Self-contained unit

[pierand]

Hello all! My hospital is currently considering letting our women's health unit (L&D, PP, Nursery, and Peds) work as a closed, or self-contained unit. I have been appointed task leader for this group and am trying to find some evidence based research on the topic. As some of you may know, L&D is a very specialized unit that doesn't usually benefit from floating nurses in to help. We already have to rely on our own employees when it comes to staff shortage, but the hospital is more than willing to float us out to help on other units, often times creating a real crunch on 2 units if the L&D unit becomes very busy and the nurse has to be pulled back.

I would like to hear from anyone who has worked in a closed unit and whether or not you felt that led to higher employee satisfaction (which we all know leads to higher patient satisfaction).

Thank you!

[ReneeRN0521]

I work on a closed unit (if we get pulled it is only to PP, Nsy, or NICU). It is fabulous knowing that I will never have to take care of a 90 year old man that has had a stroke. That being said our L&D is fairly busy for the area (about 300 deliveries per month). We have call nurses on nights and weekend days. 2 call nurses if there are less than 7 nurses scheduled or 1 call nurse if there are 7 nurses and no call nurses if there are 8 or more nurses scheduled. If we are super busy and all the call people are there we call and beg our nurses for help. I have never worked on an open unit and have no desire to. I do think that it leads to higher employee satisfaction if they work on a closed unit. The only downside is they have to be OK with being flexed down (cancelled) if there aren't enough patients.

[pierand]

Thank you so much for your input! You sound similar in size and volume to us, so I now know it's doable. We are looking to close our L&D, PP, Nursery, and Peds units. The only problem I am encountering is that some don't want to pull a mandatory call day, like you mentioned you guys do. Do you mind telling me what state you work in? Thanks again!!

[ReneeRN0521]

None of us want do mandatory call but it works on a rotating schedule. There are 6 groups with approx. the same amount of nurses in each group one month group A picks first then B and so on and so forth. The next month group B would pick first and A would pick last and that is how it goes. Usually the last group ends up being assigned their call because it works best that way but the lady that does our call tries to respect requested days off and vacations as much as possible. Call is a necessary evil in a closed L&D. That being said our PP, Nursery and NICU don't do call, just L&D. It is one of those concessions we make to work where we love. I work in Arkansas

[pierand]

Thank you so much for all the info. As I continue to explore this option for our hospital, I am coming to realize that while everyone would love the benefits of a closed unit, no one wants to deal with the necessary evils, if you will! All four of our units would have to pull call, and that seems to be the deal breaker. Maybe if we keep investigating all the options we will find one that works!