Is it like this everywhere? Ratios and such

Published

Specializes in OBGYN, Neonatal.

Hey all, just wondering if all units are similar to this...

come in having 6 couplets already from the start (on a good day you start with only 4 or 5 couplets) but on a bad day could be 6. You also have no aides so you pass all trays (breakfast, lunch and dinner) and pick them back up again, you change linens on your patients, you do all vital signs (and some patients get them very often), plus your normal nursley duties (i.e. assessments, meds, etc, etc.). Then of course you get new admissions so that means recovering them, etc. etc.

I'm just wondering if this is just where I am or if this is common in most postpartum/mother/baby type units?

I'm new to this, been doing it only for about 4 or 5 months now and I know it must sound whiney but it seems like its a heavy load, just passing the trays annoys the crap out of me. I'm not afraid to get dirty but how do you have time to do all you need to do with your patients, especially the needier ones - ie c-section delivery day, etc) when you've got to make sure you get all the trays passed and then heaven forbid you don't pick them up before dietary comes back to get them. (bitter there sorry LOL)! I've worked in one other hospital for a brief time and their nutrition services department passed and picked up trays, the nurses did not do that.

OH yeah and every one of our vital sign machines has something wrong with it - either the bp cuff is not working right, the temp probe is loose, etc. and we have computerized med administration system which is great to help protect rights but half the time the machines cut out on you or don't scan the patients and you stand there for several mins trying to scan them upside down and sideways LOL.

I love my coworkers and enjoy my job but these things mentioned above are really wearing on my nerves quickly LOL!

Up Vote Up Vote ×
Specializes in Ob, NICU.

Hi there....

We have 4 couplets max...we often have 2-3 with one admission in our shift

We also have aids who take care of bed making and trays and they also wash up and help us install our newly arrived csections. they awnser patients bells also

apparantly we have it easy!

sorry for my english....I'm not familiar with all the medical/hospital terms

Up Vote Up Vote ×
Specializes in L&D, High-risk AP, rural hosp..

Usually we have 4 couplets, but on busy nights we may have 5-6 couplets, usually with attention to acuity (equal spread of the fresh post-ops and 2 day old vags). Most days if they're lucky they'll start with 4 and get no admissions or start with 3 and take one admit. Day shift has NAC's to answer call-lights and Nutrition passes meal trays (NAC's pick them up). Sounds like you are really short staffed (by accident or design).:down:

Alison, (L&D) RN

Up Vote Up Vote ×

The place I work now has 3 m/b couples usually. If it is busy, there may be 4 or 2-3 m/b's and 2 gyn's. Much beyond that, the staff complains bitterly. I am their educator, but I do help float if it's busy. I know they do not realize, many times, how good we have it. The flip side is, the amount of info they are expected to gather and the computer charting we have means that they spend way to much time charting way too much irrelevant stuff. Everyone adapts well to caring for more pts., but not always to all of the associated documentation. It is a real bear. We do LDRP, so someone can be pulled to triage or for an L/D pt. at any time. To leave all of that charting on several pts., have to do an L/D admit, and then return to the pp/newborn charting is awful. I have done it many times.

Up Vote Up Vote ×
Specializes in OBGYN, Neonatal.

Yeah I really do think its tough b/c we have all these little things we have to do that waste time...I'm not saying that its beneath me, I mean I'm not stranger to hard work but I think that we'd be less frazzled, less burned out, more able to spend time teaching our patients if we weren't so busy passing trays, picking up trays answering call bells, changing linens, etc. etc.

Up Vote Up Vote ×
Specializes in OB, lactation.
Yeah I really do think its tough b/c we have all these little things we have to do that waste time...I'm not saying that its beneath me, I mean I'm not stranger to hard work but I think that we'd be less frazzled, less burned out, more able to spend time teaching our patients if we weren't so busy passing trays, picking up trays answering call bells, changing linens, etc. etc.

Our pp unit sounds like yours. Ideally they say they would like it to be 4 couplets but many times it isn't. We pass trays & we have a lot of other time consuming things like q4h vitals on all moms and babies all the time (more for recovering of course), falls risks assessments q2h for BABIES, pain assessments for everyone q4h, etc. etc. plus all the other regular stuff. No dedicated CNA, sometimes there is one, sometimes not (probably 50/50 on days and infrequently on nights). Also, we've been having a lot of med-surg pts on our postpartum unit b/c the hospital is full this time of year. :(

Up Vote Up Vote ×
Specializes in Community, OB, Nursery.

We usually start out with 3-4 couplets and by the time the night is over we have 5. Sometimes in the mix will be a gynie, an antepartum, or an overflow medsurg woman.

Most of the time weekend nights have either a tech OR a secretary, but not both.

Up Vote Up Vote ×
Specializes in midwifery, gen surgical, community.

When I was a student midwife I could have 12 mother and babes, had to give out meals (serve them up from a big trolley on my own), give meds, do babe assessments, vitals, change linens the lot.

One night I was the only nurse on for the whole ward 23 mums and babes. That was the night to remember.

Up Vote Up Vote ×
When I was a student midwife I could have 12 mother and babes, had to give out meals (serve them up from a big trolley on my own), give meds, do babe assessments, vitals, change linens the lot.

One night I was the only nurse on for the whole ward 23 mums and babes. That was the night to remember.

:omy: How did you survive that?????????

Up Vote Up Vote ×
Specializes in L&D.

No! Absolutely not! We have 4 couplets tops! Even at night. I know I'm lucky to have the ratios we have at my hospital. My husband and I eventually would like to move to another state. My fear is I'll never find another hospital that has the same ratios we have at my current location. When I'm doing L&D I never have more than one patient. I know there are other places that have you do more than 1:1. That scares me.

Up Vote Up Vote ×
Specializes in L&D.

Check out the thread: AWHONN Staffing Guidelines. It lists what your professional organization considers safe staffing. You's is beyond these guidelines. If your hospital consistently staffs beyond recognized safe guidelines, they will be at legal risk in the event something bad happens. Point this out to your unit manager and the Risk Management Department. Join AWHONN if you haven't yet, and learn how you can begin to impliment changes for the better in your department.

In my hospital, we pretty much are able to stick by the guidelines. The charge nurse does an hourly check off on how many and what kind of patients each nurse has and if the unit is above the guidelines. Rarely does a nurse have more than 6 patients, 3 couplets or 6PP moms or 6 healthy neonates. Labor nurses usually have 1 or 2 labor patients, if one gets an epidural another nurse watches her second patient while the epidural is given until the patient is stable. It doesn't always stay that way, but most of the time it is. Our director was able to convince management to authorize another full time night RN when she showed them our records indicating how often we were beyond the guidelines. The charge nurses hate filling out that sheet, but it has been of value to us.

B

Up Vote Up Vote ×
Specializes in OBGYN, Neonatal.
No! Absolutely not! We have 4 couplets tops! Even at night. I know I'm lucky to have the ratios we have at my hospital. My husband and I eventually would like to move to another state. My fear is I'll never find another hospital that has the same ratios we have at my current location. When I'm doing L&D I never have more than one patient. I know there are other places that have you do more than 1:1. That scares me.

Yes sadly imagine my suprise today when I came in and we had wayyyy more than 4 couplets. But thank goodness we actually had an aid today to help us with the trays and vitals. Shew.

Yeah we seriously need more staffing, I'm a member of AWHONN and I'm going to check out the staffing guidelines posted above.

Up Vote Up Vote ×
+ Join the Discussion