Core staffing for L&D

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I've been working OB for 5 years and recently relocated. I'm still working OB and I have a question about "core staffing". The first hospital I worked at delivered on average 50-60 babies per month. We were told there that the standard of care by AWHONN is to always have 2 labor nurses at ALL times-even if the unit is closed. The new hospital I am at delivers about 30-40 babies/month. The DON says she can't staff on "what ifs" therefore there are some days that there is only 1 nurse on the whole unit. I mentioned this to another nurse who has never worked in another facility and she isn't at all bothered being alone. Isn't this falling BELOW the standard of care? I'm not sure I want to be associated with this kind of care!

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Specializes in OB.

Unit I work is anywhere from 30-60 births per month. 2 Labor nurses are ALWAYS on the floor, even if there are 0 patients. You never know what is going to walk in the door...

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Specializes in Nurse Manager, Labor and Delivery.

OH MY WORD!!! What IF a patient presents with abruption? What IF a patient presents crowning? The WHAT ifs are endless. The "we can't staff for what ifs" thing has to stop. What will the DON say when something bad happens. Who will DEFEND YOU then??

If you only staff one, and you are alone....who comes and helps you while waiting for your on call person to arrive???

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Specializes in NICU.

If you only staff one, and you are alone....who comes and helps you while waiting for your on call person to arrive???

I'd be very tempted to tell the DON I expect to see her put on some scrubs and come help me if one of those "what-ifs" ever happens...

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Specializes in Nurse Manager, Labor and Delivery.
I'd be very tempted to tell the DON I expect to see her put on some scrubs and come help me if one of those "what-ifs" ever happens...

:yeahthat:

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Specializes in L&D.
I'd be very tempted to tell the DON I expect to see her put on some scrubs and come help me if one of those "what-ifs" ever happens...

:yeahthat:

And honestly, I wouldn't feel safe working there. jmo

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Are you kidding!!! I wonder how that DON would feel if her daughter or granddaughter were to come in with an abruption/prolapsed cord/or any other OB emergancy and there was only 1 nurse working. I hope that nurse isn't involved in another delivery!

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Specializes in Obstetrics/Case Management/MIS/Quality.
the don says she can't staff on "what ifs" therefore there are some days that there is only 1 nurse on the whole unit.

explain to the don that staffing for "what ifs" is exactly what happens in the er, isn't it? they wouldn't leave just one person in the er if it didn't happen to be busy at the time, would they? well, your department is essentially the ob extension of the er.

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Specializes in Maternal - Child Health.

ITA QTBabyNurse.

If she refuses to staff with a minimum of 2 OB RNs in house at all times, then please ask her to mail a letter to every OB patient, put a full-page ad in the paper and post a prominent sign at the hospital entrance asking patients for the courtesy of a phone call at least 60 minutes before arriving at the hospital, so that their nurses can be paged from home in time to admit them to the labor unit.

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Specializes in OB, CASE MANAGEMENT.

This does sound like an extremely dangerous situation I have personally worked in a small rural hospital that did 25 deliveries a month and we never had less than 3 on staff. not always rn's usually 2 lpns (iv certified) and 1 rn and it did happen several times that emergencies rolled in . the lpns would start iv's draw labs put pt on monitor while 1 lpn called md, and the rn signed consents and checked patient ( not neccesarily in that order) and it worked very well. maybe you could suggest some changes that would help or you might need to find a new job. If your license is in danger is it worth it?

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