Miranda50

Just wondering...have the number of deliveries decreased on your units over the past month. We usually do about 3500 deliveries per year at my hospital and our numbers have been way down, at least 30-40%. We're being cancelled all the time. I haven't worked a full week since the beginning of March. Our practices are projecting things to pick up mid-May. Just wanted to know if this was happening all over or is just specific to South Carolina.

It's naive to think that choice of a speciality makes one professional more qualified than another. It's true that not all doctors and nurses are created equal. But do you really think you can so easily sum up the abilities of a doctor or a nurse based on their area of expertise. After working in hospital, I sure you know the difference between an outstanding cardiologist and one with a less than stellar track record. Would you still say then that every cardiologist in this spectrum is still a better doctor than a top notch plastic surgeon, who may specialize in highly complex microsurgies to correct severe congenital deformities? The same can be said about nursing professionals. I work with some fabulous L&D nurses and have a lot of respect for their skills and abilities. However, there are some that I would never want to care for my daughter. Also, the ability to place an IV, while an important skill, does not define a nurse's capabilities or level of expertise. Do you think that an experienced postpartum nurse that manages a postpartum hemorraghe until the MD can arrive in house is any less than the novice L&D that's just started taking patients on her own. There is a wide spectrum in nursing knowledge and a long road to travel before one gains proficiency in their specialty. It's unfair to make generalizatons about how qualfied or skilled any nurse is based on the unit they work on. I'm not sure sure where you pulled your theories from, but right now, thin air does not come to mind.

It saddens (and angers) me to read comments from Irishobrn and other L&D RNs of like minds. It perpetuates the long-time division that has existed between two units that should be working together to deliver great family centered care. As an RN that has worked on both L&D and MBU, I can appreciate the challenges faced in each area. And I do agree that the skill set is different, but to say that a postpartum nurses are deficient and lazy...not at my facility. We rountinely care for well mom-baby couplets, but we also take antes, post op gyn's and readmits for things like pph and infection. Our patient load can vary based on these groups, and we usually have a total of 8 patient's per shift. Included in this mix are infants that may be on phototherapy or antibiotics and rotations to do newborn transition, which is done for both vag deliveries and c/s in L&D. Multitasking is the definition of a Mother-Baby nurse. How else could one handle routine postpartum and newborn care and all the patient and family education it involves, multiple postops, med-surg patients, PIH and pph complications, and a revolving door of admissions and discharges and still find time to work with case management when needed, initiate successful breastfeeding, draw baby labs, initiate phototherapy, administer blood products, and chart on 8 people, etc. And yes, I do my own IV's and blood draws,too. All this must be accomplished in 12 hours because we can go over on man hours on the unit. Lunch is usually not an option, because there is always something that needs to be done. So keep in mind, when you send your patient from L&D, make sure she is medicated for pain, her bleeding is controlled, her dressing is dry and intact, and there's more than 25cc in her bag (and it's on a pump that's working). Don't tell me she's been firm all through recovery (only for me to find a boggy fundus and heavy bleeding and grapefruit sized clots), that's she's been afebrile (but surprisingly has spiked a temp on the ride down the hall and now I have to start antibiotics), that she's voided (but now has a deviated fundus and heavy bleeding and I have to straight cath), or that as you were helping her into the bed, she suddenly needs pain medication. We often have to fix problems during our admission assessment that should have been solved prior to transfer, while still completing other aspects of the admission process, including the infant's assessment, which often includes blood sugars and feeding assistance, orientation to the room, newborn teaching, and pericare assistance. If the patient's a post op c/s, there's even more to do, possibly even getting all the sets of vs (because our tech has been cancelled). Remember, we still have 6-7 other patient's to care for, and it's time to help another patient with breastfeeding and her baby is scheduled for amp and gent, the 2nd day postop is needing assistance for her first time OOB and also wants help feeding her baby, the ante is vomiting, and the vag delivery has a critical H&H, and she is very upset because her baby is in the NICU. It's not always this bad, but it can be. I'm fortunate to work with many great PP and L&D nurses. We usually can work together, but still there are always the ones that create the tension. It's up to everyone who works in maternal child help to create an enviroment of respect and appreciation for all the RN's who work in these areas.