Who covers for antepartum when they are short staffed?

Specialties Ob/Gyn

Published

  1. Who covers for antepartum when they are short?

    • 0
      We never float nurses to Antepartum
    • 7
      L&D Nurses cover
    • 0
      Outside registry/pool
    • 4
      Postpartum nurses float
    • 13
      We are all expected to float to all areas

24 members have participated

Hi! I work in a hospital that has L&D, Couplet Care and Antepartum units, (well baby nursery and NICU, too, but that isn't the issue right now).

Those of us that work in Couplet Care are expected to have a basic fetal monitoring class and take a test on some strips every year as a mandatory requirement. We are then expected to cover for antepartum patient's if they are short antepartum nurses. This is very stressing to most of us as we have no real experience with fetal monitoring and get some pretty sick antes.

We recently have had some issues with this as no one is comfortable with floating to antepartum, so the ones with a bit more experience are floated there more than their "turn" and it is causing bitterness and frustration.

We were recently discussing what should be done and most of us came to the conclusion that unless we have actual orienting days and the patient is not on continuous monitoring, that it should be the L& D nurses that float to antepartum and postpartum nurses could do recoveries or something to help out in L&D if they are busy.

So, what do you guys do at your place? I know that I am not comfortable with floating there, but haven't had fetal monitoring yet (next month) and am not able to yet anyway. It is scary just hearing report sometimes about the ante patients. I like my babies on the outside where I can see them!

Thanks!

0 Votes
Specializes in 5 yrs OR, ASU Pre-Op 2 yr. ER.

Everyone on our maternity floor is trained in all aspects (L and D, antepartum, post-partum), so any of their nurses can work anywhere.

This avoids a lot of staffing problems to have everyone cross-trained.

0 Votes

Our PP nurses are also expected to go to antepartum and vice versa. You need to get a good orientation there though and you shouldn't be expected to take the sickest patients. Personally, I think most antepartum patients can be cared for by a PP nurse with orientation, but that requires a commitment from the hospital and the nurses.

I don't know exactly why the pp nurses would think that doing recoveries to help in L&D would be a solution. Those patients are just as labor intensive and since they are only there for a short time, I don't think you'd be saving them much work. I used to find that by the time I was finished with all the paperwork in between my checks it was already time to send them to PP. Shirking the floating to them will just cause more trouble if you ask me.

0 Votes
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We are LDRP so we ALL do antepartum care. It's my LEAST favorite thing to do.

0 Votes

Our antepartum pts are cared for by L&D and/or PP. We don't have a designated antepartum unit.

0 Votes
Specializes in Babies, peds, pain management.

We are also LDRP and depends on the situation. If the patient is preterm labor on mag, it's L&D, on brethine po, it could be MB (mother-baby) with an L&D charge nurse, there's always a resource. If hyperemesis or pregnant pt with some problem other than OB-related, she could go to the Women's Unit (GYN, mainly) and still have an L&D nurse as back-up as needed. We don't keep too

many critical antepartum pts.

0 Votes
Hi! I work in a hospital that has L&D, Couplet Care and Antepartum units, (well baby nursery and NICU, too, but that isn't the issue right now).

Those of us that work in Couplet Care are expected to have a basic fetal monitoring class and take a test on some strips every year as a mandatory requirement. We are then expected to cover for antepartum patient's if they are short antepartum nurses. This is very stressing to most of us as we have no real experience with fetal monitoring and get some pretty sick antes.

We recently have had some issues with this as no one is comfortable with floating to antepartum, so the ones with a bit more experience are floated there more than their "turn" and it is causing bitterness and frustration.

We were recently discussing what should be done and most of us came to the conclusion that unless we have actual orienting days and the patient is not on continuous monitoring, that it should be the L& D nurses that float to antepartum and postpartum nurses could do recoveries or something to help out in L&D if they are busy.

So, what do you guys do at your place? I know that I am not comfortable with floating there, but haven't had fetal monitoring yet (next month) and am not able to yet anyway. It is scary just hearing report sometimes about the ante patients. I like my babies on the outside where I can see them!

Thanks!

That's where being an LDRP is wonderful. We all do everything because we are crosstrained in all areas.

0 Votes
Hi! I work in a hospital that has L&D, Couplet Care and Antepartum units, (well baby nursery and NICU, too, but that isn't the issue right now).

Those of us that work in Couplet Care are expected to have a basic fetal monitoring class and take a test on some strips every year as a mandatory requirement. We are then expected to cover for antepartum patient's if they are short antepartum nurses. This is very stressing to most of us as we have no real experience with fetal monitoring and get some pretty sick antes.

We recently have had some issues with this as no one is comfortable with floating to antepartum, so the ones with a bit more experience are floated there more than their "turn" and it is causing bitterness and frustration.

