D as the "happy" place. They put pressure on our immediate manager, who lost her job as manager once before for being "too employee friendly", and is so afraid of losing it again that she will jump through hoops for the higher-ups. One member of our hospital administration used to be the L&D head nurse. When she was in our dept, she constantly fought against us being pulled to other areas, now she is one of the main people saying that unless there are more than two laboring pts and one triage, we should be fine alone. She even called us the "vacation station" in front of a couple of our nurses. I love L&D and even tried working at another hospital, but got the same old stuff there, so I just came back to the hospital I had been at originally because at least I had been there long enough to be comfortable with the OB/GYN's. I'm still trying to decide what to do. It's not like I'm totally alone. Nsy and PP are just down the hall and I can scream to them for help if all else fails and I know them well enough to know that they will come running, but still it would be awesome to feel some support for what I do from management.

Gosh, do I know this feeling well! I work hard keeping up with my charting, etc. so that as soon as my moms deliver and are safely recovered, I can move them to post partum and help there (our post partum nurses are terribly neglected by management). But try as I might, I can't get past one particular nursery nurse who will wait for me to empty out to start her assessments on her babies! The sad thing is, she doesn't make any bones about it. She will plainly say that she will wait for me. For the longest, I would just suck it up, but I finally told her that I didn't mind helping out, but that she needed to get out of the habit of "waiting".

Not trying to hijack the thread or anything, BUT, do any of you ever get a bit of a sour taste in your mouth when you help a patient labor for hours, hold their hand, coach them, bring them ice chips, blankets, or what ever else they request - all the while monitoring them and trying to make them, as well as their 150000 family members who are in and out the locked doors all night when you have to buzz them in and are alone with other patients, feel special, and when it is all over and that beautiful, long awaited baby is out, they look at the Dr. and say, "May I take your picture with the baby? I couldn't have made it through this without you!!!!" while you are being ignored?!! (Is that the longest run-on sentence you've ever read, or what? LOL)

I don't she why you should be called on the carpet. I have seen patients do the same thing - nurse in the room, no ctx - out of the room, ctx appear again. As far as asking her about abuse, this is part of our screening on both admissions and triages. I think you handled the situation very well.

I'm curious what your policies are in your various facilities regarding pitting women who are in active labor, but the fetus isn't viable - or when it is questionable whether the fetus is viable. Our policy states that we start pitocin only when the absence of fetal heart tones is verified by ultrasound (per MD). I had an MD the other night scream at me when I wouldn't start pitocin on a woman who had been told in his office only the day before that she was nearly 21 weeks. She came in 3 cm, 0 station, 100 percent effaced - bleeding. She said when she had been seen in his office the day before, that he had given her antibiotics for an infection the day before for a "uterine infection" (this had been her first MD visit). When I notified the MD, he came in, did an ultrasound, and confirmed that she wasn't abrupting, but he said that her membranes were ruptured. He ordered pitocin because the fetus wasn't viable (he said 18 weeks), she was in active labor and would deliver anyway (there were no contractions palpated or on the monitor at the time). We had no prenatals on the woman, so he left to go get them in his office. I wasn't sure what to do since she was only 18 weeks, so I called my manager at home. She told me that we DO NOT PIT unless there were no FHT's. When he came back, I told him that this was our policy and that I couldn't start pit. He started yelling at me, "FINE! We will watch her die then from hemorrage or from sepsis!" I just watched him scream, throw his fit, and order some labs. Just before he left he said that there was a way he could get around the policy. He said he could consult with another Dr., call in clergy, and if all were in agreement that the mother was in danger, that we could start pit, but that the patient wasn't really in danger, so he wouldn't so that at this point. This was all said calmly, then he turned to me and told me to call him when his patient was dying. When I read his orders, I was astounded to find that there were no antibiotics ordered, so I gave him time to get home and I called him. When I asked if he had meant to order them, he said, "What for? She isn't running a temp." I reminded that she had said she received some from him the day before for an infection, but never got them filled. He just said, "No!" and slammed that phone down. The same Dr has been repremanded time after time for ordering us to start pit on these women, and each time the situation ends the same way. I was just curious if any of you have faced similar situations and how it was handled.

Literally