L&D staffing

[bvb]

I have been asked to collect data about how other hospitals staff their L&D units. We have been having ongoing problems with this at our hospital. We had some docs leave and now our deliveries are down and they want to cut staff to 3/shift. Our average deliveries/yr. were 1600-1700 now projected to be 1200-1300. We think this is a really bad idea as we have a 16 bed unit, receive high risk transfers, do our own c/sections, triage and antepartums. We realize our numbers are down but as all L&D RN's know, you never know what's coming in the door or when fetal distress will occur! Closing beds is not an option either. We usually have a secretary and an OB tech who scrubs for sections, but not always. We also have a voluntary call system but alot of our nurses live 30-60 min. away so 3 with one on-call still seems unsafe to us. (right now we sign up for call to make the 5th nurse)

If any of you could provide me with the following info I would greatly appreciate it!

Beds in your unit; number of deliveries/yr; do high risk, AP's, own c/sections, triage?; number of nurses/shift; on-call system?; mandatory call-off or on-call for low census?; induction policy?

Thanks so much for your help!

P.S. It would be helpful, but not necessary, if you could provide the name of your hospital and where it is.

[rdhdnrs]

University of Arkansas for Medical Sciences Little Rock

1200-1300 deliveries/year

We never go below 4 RNs on the deck. We have 11 LDR rooms, a four-bed triage unit staffed 24/7 by a triage nurse (not counted as floor staff) we do our own sections/tubals. Most of the time we have 5 nurses, a secretary, two techs. We have mandatory call for high census, can be given holiday for low census.

Our docs can schedule no more than three procedures each day.

Good luck!!

For what it's worth, I think your unit should have AT LEAST five nurses on every shift.

Lisa

[Debbie, RN]

I work in a 12 bed, Level 1, LDRP unit. We always staff with a minimum of 3 RN's, and one OB scrub tech/secretary on Night shift, regardless of the census. Our "core" staff is 3 RN's.

Since we are a level one, we do primarily low risk cases but occasionally we will have a preterm delivery "drop in" when she is too far dilated to ship out to the nearby level 3 hospital. Then we end up shipping the baby out post partum. We do have mandatory call off or canceling of even our regular staff (not pool) when the census is low. The staff has the option of "floating" to another area of the hospital but they usually opt to stay home. Staff are required to sign up for two 12 hour call shifts per month.

We do about 80 deliveries a month on average.

Your most has enlightened me - I thought the staffing in our unit was sometimes low. I now think otherwise. How do you keep nurses on staff there?? Do you have travelers?