RN4mommy's

We have residents all the time get upset with the nurses for 'managing' the patient :) (last I checked this was our job). We have tried the thing where we say, 'if you want to up it you will have to do it yourself.' There have actually been times when they have upped the pit themselves on a non-reassuring strip/hyperstimmed uterus! Problem is, they don't know how to work the pumps, and they don't stay in the room after they up it. So then who's responsibility does that patient become when they up the pit and leave the room???

Thanks to all for the feedback. Yes it is an aweful situation. I guess all I can really do at this point is continue to work the floor when I can to lighten their loads and continue to protest and document...document...document! Thanks for the risk management advice. That is an awesome angle that I hadn't thought about pursuing. I also finally have a meeting tomorrow with the director of HR which I hope is a first step. At least they are agreeing to meet with me which is more of a response than what I have ever gotten before. Another approach I have used in the past few days is $$$ since we all know is the only language admin understands. I figured out the average cost to replace the people who have left will be $550,000!!! My point to them will be that it would have been and will be less expensive to keep a few extra nurses around to comply with ratio guidelines, opposed to staffing us with bare bones, burning everyone out, and having a mass exodus. Wish me luck tomorrow as I will probably want to lodge myself across the table at them, but we all know that won't get me anywhere

I am a nurse manager for a very busy LDR/High Risk Antepartum/and Mother-Baby unit and I have to say I have had quite the opposite experience as some. The ONLY applicants I have been getting for about the past 18 mos is new grads, therefore that is about all I have been able to hire. Since I have had sooo many applicants, I can say that I have had the option of only picking the cream of the crop though. In general, all have adjusted very well. We have a system with the new grads though where we give them 6 mos on mother/baby to "prove" that they have their time management down before we advance them on to L&D/ante. I have to say I don't mind hiring new grads at all because they are very moldable and are generally very excited and eager to be there. I still come from the school of thought that any med/surg experience you obtain will be invaluable to you as well, no matter what career path you choose. Good Luck.

I agree with BETSRN, we used to be an LDRP and it was aweful in times of high census, we would have to wake moms up in the middle of the noc to move to an overflow unit. We used to have tons of pt complaints. We have switched back to an LDR. The mom's seem to complain much less because they are explained the POC when they are admitted that they will be moved to another room a few hours after they deliver. We have eliminated whisking them away in the middle of the noc We took our 20 bed LDRP and turned a 10 bed hall and designated it as LDR, took the other 10 beds and designated it as "Preterm alley" Then the old overflow unit is now all mother/baby. We do have a well baby holding nursery that is staffed with an LPN. Provides better continuity of care with less moving around of patients and better for assignment making as well from a nursing standpoint.

Our hospital typically does NOTHING for our nurses. So last year I planned a week's worth of unit specific activities for my people. Things included me flipping pancakes for them (which was inexpensive for me and they loved it!), having an ice cream day, a pizza day, bagels etc.....We all know nurses love to eat! Then I ended the week by all of my ancillary staff throwing the nurses a party (potluck) and had a separate room set up where I had massage therapy students give them all 10 minute massages (which cost me nothing because they needed the hours to log). All in all, it only ended up costing me about $200 which was well worth it to have a Happy Nurses Week. Plus it made me feel very good to be one of the only members of management to recognize them and say thanks. It was money well spent

There is an absolutely awesome website from the University of Texas that my manager shared with me. It was an awesome resource for guidelines and policies. They have all of their policies on line and available to the public for you to use as a resource in development of your own. It is a true godsend. I wish a book existed on sample OB policies or that more hospitals would have their policies on line to the public like University of Texas. Here it is: http://www.utmb.edu/policy/nursing/nursing.htm They have a whole section on OB and Newborn policies. Hope this helps :)

Hello all- This is my first posting and I'm hoping this site might be helpful. I am a relatively new nurse manager promoted from within (I used to be an LDRP nurse on my floor). I absolutely love my unit and only took the job because I thought I could make a difference. However, about a year ago we had massive budget cuts and we lost our acuity system. We now staff like a med/surg unit where the number of nurses we are "allowed" is based on the number of patients present at 0500 and 1700. Many of my nurses have given it their all, but are burnt out and overworked. They are taking upwards of 6-7 mother baby couplets regularly, 3-4 high risk monitored patients, and 2-3 labor patients. Insulin gtts, Mag, high risk doesn't even come into play when making their assignments because with our patient population, almost all are high risk. I know for a fact that our current staffing patterns do not fall within AWHONN guidelines, but have been speaking on deaf ears when it comes to administration. I am now starting to have a mass exodus (I can count 8 people that have left in the last 6 weeks). It just makes me sick because I love this unit and I love the people I serve. Not to mention, all the people leaving just ends up making my ratios worse for those who are choosing to stay and stick it out. The average staff nurse doesn't know how hard I am fighting, and quite frankly I'm ready to give up all together . Nursing admin keeps saying "benchmark" what other hospitals do (which I have done before), but no changes have ever come to fruition. I'm wondering if any of you can give me feedback as to whether or not you staff with 'core staffing', use an acuity system, what your ratios are etc etc. Please help.