[rnWinn]

Hi, I am about to move to California to nurse (hopefully in San Diego, or Lompoc, Encinatas, Santa Barbara or nearby). I am used to 1:1 nursing (usually) with continuous EFM, and I am with the patient the whole time. How does it work when you have central monitoring? I guess you can have 3 or so labor patients, but how do you provide any support? Is there anybody in the room with them all the time? Or is it just their husbands/friends or whatever?

I'm really curious.

[CrunchyLaborRN]

With central monitoring we have anywhere between 1-3 (sometimes 4) patients depending on acuity. There is not always a medical professional in the room. Our nurses are really good about keeping an eye out on ALL of the patient's (on the monitor), not just their own.

[Mrs.S]

We have central monitoring, and anyone on continuous is still 1:1 unless there are extenuating circumstances, in which case we watch each other's strips. To be honest, I've always been curious what it is like to NOT have central monitoring

[SmilingBluEyes]

We endeavor to keep it 1:1. SOME times we are 1:2. Usually, we try to give a labor nurse a stable couplet or GYN patient, rather than an active labor pt. Or they can do "rule outs" and NSTs. It works fairly well. But then, this is an LDRP and GYN unit I am speaking of.

[babyktchr]

WOW...where do you all work that you can have 1:1 labor patients. We have 1:2 unless they are pushing.

[eandgsma]

We have 1:1 or 1:2, depends on how busy we are. If we are pushing, then its 1:1 for sure. We are in pods of 3-4 rooms, we have monitoring in the pods for about 9 rooms (so our pod plus 2 more). We all watch the strips. Charge RN has all the strips on a monitor at the front desk. We have upwards of 8000 births a year now. The only way we have more than 2 pts is if they are preterm and not in labor, then we can have 3-4 but that is rare on L&D, they are usually sent to the High Risk floor (when they have the room). The one thing that I am really enjoying about L&D is that everyone is willing to jump in and help the other, a great team spirit.

BTW, I'm new to L&D, just an extern on the floor since June. But I'm applying for the new grad position, interview is on Tuesday!!!

Good luck wherever you decide to move!

[Mrs.S]

Originally Posted by babyktchr

WOW...where do you all work that you can have 1:1 labor patients. We have 1:2 unless they are pushing.

I am in WI, and from what I hear that is the norm at the other hospitals in the area as well.

[rnWinn]

With the central monitors, do they print out a continuous hard copy at the front desk, or are the hard copies in the room (ie. so you can quickly write things down on them you've done)?

[SmilingBluEyes]

I work in a smallish community hospital that has LDRPs. We shuffle patient assignments in order to make 1: 1 labor as much as possible. This may mean, taking the next labor pt who walks in the door if you are the one with the smallest/"easiest assignment. Also, our "charge" takes a patient load, as well, albeit usually just the one labor patient, or most stable couplets. The charge and the PP nurses for the day, also catch all the newborns born, as well. It takes a lot of versatility and patience, as well as efficiency. It's essential all nurses are "cross trained" so they can perform any or all roles in a given shift.

Teamwork is definately our key. And I am glad for it. It works most times, unless chaos reigns (we all know that never happens in OB right?)

[SmilingBluEyes]

Hard copies of what? THe strips or charts? We print our own charts/flow sheets when done, where I am. The paper strips are still being printed on the monitors until our archive system is proven for at least a year (we just went to QS charting a few months ago).