Trends in Post Partum, Nursery, Special Care after budget cuts?

bestbabynurse · Feb 15, 2009

Just curious as to which areas I should concentrate on as far as keeping up my skills is concerned, or picking up new ones. Any input will be appreciated. Everybody is thinking job security these days.

FemmeRN · Feb 15, 2009

In the postpartum unit where I work, we've seen a big cut back in the hours for lactation consultants. We've also lost the ability to pay time & a half for people coming in to fill shifts when we're short staffed. There seems to be in an increase in patient load per nurse, but that's been recent and somewhat inconsistent, so I'm not sure yet if it's the result of a change in the staffing matrix, or just that we're working short staffed b/c of an inability to get nurses to come in and work extra for regular pay.

One thing we're focusing on to reduce costs is decreasing supplies and linen costs. We've been trying to stock fewer diapers/wipes/bottles at a time in the baby cribs, and bringing fewer pads/linens/gowns into the room. We have a big problem with patients going home with baby tshirts and blankets, so we're trying to reinforce the fact that those are hospital property. It is apparently helping, but the downside of stocking fewer supplies in the room at a time, and only replenishing them when they are truly out, is that nurses and techs are both doing a lot more running back and forth between the supply room and pt rooms during the day. It's also not great for patient satisfaction, that they have to call b/c they're out of things frequently.

bestbabynurse · Feb 15, 2009

Thank you. Just the sort of thing I was looking for. I'd rather run around than be replaced by tee shirts. :-D

MultipNP, BSN, MSN, APRN, NP · Feb 18, 2009

We are constantly running out of supplies because we are understocked due to budget cuts. Staffing is even scarier. Charge nurses get yelled at if we are even staffed adequately. We have to work with the BARE minimum on every shift. Many of us are losing at least 1/3 of our pay because of being put on call so much (there's not enough PTO to cover all of that call!!!). Plus, mgmt. is looking for things to write nurses up about (I really think they are looking for an easier way to get rid of some nurses -- by writing up every tiny infraction!).

If I were to have a baby right now -- I would NOT go to the hospital where I work!

bestbabynurse · Feb 19, 2009

O.K. Your unit scares me. We have had a few staff members cut. So, I doubt if they're hiring. But if they were, sure wish you could join me where I am. We have a few little issues, but on the whole we care about each other. Hope things get better where you are. Was thinking about learning to scrub in, but now I'm thinking to leave well enough alone too.

Elvish, BSN, DNP, RN, NP · Feb 19, 2009

Instead of flexing for low census, mgmt/charge nurses are asking staff to reschedule to fill holes if possible. They are also cracking down on linen usage, but this is not a new thing.

Since Medicaid and several other insurances don't cover circs anymore, I have suggested that we stop doing them unless family pays something up front. Not even the whole amount, maybe half? Something. I would be willing to bet a LOT that circs are bleeding us out. But that didn't fly because 'the residents need their practice.' Puh-leeze.

Stroudry · Sep 9, 2011

My unit cut way back on staff. And even further on orientation. I'm a new grad and I got roughly 6 weeks and that was stretched out and included some staffing days. Budget cuts in healthcare have scary results.

lakec4me · Sep 10, 2011

your unit should be following the awhonn guidelines for staffing, check it out on their website.

rn/writer, RN · Sep 10, 2011

Where I work, we actually put little signs on the cribs that say, "Baby linens are hospital property." (I was skeptical, but we really have seen a decrease in loss.) And we don't give out the diaper bag gifts until mom is ready to be wheeled to the elevator. Some people would stuff them full of tee shirts and diapers and then say they didn't have any in the crib.

We have been encouraged to bring less linen into the room. The beds are not usually changed unless they are visibly soiled. The pads are changed several times a day. We encourage the patients to hang their towels to dry and use them the next day. People don't usually change their sheets or towels every day when at home and our patients aren't in for illness, so most are okay with re-using things. If someone does have a problem with this, we will bring them fresh linen.

Our kitchenette has scaled back. We used to keep soup, canned meals, cookies, chips, four kinds of juice (five, if you count prune which is mainly used to help get things moving ), and a bunch of other items. Now we have Jell-O, yogurt, cereal, toast, milk and maybe some fresh fruit. For beverages, we have only cranberry and apple juice and some kind of white soda--regular or diet. That might sound like a lot, but when a woman has labored for two days and the kitchen won't open for ten hours, her eyes don't exactly light up at the choices.

We do keep a number of box lunches on hand--a turkey sandwich on whole wheat with mayo and mustard packets, a fruit cup, and graham crackers. Again, not a banquet, but if you're hungry enough . . . .

What we have lost that I miss the most is funding for education. It used to be that we could attend seminars or take a class and be reimbursed. Oh well. Maybe that will be restored someday.

I think our department (Birthing Center/Women's Health) is doing well over all because we tend to bring in more money that other areas. And it's generally a happy place with higher patient satisfaction rates.

I do hope that the economy picks up soon, however, as our census has dropped. When times are good, people tend to have more babies.

Elvish, BSN, DNP, RN, NP · Sep 10, 2011

Mir....you are welcome to mosey on down to my neck of the woods. It has been a madhouse for several months with no end in sight!!!! My first night from maternity leave I admitted 3 pts in 12 hours, 2 of whom were c/s. In total, we had 18 deliveries that night!!!

So I'm sure my unit would welcome some help!

germanshep · Sep 14, 2011

My unit was on a hiring freeze for 2 years while cenus was low. This turned out to be REALLY bad because the nurses were becoming so burnt out and leaving to go elsewhere. The cenus picked up in the summer and about 8 new employees were hired. We are stocking less linens, less diapers, wipes and formula. We often do not have a CNA. In addition to 4/5 couplets, new admits, discharges, etc we have to do vital signs, empty foleys, get patients out of bed, etc. This would be fine once in a while but with a high couplet load, sometimes I do not even eat during 12.5 hours.