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How do we safely stand up for our patients, and ourselves? Maybe I'm just

" not organized " , but I've been doing OB for 6 years, and feel justified in

feeling " left out to dry " What do you guys think?

" Not organized " ????? I wouldn't say that at all, Bobbie! It's hard to be

" organized " when all h*** is breaking loose and you don't have sufficient staff.

From a management point of view (been there, done that, threw out the

T-shirt), it is hard to maintain sufficient staff for a unit like L & D which in

your case seems to have a pretty low census and slower pace than the larger

Level IIs or IIIs. In the large centers, not only is there a higher census of

active laboring patients/clients, there is also a bigger " bank " of staff to call

in when it's busier, or just to fill in. In a smaller L & D, the hospital doesn't

want to pay nurses to either send them home when it's quiet, or float to other

units. All of this leaves you in the same boat--you were left in a hurricane,

without a paddle, and maybe even without the boat too.

How supportive is your manager? Is there any possibility of an on-call system

to cover these kinds of days? I find that in many hospitals, L & D is the

" forgotten child " when it comes to getting help from supervisors.

One thing that *did* help at several of the hospitals I am familiar with--they

went to a unit self-scheduling system, and self scheduled call time for everyone

as well.

If none of these things can be tried, all I can do is sympathize with your

rough shift, and congratulate you for completing it as well as you did with

limited resources.

----Jeanine

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I'm sorry you had a bad night. Reminds me why I left the hospital!

starmom wrote:

>

>

> Its not just the smaller hospitals having problems staffing L & D, Im in

> a large hospital, with a level three nicu and we have close to 3000

> deliveries a year. They have been trying to get more people hired, pref

> with L & D experience, but are hiring also anyone willing to learn

> mother-baby and L & D.

>

> Our experienced staff are getting really fed up with being so short of

> real help and being so overworked! Not to mention as you have

> experienced the stress of trying to juggle too many things at once and

> holding your breath that all goes alright.

>

> Its such a tremedous responsibility I think to have two lives at stake

> at once, and so much depends on the nurses to keep all well and make

> alot of decisions. We have also recently experienced some difficulties

> with our nicu people as far as cooperation when a baby is " bad " and it

> is not taken seriously enough! fast enough!

>

> In our new unit the ldrp some of the staff have been wearing pedometers

> and logging in around 8 miles a day!

>

> no wonder everyone is so tired!

>

> It sounds like you handled your bad shift well considering the

> difficulties and for that you should be proud of yourself and try to get

> management to work out some back up, the cost of extra staff would be

> way less than the cost of a lawsuit if something goes wrong!

>

> take care;

> sue

>

> ---------------------------

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>

>

> I'm sorry you had a bad night. Reminds me why I left the hospital!

> >

> >

> > Its not just the smaller hospitals having problems staffing L & D, Im in

> > a large hospital, with a level three nicu and we have close to 3000

> > deliveries a year.

Yes, me also!

And the sad part is, hospitals are losing wonderful, dedicated nurses to

burnout because of the lack of appropriate staffing, AND often the lack of

support as well.

----Jeanine

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Its not just the smaller hospitals having problems staffing L & D, Im in

a large hospital, with a level three nicu and we have close to 3000

deliveries a year. They have been trying to get more people hired, pref

with L & D experience, but are hiring also anyone willing to learn

mother-baby and L & D.

Our experienced staff are getting really fed up with being so short of

real help and being so overworked! Not to mention as you have

experienced the stress of trying to juggle too many things at once and

holding your breath that all goes alright.

Its such a tremedous responsibility I think to have two lives at stake

at once, and so much depends on the nurses to keep all well and make

alot of decisions. We have also recently experienced some difficulties

with our nicu people as far as cooperation when a baby is " bad " and it

is not taken seriously enough! fast enough!

In our new unit the ldrp some of the staff have been wearing pedometers

and logging in around 8 miles a day!

no wonder everyone is so tired!

It sounds like you handled your bad shift well considering the

difficulties and for that you should be proud of yourself and try to get

management to work out some back up, the cost of extra staff would be

way less than the cost of a lawsuit if something goes wrong!

take care;

sue

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Bobbie,

Boy, can I sympathise with a bad situation! First, I guess I would have

called the house super (if no available staff to call, as if you had time!). I

would have directed her to call my manager. If no help/response, I would have

filled out every incident report for inadequate care I could have. It seems to

be the only thing that gets anyone's attention!

Cheryl

Lawrence, KS

----burke@... Wrote----

> Hey, I worked last night and I need to vent so I can finish sleeping...I

> work in a small hospital in rural NC.  We usually have about 30 deliveries

> per month.  Last night was the pits.  We had 3 postpartum mothers,

> two of whom were breastfeeding, and one who had stopped because she thought

> that her baby's bilirubenemia was " her fault " ; three babies, including

> one on the biliblanket, and another on IV antibiotics; and a G4 in who

> was in latent labor, (she was 4 cm at 7pm, and 6-7 at 7 am, but was

<u>wild </u>

> with pain, and needed a lot of care; and a thirteen year old who had cervadil

> placed and then got tetanic ctx's so I had to pull the Cervadil, and start

> her labor notes, IV etc.(good thing I did because she was closed thick

> and high last night, and was 2-3 at 6 am, and I heard she delivered at

> 7:30 this morning). Obviously the 13 year old was a high need patient,

> screaming, crying, trying to get up and " run away " from her discomfort,

> etc.

> <p>To handle this case load, we had two rns, no aide, and no secretary......

> <p>How do we safely stand up for our patients, and ourselves?  Maybe

> I'm just " not organized " , but I've been doing OB for 6 years, and feel

> justified in feeling " left out to dry "   What do you guys think?</html>

> <hr>

> <!-- begin

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  • 2 weeks later...
Guest guest

I have just been reading the archives. This night sound all too familiar.

It sounds like many nights we have at our facility. This is why I set out

to find this list. I wanted input from other nurses. In this scenario we

may have one RN and one LPN ( You did not mention the infants, were you

also responsible for them. That would be 3 moms/3babies and 2 labors) The

management would states " Don't worry they won't deliver " How do they know

that when as a nurse I am not always certain. The management states we do

not qualify for more nurses. My manager has never worked any maternal

child unit, her background is emergency room. Our LPN's can not do labor

patients. We are responsible for all the postpartum, antepartum, nursery

and any labor that walks in. I feel this was an unsafe situation for you.

We have a union. We can fill out forms called " unsafe practice report " .

This alerts the union that we feel we are unsafe. The report does state

that when we sign it, we are holding management responsible for anything

that occurs prior to them getting us more help. Depending on the situation

some off shift managers do not like these forms and will get extra help. We

are short on call in staff so sometimes we have no choice. We work short

staffed. Good Luck to you in the hospital.

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