Can anyone give me guidelines and/or references regarding nurse to patient ratio on labor and delivery?? I work in a small hospital with no ancillary staff such as aides, techs, runners or even a secretary on 3-11. I am not comfortable taking care of 2 active labor patients with pitocin running, epidurals, internal leads, IUPCs etc. We also get many "labor checks" which 9 times out of 10 are not in labor but require monitoring, assessments, UA's ( which we must enter in the computer and run to the lab which means we leave our labor patients unattended ) Granted, being small means this does not happen every shift but I think my license is on the line many an evening. Of course if it is more than one care provider, they think they are the only one who matters. A primip pushing is a one on one in my opinion but I am often treated as "old fashioned" as I am the oldest nurse on the floor. I think I hold my own and am capable of working to the max......but I am not inflating my ego by taking on more than I think I should. I just don't feel right about it. Help.