AWHONN Staffing Guidelines Please check this out:

"[quote=rnrnrn12;2910270]Soooo..........I have a real serious problem that I need some guidance on......it seems our labor and delivery unit has decided to leave the floor with one RN and one technician when we have no patients on the floor. The second RN is put on-call and to respond within 30 minutes. Isn't there a guidance that states the need for "two trained RN's staffed on unit at all times" for a labor and delivery unit? I thought I remembered reading this somewhere?

WOW do I fear the safety of the patients that show up in emergent situations!! Scary!!

What do you think? Can someone point me in the right direction for some AWHONN/ACOG/AAP guidelines or requirements?"


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Boy - do I feel your pain. We are a small unit and always go down to one nurse if we are empty - with no tech! I have worked L&D for several years in bigger hospitals, but never by myself until I came here. I have had several close calls in the 4 years I've been here, but by the grace of God, everything worked out each time. We can't even get our administration to let us keep a tech with us when we're empty. I too, hope that someone posts the answer to your question about guidelines mandating 2 RN's at all times. Good luck!

i work on a pp complications floor..so we get anything from pt's still on mag to pts with psych issues. we also take babies in our assignment. the awhhon guideline seem like heaven to me as my average assignment is about 5 moms and three babies. EVERY mom has a complication so it's not a breeze. my assignment could consist of a mag pt, a chorio mom and baby (both on antibiotics), HIV, and whatever else happens to come since we are steadily admitting new pts. we also take pp readmit wound infections, mastitis, or other post D/C complications....we rotate charge nurse but charge nurse gets an assignment!! staffing is always an issue unless we are slow which then we are forced to be canceled which is a whole other can of worms!! LOL

It's good (not really "good") to hear that other units have the same problems all over the country. What I don't understand, however, is why you have to take the post D/C patients on your floor. At our hospital they are considered med/surg patients once they are readmitted. How large is your unit? How many deliveries do you have and what are your staffing ratios?

Our mother/baby unit also has antepartum and gyn surgeries. Any suggestions on staffing?

" It is unfair to ask someone to do something that you would not do yourself" Elananor Rosevelt

Bear530, our unit also has gynies and antepartums. Our unit makes it so that we have 4-5 adults per nurse. This includes antepartums, gynies, or postpartum mothers w/ babies. If there is a particularly sick or heavy-duty patient, sometimes mgmt will allow that particular nurse to max out at 3-4. On one occasion (ruptured hematoma, mom transferred to SICU and back to us, got 8u PRBCs plus platelets) one nurse had 2 patients. But that's VERY rare. Generally we staff like I said previously.

I was wondering if anyone has had the problem in their hospital of leaving one nurse on an OB unit with another on call when the unit is closed. (no pt's) or leaving one nurse on the unit alone with one gyn pt. The call people can be 30 to 45 mins away. I am not comfortable with this, knowing that things can change very quickly in OB and you can have an emergency just walk through the doors without anyone knowing she's coming. I've been trying to find out what the standards are for safe staffing when a unit is closed or with only one pt but have not been able to find anything. If anyone can give me any information it would be greatly appreciated. Thank-you

Our hospital always has 2 OB nurses in the building no matter what the census. The second my be on another unit as helping hands but readily available to return to OB. You are completely correct that anything can and does walk through the door at any time. I actually delivered a VBAC who arrived and delivered within 10 minutes of arrival. It is always the walk ins that need the care the most it seems.

thanks for your reply, what state are you in? We're having a meeting with the hospital administrators on tues and was looking for some documentation on safe staffing in Ob and specifically not leaving one nurse here alone. They just don't seem to get it.

This is a rediculous guideline. I work in a small hospital, where I AM the charge nurse, and I AM the labor nurse. We have just started using computer charting that is HORRIBLE and time consuming. It is so unsafe to labor two at a time!!! These people that make these guidelines need to come job shadow me. UGGGG!!!!! I work nights, and I am lucky if I have a post partum nurse on call. I'm it people...whatever walks in.