We were recently discussing what should be done and most of us came to the conclusion that unless we have actual orienting days and the patient is not on continuous monitoring, that it should be the L& D nurses that float to antepartum and postpartum nurses could do recoveries or something to help out in L&D if they are busy.

So, what do you guys do at your place? I know that I am not comfortable with floating there, but haven't had fetal monitoring yet (next month) and am not able to yet anyway. It is scary just hearing report sometimes about the ante patients. I like my babies on the outside where I can see them!

Thanks!

Hi I work in a hospital that mother/baby and antepartum are a combined unit. About one half of our nurses have been crosstrained to antepartum and the other haof have crrosstrained to nursery. There usually seens to be more than enough staff to cover each area. The newer trained antepartum nurses were not very eager to cross-train as was I when I first started. However, i love to do antepartum now much more than pp. You get to know your patients much better since they are there for a longer time, and then seem them through delivery. You might find that you love it just as i do. good luck

0 Votes

Thanks for your responses. I totally agree that if we were given a proper orientation, that it would be okay, but we aren't given one and are short staffed right now so I can't see that happening for awhile. The main problem is that none of us are cross-trained really and we don't float to other departments usually. Some do float, but in general we don't and aren't trained to do so. The patient's deserve a nurse who knows what they are doing and that is our biggest problem with this and the fact that it is our license on the line.

How many days of orientation do you think would be sufficient? I ask, because I am taking the fetal monitoring class in a month and I want to ask to have some orientation if I am going to be asked to float there. I know they won't give us much, at least not until we are fully staffed, but maybe 2 days? We wouldn't be there alone, there is usually an experienced ante nurse there as well. If they were helpful when we floated it wouldn't be so bad, but that is a whole different thread. LOL. Though I never get being mean to floaters, I always try to be really nice so they will come back if we need them again! :D

0 Votes
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I think if you do couplet care, you need weeks, not days, of training to do antepartum. You need to know L and D basics in order to care for antepartum patients, triage them, (possibly delivering precips etc) and treat them for preterm labor and other issues that arise.............you need to know well how to read NST's and interpret them. This does not take a day or two....more like a few weeks, to cover all the liability you have in antepartum.

I am just wondering, how does "antepartum" work where you are? DO the nurses there actually rule in or out labor patients, in effect, triaging them? Do they work with the doctors to make decisions regarding who is admitted and who is discharged? If so, you need more than a day or two to know what you need to get by in antepartum. Forgive my ignorance, like I said----I do LDRP and we are all cross-trained to do it all there. We all do "antepartum" care in this light. Good luck to you. Sounds as if you have some very legitimate concerns there. I think L/D-oriented nurses should cover antepartum care, really.

0 Votes
I think if you do couplet care, you need weeks, not days, of training to do antepartum. You need to know L and D basics in order to care for antepartum patients, triage them, (possibly delivering precips etc) and treat them for preterm labor and other issues that arise.............you need to know well how to read NST's and interpret them. This does not take a day or two....more like a few weeks, to cover all the liability you have in antepartum.

I am just wondering, how does "antepartum" work where you are? DO the nurses there actually rule in or out labor patients, in effect, triaging them? Do they work with the doctors to make decisions regarding who is admitted and who is discharged? If so, you need more than a day or two to know what you need to get by in antepartum. Forgive my ignorance, like I said----I do LDRP and we are all cross-trained to do it all there. We all do "antepartum" care in this light. Good luck to you. Sounds as if you have some very legitimate concerns there. I think L/D-oriented nurses should cover antepartum care, really.

smiling,

i figured that orientation would be more than a few days, which is probably why none of us has been trained. i am not even sure how our antepartum unit works. they are a separate unit and usually have their own nurses, just lately they have been short and we have been covering them (couplet care RNs, not me). we have a leve 2e NICU and are headed for level III so i think we get some sick mamas. just hearing report on their patient's scares me sometimes. (one of our 2 couplet care areas shares the floor with antes and we hear report on all of the units patients).

i don't know if i will float if they ask me to. it is too scary. they wanted me to go the other day, but i was saved by the fact that i haven't had fetal monitoring course yet. it is a double edged sword, we have to have it, yet we are then forced to float somewhere where we aren't safe to be.

i could see if we were crosstrained, that would be a different story. if i didn't like going, but had the training, i would just have to deal. BUT, we are not trained, or even given orientation. and to make it worse, they (other ante nurses) aren't helpful when we are sent to help.

in our case, wouldn't you think that L&D are the only ones that should be over there? at least they are trained to monitor pregnant women and their babies!

0 Votes
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
smiling,

i

in our case, wouldn't you think that L&D are the only ones that should be over there? at least they are trained to monitor pregnant women and their babies!

based on what you tell me, YES only L/D nurses should staff this unit. Unless and until you are properly oriented to L/D, it's not safe to staff w/unoriented PP nurses in antepartum.

0 Votes
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