April 22, 2008

Hospital Politics

A few months ago, I talked about how the hospital is going to build a new building and that OB and ICU would be the first dept. in the new building. The current building is just really old, new additions have been added through the years, its confusing how to get from one floor to the next. The old part is just getting to the point where they won't be able to keep it up with codes in a few years. Anyway, we were asked what we would like in a new unit. The OB director, who gets to make the final decision, asked us about LDRP rooms. No one liked the idea. Literally no one. We currently have separate labor and postpartum areas, connected by a hallway. It seems to most of us that it works, as we wouldn't want to be recovering from a c-section and have a woman laboring without an epidural next door, who is next to someone who is holding her stillborn baby. So we all voted no. Well, turns out they really don't care what we want. The plans for the new unit are to be in a triangle, with 2 OR's in the middle and the nursery in the middle, and for all the rooms to be LDRP rooms. The nursery won't be the size we have now, as they really want the babies to stay with the moms. Which is all good with me, but the culture around in this area is to send the baby to the nursery, especially fresh c-sections, for the night and come out for feedings. People will be unhappy with a change like that. We will also handle sicker babies, just not any on vents, or who are really sick. There will be 3 pods, staffed with 1 labor nurse, 1 nursery nurse and 1 postpartum nurse. I'm really unhappy with that. What happens if my labor patient's baby takes a dive? The nursery nurse/postpartum nurse won't be comfortable helping with that, and if another labor nurse comes from her pod, that leaves her patient unattended. What will happen is that everyone will be expected to be able to work all areas, and you can't keep your skills current on 4 areas (ped is also part of our dept., for now). Maybe it won't be that bad, or maybe they'll change the plans, but I doubt that. I just wonder why they even bothered asking us what we wanted when they were going to do what they wanted anyway. I mean, that meeting last year was very long. I could've been doing something else. Yes, I'm being resistant to change, but things work well like they are. If my baby's heading south back in labor, I know that I have competent labor nurses right out at the desk, ready to help. The nurses who do nursery/peds shouldn't have to learn labor, too. It will be a few years before anything happens, so we'll just see how it goes.

4 comments:

Mrs. Spit said...

Just my 0.02 cents with the stillborn baby thing.

I hated having to move after loosing my son. In the delivery room, I could hide in my room, and I didn't need to interact with anyone.

After being put on the post natal unit, I was in this tiny, ugly unit, in a ward full of women who just had babies.

I would have rather stayed where I was. . . .

Anonymous said...

The thing is, I think that more women prefer LDRP rooms. I don't think most women want to move; I know I would prefer not to move. I think if you are dealing with a situation like a stillbirth, then it doesn't really matter where you are. LDRP rooms allow women to get a sense of comfort in their surroundings.

I would be annoyed by the other set-up you discuss; the pods. But I'm sure that they'll figure it out - I don't think you are wrong about your fears there.

Nurse Lochia said...

I recognize that LDRP rooms make it so you aren't having to move, and some women like that. I personally was glad to get out of the labor bed and be in a fresh room, and in a more comfortable bed. It was like I entered the labor room pregnant, emerged a mother, and it was m wheelchair ride of fame. Just my opinion of things. The whole stillbirth thing, I used that as an example of someone wanting alone time and having the possibility of hearing a woman screaming while giving birth, and then hearing a baby's cry. Our moms who have a stillborn have the option of staying in their labor room and going home from there, being moved to a different floor (like med/surg), or staying on postpartum. We have a hallway that is away from the nursery and is more secluded so they don't have to be around happy moms. We really work to do whatever it is that will make the mom more comfortable, whatever that may be.

Niffer said...

Okay, so I work in a hospital with LDRP's, infact we're the only hospital in town with them. I love them! I've had all 3 of my munchkins there and I would have hated it the other way! There is some tension among nurses as we are all cross trained and some don't like labors, and some are accused of being "Labor Whores" pardon the expression! But other than that everyone likes it! we brag to our mom's on tours that they can't get this anywhere else in our city. I agree with the demise thing, but usually our mom's get to go after 4 hours (recovery) if they are stable. Our unit is being remodeled as our rooms are only about 350 sq ft, Yikes! I think they're gonna make 2 rooms 1, or 3 rooms 2, something like that. Hopefully this time they'll listen to us nurses so we can have a super functional unit. At this time we only have 1 nurses station (no pods) but we only have 15 LDRP's (smaller hospital)