Re: staffing...please explain - page 2

I am not really interested in nurse-to-patient ratios right now. I can read many threads regarding this. My question is, do any hospitals staff according to acuities anymore? Case in point: ... Read More

  1. by   webbiedebbie
    I was just quoting my manager who stated that the hospital follows ACOG guidelines. I didn't believe her either. I looked up ACOG and couldn't find anything there.

    I also checked AWHONN's site and couldn't find anything there either.

    Money talks, I guess. Hospital administration and billing decide on staffing. No wonder there is a nursing shortage!
  2. by   Mimi2RN
    Originally posted by webbiedebbie
    Thanks, rdhdnrs....I sent you a pm.

    I work a Postpartum unit...granted, there are many times we are not busy. But when we are, that is when we are short-staffed.

    I am a professional and I feel I know an unsafe situation when I see one. (So far, I have worked 2 of these nights in this hospital).

    Our system currently only allows for 3 nurses total for 11 patients and higher (up to 23 beds). That may be fine in some instances, but the majority of the times, we only have 2 nurses and may or may not have a CNA (and they only work up to 11 p.m.).

    How do I get the hospital to start staffing by acuities??????
    Debbie, are you including the babies in your numbers? or does that mean 11 couplets and higher? So many place don't seem to count the babies, but they can take a lot of work. Even if you have babes with a nursery nurse, they won't be there for every feeding.

    I do know how fast pp patients can go bad.....having babies is not always an easy, joyful time.
  3. by   pickledpepperRN
    You can buy the book "Guilelines for Perinatal Care" on line. It is from the American Academy of Pediatrics, the American College of Obstrticians and Gynecologists, and the March of Dimes.

    I'm an adult nurse who hand wrote page 19 when taking a relative for a prenatal visit. I do serve on a practice committee of nurses at my hospital.
    Table 2-1 :
    NURSE/PATIENT RATIO CARE PROVIDED
    ------------------------------------------------------------------------------
    INTRAPARTUM
    1:2 Patients in labor
    1:1 Second stage of labor
    1:1 Medical or obstectric complications
    1:2 Oxytocin induction or augmentation of labor
    1:1 Coverage for initiating epidural anesthesia
    1:1 Circulation for cesarean section
    ANTEPARTUM/POSTPARTUM
    1:6 Antepartum/postpartum patients without complications
    1:2 Patients in postpartum recovery
    1:3 Patients with complications but in stable condition
    1:4 Recently born infants and those requiring close observation
    NEWBORNS
    1:6-8 Newborns requiring only routine care
    1:3-4 Normal mother-newborn couplet care
    1:3-4 Newborns requiring continuing care
    1:2-3 Newborns requiring intermediate care
    1:1-2 Newborns requiring intensive care
    1:1 Newborns requiring multisystem support
    1:1 or greater Unstable newborns requiring complex critical care

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