perioperative L and D

[drmwvr]

Does anyone else scratch their head over the old L and D paradigm of bedside nurse = OR nurse = recovery room nurse? I have never seen it done any other way in 15 years of anesthesiology and I wonder if it grinds upon obstetricians the way it does me. It's a hill I know I'll never die on, so I don't expect anyone else to grab their lance and do battle with the nursing admin. windmills. It just seems that in this day and age such "hat swapping" would be on the less safe side. It surely isn't on the expedient side, on any level.

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[Farmer Jane]

I hated it when I did it. That said, in a busy L&D unit I don't know how it would be staffed otherwise. To have separate OR nurses and PACU nurses, you'd increase your total numbers and most hospitals are already cutting to the bare bones. Another aspect is time: one of the advantages of the jack-of-all-trades approach it that you don't have to switch nurses, giving nurse to nurse report each time. That can make a pretty big difference in an emergency c-section.

I also worked in a small community hospital, and the patient went to the OR, so the OR nurse and PACU nurse were called in, and the OB nurse took care of the baby in the c-section room, as there was no NICU. I can't say either was the better setup. As someone wanting to have a baby very soon, I would undoubtedly prefer to deliver at the first hospital I cited, due to specialty resources (like NICU) and speed of c-section when necessary.