Cuplet Care

I don't know if Florida has mandatory staffing ratios pertaining to maternal-newborn nursing, but anything over 4 couplets is unsafe, and NOT in accordance with AWHONN standards. I can understand taking 5 temporarily, in a pinch, but would absolutely refuse any more than that.

Are you working in a union setting? Does your state allow for safe harbor reporting of staffing and patient assignment issues? How is abandonment defined by the Nurse Practice Act?

I would definitely find out the answers to these questions before I returned to work in that setting!

One thing I did a few years ago was write an incident report about patient to nurse ratios and outlined the acutity of the patients, this was sent to the medical director of the ICU. It got things fixed. Next time our nurse patient ratio got too high he transferred two patients to another facility. Staffing was under control after that.

Florida does not have mandatory staffing laws. We are in sad shape here on the lower west coast in winter. We ( and several are hospitals) frequently go on diversion because of lack of beds. This raises a problem here because we are overrun by elderly snowbirds in the summer that sometimes exceed our resources but when summer comes and they leave we end up closing half the units in the hospital. Our unit (obviously) isn't effected that much by this issue) but I did work cardiac for 4 yrs and the norm ratio was 6-7 pt per nurse on day shift. This was the chest pain/acute MI unit. Almost all our pts were on Nitro, heparin therapy, natracor, or other gtts that require close monitor. We also took care of the post cardiac caths. Dangerous! Our L&D unit is strict about all AWONN recommendations but staffing. We have been told we just have to "do without" as far as staff goes because our unit is one of the least reimbursed of our hospital and they can't afford overtime or additional staffing. Our unit is in the red. They would rather risks our pts care and a lawsuit than heaven-forbid lose any more revenue. We don't have seperate antepartum/low risk/high risk areas so our ratio as of late has bee 3:1 ( these include pitocin inductions, active labors, PTL on Mag ect.) It is so scary! I was very verbal about safety issues and was told I was being negative! I feel for you because we need I serious overhaul where I work. ( Our sister facility is in the "ritzy area" and is doing well financially so we often feel neglected when it comes for funding for improvements.):angryfire