Core Staffing

[SammyW0406]

I have a question and maybe I am way left fiield in even thinking this, but I thought I would get other opinions. I work in Labor and Delivery. Our "core staffing" is suppose to be 3 RNs. We are an average sized hospital I would say and do approximately 140 deliveries a month. Just recently went to Level III NICU. Because of the holidays our Manager decided to change core staffing to 2. So we had 2 RNS and 1LVN who can only scrub. She cannot triage or help too much with deliveries. To me this leaves potential for a disaster. Suppose a prolapse cord comes through the doors. You have your LVN setting up to OR to scrub. One nurse with patient (seeing as how she cant exactly move) and one other RN to call the doctor and get the patient ready and notifiy nursery and anesthesia. -----so am I being crazy???? It seems lately that they are trying to get by on the minimal staff. I understand the economy and wanting to save the hospital money. But I am risking my License??? I do CARE! Our director of nursing has already said that she backs every decision our director and manager decide!!--seriously can she just straight up say that??? When did they stop caring about their employees and wanting to treat us with a little respect. I wait for the disaster to come in--because most likely we will have at least another one in labor or something crazy going on because it's just the way of labor and delivery. I don't think any hospital would staff an ER like that because it was the holidays and they thought NO trauma would come in--maybe I am wrong. Maybe they would. Thoughts please!!! Tips on how to deal! THank you

[feisty]

Our facility is doing the same thing. We do have an OR team on call that takes the C/S cases and the staff working only takes care of mom and baby and are in the section only to catch baby, so to speak. This is still very dangerous. The other night we had 3 RN's and one LPN. The LPN had a full load of couplets, each nurse had a labor, 2 couplets, and outpatient triage. Not a good situation. Throughout the night 2 of the labors delivered, one was almost a C/S due to decels and pushed for over an hour. We also had 2 spontaneous labors walk through the door which resulted in C/S's and 2 babies in RDS. The RDS babies take one on one care from the nurse so that leaves 2 nurses on the floor taking care of everyone including the fresh sections. We do have a CNA and a HUC which helps because most of the babies from the couplets end up in the nursery to sleep during the night. I hate risking my license that I worked so hard for, but in this area all the hospitals are working their staff like this so nowhere else to go.

[tokmom, BSN, RN]

I don't typically work mother/baby and never delivery, but my former hospital staffed with at least 4 RN's and some on call if needed. My current hospital is very tiny and they deliver about 20 babies a month, give or take. There are always 3 RN's scheduled. Some days they sit and do a lot of nothing, but are there.

What if all of you called a meeting and voiced your concerns? If they still didn't listen, I think I would call in the union and the OB's and see if they could help. In any case, I'd document, document, document, the refusal of any meetings, extra help, or anything that goes wrong in a delivery.

Good luck. I worked a med/surg floor that was staffed like that. It was scary as heck.

[MedSurgeMess]

This isn't just happening in the OB areas of hospitals, it's happening everywhere. Due to decreased reimbursements, hospitals are staffing as little as possible. It's scary and at times dangerous, and even though you can try a meeting with management, I doubt it will do much good. Right now, they only see the bottom line, which is keeping the doors open. Most hospitals are not making any profit, in fact losing money hand over fist.....the arguments for cuts-well that's a whole other post!

[tokmom, BSN, RN]

This isn't just happening in the OB areas of hospitals, it's happening everywhere. Due to decreased reimbursements, hospitals are staffing as little as possible. It's scary and at times dangerous, and even though you can try a meeting with management, I doubt it will do much good. Right now, they only see the bottom line, which is keeping the doors open. Most hospitals are not making any profit, in fact losing money hand over fist.....the arguments for cuts-well that's a whole other post!

I totally agree on that! My last hospital was a huge mess when it came to staffing. Totally unsafe and downright scary.

I thankfully have stumbled upon a small hospital, owned by a larger system, that staffs very well. Max pt's on any given day is 4 on a med/surg floor and that is with a CNA. It's amazing staffing and I hope it never changes.

[SammyW0406]

And because of this staffing.... A girl coded in our c/section room!!! It took that to get our management to see we needed help! This is what is wrong with nursing, but as staff nurses our hands are tied!!! Someone should not have to code and have no help because there only two RNs on the floor. And what was bad.... when they called the code overhead the operator announced it to the room and the code team couldn't find it because no one knows our OR by that number. Bad Bad outcome!