April 22, 2008
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.