number of nurses in delivery room

  1. Am looking for information-how many L&D units out there only have one RN present at deliveries-for both vaginal deliveries and C/S--that means this one RN is responsible for both mom and baby--trying to find a standard of care here. I feel that baby should have its own nurse and mom should have hers too-at least until both are stabilized. Our busy unit currently has no guidelines so that one nurse does all! Can be very scary if mom hemorrhages and you are resuscitating baby:uhoh21:
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  2. 29 Comments

  3. by   luv l&d
    In a c/s, we have one nurse for the baby (NNP) and one circulator for the the mom. If it is a normal vag birth (ie no mec or risk factors) one nurse for both. We don't do mom/baby so the transistion nursery come in in about 20-30" to do the initial ass. on the baby. Always can call for assistance if needed.
  4. by   Jolie
    We have 2 RNs at every delivery and/or C-section, one for mom and one for baby. To do otherwise is asking for trouble, in my opinion, as we have all had things go south in a heartbeat.

    It's been awhile since I've renewed my NRP, but it seems to me that their standards call for 2 certified providers in every delivery, so that may give you with the justification you need to insist on a second RN. In these lawsuit-happy times, I would be sure to stick to their stated standard of care.
  5. by   ShandyLynnRN
    in our hospital, we always have 2 RN's in vag deliveries, and if there has been fetal distress or mec we also call RT in, just in case, and then if everything is OK, RT leaves. Then one RN cares for mom's recovery, vitals, fundal checks, etc, and the other cares for baby, assessment, meds, vitals, etc, until they are ready to be moved to their postpartum room. Then, one RN usually takes over both mom and babe.

    If it is really hectic, we still have 2 RN's for delivery and for the first few minutes until we know that babe is stable, and just "warming up" and the OBT takes over for vitals on baby, while the RN recovers mom and keeps an eye on babe.

    In C/S, only one of our RN's go, and RT ALWAYS goes, so there ARE two NRP certified personell there... the anesthetist is there to monitor mom, and circulator too, and then they go to recovery where the recovery room nurse cares for mom until transfer to our unit.
  6. by   imenid37
    2 rn's for svd. one for mom, 1 for baby. 1 rn for baby at c/s for baby. or team does the or stuff. ped physician also present for c/s.

    just took nrp yesterday. the standard is at least one provider whose sole responsibility is the baby ..or something to that effect.
  7. by   HazeK
    Absolutely, Always two for c/s.....

    90% of the time, two for vaginal deliveries.

    On occasion, is RN & tech for vaginal deliveries "when the bus has unloaded"!

    haze
  8. by   fieryrn
    always two...(well at least 98% of the time) for a vag del.
  9. by   NurseyNursey
    Our hospital bites on this. There is very frequently only one nurse in the room during a delivery and often it is an LPN. I am not comfortable with this and have made it known. I don't think that it is safe or appropriate care.
  10. by   ShandyLynnRN
    I think that there should ALWAYS be two nurses at delivery. There are too many "what if's" that could happen too quickly to call for assistance. With one nurse in delivery, what happens when the baby crashes and mom seizes or starts hemorrhaging???
  11. by   NurseyNursey
    Exactly, ITA!
  12. by   imenid37
    Originally posted by NurseyNursey
    Our hospital bites on this. There is very frequently only one nurse in the room during a delivery and often it is an LPN. I am not comfortable with this and have made it known. I don't think that it is safe or appropriate care.
    that totally bites! i guess it's cheaper that way... until the lawsuit happens. i love places that thumb their noses at national standards, like awhonn and nrp. if they are like my former employer lots of the nursing admin. types hold positions in the local chapters of things like awhonn and nann. really frosts me! forget the pt. or nursing staff let's put the $ first. i think they've changed the name of previous employer to...
    $t.______ medical centre where the $ comes first!

    sorry off my soapbox now!
    Last edit by imenid37 on Mar 10, '03
  13. by   Jolie
    NurseyNursey,

    Do I understand correctly that a single LPN attends to both mother and baby at deliveries in your hospital? I hope I'm not stepping on any toes here. It is not my intention to degrade the knowledge or abilities of any LPN, but I don't understand, from a practical perspective, how that could be.

    I know laws vary from state to state, and policies vary widely from one hospital to the next, but in my experience, LPNs are usually not allowed to start IVs, hang new IV fluids, program IV pumps, give IV push meds, take verbal orders from physicians, complete nursing assessments of patients, etc. How in the world are they able to independently care for laboring patients and newly-delivered infants?

    I can only assume that they are "teamed up" with an RN who must be "over-seeing" the care of a whole bunch of patients. How scary! Please tell me I've got it all wrong!
  14. by   elleRN
    i frequently do a svd on my own as an rn, if it isn't too busy on the unit, a second rn usually comes in to help out that first few mintues. otherwise it is really hectic running back and forth from the baby to the mom. the ob is attending to the mom, repairing epis etc, while i am tending to the baby, then i run to hang the pit and get sutures in between. it is essential to have everything prepared and within arm's reach before the actual delivery. plus we always hit the call bell if we need help and another rn will then come in to see what is needed. so far it all works out well. if there are forseen problems with delivery, peds team is always called to be present for delivery, whether it be mec or vaccum assisted etc. as for c sections, there is the scrub nurse and the circulator, in addition all c sections require the peds team to be present. they tend to the baby. depending on situation, peds team has either a mother baby rn or a nicu rn, a peds resident, and either a neonatal np or pa. that system works out great.

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