AWHONN Staffing Guidelines Please check this out:

I work in a separate postpartum unit at a unionized hospital in California. We have couplet care; our max is 4 couplets, and most of the time assignments are made within ratios. Our moms have the choice of sending their newborn to the nursery during night shift which is staffed with one nurse assessing and caring for 8 or less newborns.

Lately though, if a nurse has two or more newborns going to nursery then she is assigned another couplet. Management is saying that as long as we aren't over 8 patients total, i.e. 4 mom/4 babies, 5 moms/3 babies, 6 moms/2 babies, etc... then we are still within ratio. I am hoping to get some input on this because it just seems a little funny to me when the state ratio law for just postpartum moms (no babies) is 1:6. I asked about that and was told by management that we are a couplet unit, not just postpartum and are allowed 8 patients total, doesn't matter the mom/baby mix.

Any thoughts on this? Keep in mind, the nursery newborn(s) might be breastfeeding on demand in which case the primary nurse is still responsible for taking baby back and forth, and helping with breastfeeding. Sometimes moms change their minds and/or want baby back half-way thru the night as well, not to mention the hour after the nursery is closed and the primary nurse has full responsibility of all 5 or possibly more couplets, until the next shift comes on.