Labor and Delivery staffing

  1. What are your views on having 1 staffed for midnights on a closed L+D unit. Do you think that a nurse should ever be alone on L+D. Keep in mind at our hospital, Anesthesia are not in house and niether are the docs, also no one from any other floor has OB experience. All opinions welcome.
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  2. 13 Comments

  3. by   rUmad2
    Do your L&D nurses have other responsibilities (postpartum, nursery.) Do you do C-sections in your unit?
  4. by   Darchild77
    Quote from rUmad2
    Do your L&D nurses have other responsibilities (postpartum, nursery.) Do you do C-sections in your unit?
    yes, we are also postpartum unit, nursery, pediatrics, and do our c-secs on our floor.Oh, and we also do hysters and any med-surg overflow.
  5. by   nrsnan_1
    Being the lone ranger in L&D is never a good idea. What kind of back up system for help is in the hospital? I worked alone in L&D but had postpartum/newborn nurses at close proxmity. Also, the night nursing supervisors came if needed. However, I do not believe that is the best choice.
  6. by   Darchild77
    Quote from nrsnan_1
    Being the lone ranger in L&D is never a good idea. What kind of back up system for help is in the hospital? I worked alone in L&D but had postpartum/newborn nurses at close proxmity. Also, the night nursing supervisors came if needed. However, I do not believe that is the best choice.
    I'm not sure what you mean, I'm not aware of any Backup system.
  7. by   nrsnan_1
    Who responds from within the hospital if you call for help? What is their experience in L&D? In the little hospital in LA that I worked at, I was the lone L&D nurse at night. However, the postpartum nurse would come if I needed her and although she had minimal L&D experience, she could start an IV, call doctors, set up delivery room, etc. Also, the night nursing supervisor could do the same and would come if I needed her. The ER doc made many a visit to my department to catch precipitous babies if he wasn't tied up with an emergency.

    Quote from Darchild77
    I'm not sure what you mean, I'm not aware of any Backup system.
  8. by   fergus51
    I think she means who helps if you are alone and busy? If there is an emergency requiring your attention and another patient comes in, what do you do? And how do you get a break when there is no one else there? I wouldn't work without any other nurses nearby.
  9. by   Darchild77
    Sorry, just a bit dense today. Our hospital super would come and some med-surg nurses would come, but the ER doc wouldn't come in a million years!!! Nobody, I mean NOBODY, else in the hospital has L+D experience. And a lot of the nurses on my floor live 30-50 minutes away(at least 10 out of 20 nurses).:stone I just feel that this is too much responsibility for anyone, more less a new grad, and it scares me. Back to the backup thing, the only thing I could is call a nurse(L+D) that lives 5 min. away, and pray she comes in.
  10. by   rUmad2
    Your concerns are completely valid. I work in a small rural hospital (300 births per year) so we wear many hats, too. We worked very hard to convince our administration 2 OB RNs (we do labor,delivery, pp, and nb with our C-sections being done in surgery) at all times even when the unit is closed. All it took to reinforce this staffing was a 34 week gest. breech complete with history of previous classical C-section when the unit was CLOSED to realize what happens in OB. We can go from 1 to 100mph in the time it takes to inhale.

    I surveyed hospitals my size and the staffing is varied to dangerously creative. And, I'm not convinced adminstration will let ours alone. The only advice I have would be to keep a log of true OB emergencies and start to explain how they could happen at any time and one RN inhouse isn't enough. Two weeks ago, we had a 24 week gest breech, complete who delivered in 13 minutes from the time she arrived! Thanks goodness it was shift change. The 500gm boy was doing great but in that instant, if there were only one OB RN inhouse, the outcome could have been completely different.

    Good luck and don't give up.
    Beth from Illinois
  11. by   imenid37
    You should never be the only nurse for the OB floor. If we are closed then at least 2 of us are in house and the other 2-3 who are scheduled to work must be on call. What if a pt. has prolapsed cord or seizure? It is not fair to you or her or the baby. This idea saves someone lots of $, until the BIG lawsuit is filed on the rare occasion that something unexpected happens. The hospital cannot afford NOT to have proper staffing. Check w/ your state board of nursing/ health regulatory agency. In the state of PA, there must be two licensed people on the unit when there is a pt. Good Luck! You really need it!
  12. by   USA987
    We have approx. 2400 deliveries/yr. Have to have 3 L&D nurses & 2 SCN+ nurses in-house at all times...some of them may be working on postpartum...but they are just a shout away....
  13. by   SmilingBluEyes
    very very bad idea for the reasons already mentioned. I would NEVER work like that. NEVER.
  14. by   JaneyW
    I work in a small but busy hospital. I am in CA and we have had to have 2 RNs at all times in my area for a while now--not just with the new laws. If someone is pushing, they are a 1-1. It is way too dangerous to be there by yourself--especially if you're not very experienced (I'm not either!). I have spent a few nights with no patients and was very glad for the company of the other RN! Good thing I enjoy who I work with.

    There are also many nights--esp Sunday NOCS/Mon am--when it seems a bus pulls out and lets out 6-7 labor patients at once at 5:30-6am after a night of no patients at all! It is so hard to go from 0 to 100mph when you're at that puchy time of the morning!

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