safety/risk in the ob department

[jward]

Need help with a risk question. I manage a small OB Dept. We do approx. 200 deliveries a year, low risk status. We have 3 LDRP's, 3 antepartum rooms and a nursery (of course). Our staffing is 1 RN and 1 LPN or UT. On the day shift I am here so there is actually a backup nurse available to assist. On the weekends and at night there is not a nurse in house that is qualified to assist in OB. Does anyone have any information on staffing guidelines in an ob unit from a risk stand point? If you do please send me the name or e mail address where I can get some information. Thanks.

jane

[canoehead, BSN, RN]

I don't have guidelines but work in a hospital similar to yours. We have had all OB nurses on call and the supervisor puts the patient on for the initial strip, vitals, etc. It is at the sup's discretion if she feels comfortable doing that-she can have an OB nurse stay in house. We have the sup take NALS and be the second for any delivery, the OB nurse takes charge and delegates tasks in an emergency. Or the sup is available to tend to Mom while the OB nurse cares for a sick baby. The docs also take NALS and become the second nurse if the baby needs it. If both are sick we call in the code team and the OB nurse "runs" the nursing end of it.

I've worked in this hospital for 7 years as an OB nurse and a sup and it does work out if everyone knows what will be expected of thm ahead of time. The worst situation I've been in was an abruption requiring uncrossmatched blood and a stat section coming in without phoning ahead. We had a MS nurse doing "shock" interventions, and OB nurse coordinating at the patient bedside, and a recorder, and of course the doc. You MUST have people that can take charge and equipment at the bedside so no one has to leave to search for something, but it can be done.