[madrcs]

Recommended staffing guidelines according to ACOG/AAP states that you have 1 RN to 3"unstable" antepartum patients and 1RN to 6 "stable" antepartum patients. Please define "stable" and "unstable" for me. This is causing confusion. Thanks!

[AmberL&D/RN]

As a nurse that currently is working on an antepartum floor and in a BAD situation... I don't see any of the patients as "stable". They are all ticking time bombs if you ask me or they wouldn't be in the hospital. Any antepartum patient has the potential to turn "unstable" at any given moment. With 6 moms you have to take into consideration a minimum of 6 babies which totals 12 patients. Sorry this didn't really answer your question though.

Amber

[madrcs]

Amber, I am in agreement that any and all pregnant patients in th
e hospital are ticking times bombs. How large is your ob unit? Do you have all these patients on continous monitoring?

[bbnurse]

Stable, to us, means not in active labor, in crisis for whatever the admission dx was or near term. May include controlled gestational diabetic, arrested preterm labor, pregnant with a medical or surgical problem or things of this nature.
Unstable is active labor, bleeding, unconscious, seizing, etc.

[webbiedebbie]

My unit staffs this same way...only we have 6-9 patients each! We start off with 12 patients/2 nurses. Then we can get up to 4-5 admits during the night. Sometimes, we have a C-section to prep that shows up at 5:30 in the morning! We don't always get the help we need. Our moms do rooming in. I feel responsible for the babies as well. I am not happy with this type of staffing. No CNA and no secretary either.

[madrcs]

bbnurse what is your nurse to patient ratio for the stable antepartum pt.? What clinical experience must the nurse have before she works on your unit? Do you monitor these patients at any time?

[AmberL&D/RN]

Last night I had to stand my ground regarding staffing issues. I was on APU with an orientee, (no tech or secretary either). Got a call from triage wanting a bed for a g3p2 drop in (no doc or prenatal care). Thing was is she said it was her due date and had previous section x2. Came in for ctx, and ?srom, So they wanted to send her to antepartum to "R/O labor" I had 5 other patients (including 2 cervidil inductions, a prom at 29wks, a 33 wk PIH, and a 35 wk complete previa) So three of them were on Cont monitoring. I was like OH NO YOU DON'T... rule it out down there!! I am not gonna be 2 floors up from the OR with this patient! But I was just the "panicking antepartum nurse". This hospital has a different idea of what "stable" is than I do, because they say 1:6 with stable patients. Since my only help was an orientee she really didn't count on paper as being a licensed RN, so technically it was just me. They do staff with only 1 RN on the floor quite frequently which I totally disagree with. Especially with what they consider "stable"
But...I am just doing my time now until my contract runs out...tick tick tick

Amber

[madrcs]

AmberL&D, The APU that I work on DOES NOT ALLOW CONT monitoring. Those patients stay in L&D until they are STABLE and then they come to the unit for further observation and hopefully discharge. Cervidal inductions are also done in L&D. Those patients need a 1:2 nursing ratio. We do keep stable prom's, pih,ptl complete previas ,kidney stones, pyelo etc on this unit. We always have a tech. We monitor these patients for 20 min once a shift and more frequently if needed. We also chart once a shift and whenever there is a change. We always have a tech and/or unit clerk that works with us. The max we can have is 7 patients. If any of these patients turn into a one on one or crash they go directly to L&D which is on the same floor as the APU. I hope for your sake that your contract runs out soon.