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L&D Staffing Ratios


I have been working in L&D for just about a year now and I was wondering how many laboring patients do you take at a time and where do you work? I usually have 2 patients at a time and it doesn't seem to matter what stage they are in. There have been several nights where I have deliveries 30 min to an hour apart. I love the work, but I just really question how safe it is to have to care for 2 patients where both are in the second stage. I would really like to stay in L&D, but I am looking for another facility that values patient safety. What I'm basically asking is what facilities have either a one to one ratio, or if two patients, one is not in active labor. Thanks so much!


Specializes in L&D,Lactation. Has 28 years experience.

Where are you working? I am in California and I have 1 active labor patient. We have central monitoring but not in the rooms, so if I have 2 patients when I am in with one I have no idea what is happening with the other, so in active labor (greater than 4-5 cm) they become 1 to 1. What you are doing sounds downright scary. Do the babies stay in? So you can have responsibility for a newborn and be doing another delivery?

babyktchr, BSN, RN

Specializes in Nurse Manager, Labor and Delivery.

Second stage becomes a 1:1.

Laboring patients 2:1.

Why have central monitoring if you don't have it in each room? ( just found that odd)

Interesting how this question keeps coming up. If you go to the top of these threads, the AWHONN staffing guidelines are there.

I am so impressed (and jealous) at how many hospitals can staff 1:1 for labor.


Specializes in L&D, PP, Nursery. Has 12 years experience.

I work L&D at two differant hospitals. At hospital #1, we have 1:1 ratio for a laboring pat, regardless of the stage of labor. We only have 2 if an NST or Outpatient arrives and there is not another available nurse. If that turns into an admission, another nurse will be given the assignment or the call nurse will be brought in. It does have central monitoring, including in the rooms. At hospital #2, you may have 2 active labor patients, plus an outpatient or 2! We do NOT have central monitoring in the rooms. You just pray that a nurse at the nurse's stations picks up on a funky tracing if you're in the room with a patient! Not safe, but that's the way it is!

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