Responsibility to Assess: who can do it? Please help!

[Safety1st]

Hi,

I would love insight from OB RNs but any other RN too!

I am a neonatal nurse, and I practice at a hospital where we are often floated to the maternity unit to assist as a Nursery Nurse. We then operate as the Code Team Leaer for any emergency delivery or emergency in the NICU/SCN. We must be able to leave at a second's notice. The role of nursery nurse isn't defined at our institution and therefore there are many opinions of what that person should do on a given shift. Can someone help point me to where I can find legal answers to these questions. Can anyone tell me what they do at their hospital, and what is appropriate for this role? 

 

1) Who should do a baby's assessment? a) the couplet nurse (Post-partum RN assigned to mother and baby) or b) the nursery nurse who is not given an assignment

2) How does this work in your baby-friendly hospitals?

3) Should the Nursery RN report back to each nurse after performing an assessment with full updates and concerns? Is the Assigned PP RN responsible for following up with the Nursery RN to get details on the assessment and patient data?

4) If the Nursery RN goes to a delivery (as is the priority in the role), and cannot perform delegated tasks, who is responsible for making sure they get done? Nursery RN or PP RN?

5) What is the charge nurse's role in all of this communication and delegation?

6) If you take report on a patient (that is technically not assigned to you), do you then become the assigned nurse responsible for that patient's care?

7) If you document an assessment for a patient (although it is technically not assigned to you) are you taking legal responsibility for that patient for the rest of your shift.

If you have or are able to find resources that clearly answer these concerns I would be eternally grateful. We are hashing out the role on a committee right now and I would love to bring some real answers. I'd love to know what you would do on your floors too, if that is all we have to work with.

I do not feel comfortable taking on the role of assessment nurse to aid the assigned nurses when there can be 12 babies in the unit. Especially if documenting assessments transfers their care and responsibility over to me. I do not want to have a 12 baby assignment, nor do I think it is safe in any way.