Minimum staffing requirements

[OBRNinTN2010]

I work for a small hospital. Our OB Unit has 9 beds and we do about 330 deliveries per year. We are scheduled with an OB nurse and a Nursery nurse for each 12 hr shift, but they often put the nursery nurse on call even if we have 1 mom and 1 baby. I know that things can go bad quickly in OB, and being alone on the unit with my other nurse at home in bed about 30 minutes away is unsettling to say the least. I have seen the ACOG staffing guidelines but I can not find anything that states that there should be 2 qualified nurses at all times. I have asked several nurses at other facilities and 2 is their minimum. Does anyone know if there is a "standard" for this and where I can find it?

[RunningRNBSN]

What state do you live in? Minimum staffing can depend on state laws (if your state has these laws), union standards (if you have a union), or just based on your hospital policies.

I live in an urban city hospital and thus things are different for us; however, my unit (PICU) requires that 3 nurses be on the unit, even if we have 1 IMC patient and that is a hospital policy.

[OBRNinTN2010]

I live in TN. We do not have union and I have not been able to find any staffing requirements mandated by the state either. I only question it because of my level of discomfort and it does not seem to be a standard.

[babyktchr, BSN, RN]

Yet another BLINK BLINK moment. This is madness. Not only is this unsafe, but lets look at it in a different way. How do you get a break if you are the only one working? I look at it from this stand point and how I present to my power gods.......if two NRP trained people are required for any delivery, then I need at least two people on the unit at all times, regardless of low or no census. AWHONN states that there must be an adequate number of staff to handle any emergent situation. Simply put, ONE person cannot do that.

[core0]

Yet another BLINK BLINK moment. This is madness. Not only is this unsafe, but lets look at it in a different way. How do you get a break if you are the only one working? I look at it from this stand point and how I present to my power gods.......if two NRP trained people are required for any delivery, then I need at least two people on the unit at all times, regardless of low or no census. AWHONN states that there must be an adequate number of staff to handle any emergent situation. Simply put, ONE person cannot do that.

The more important question is who is watching the patients when the nurse is in the bathroom, eating dinner etc. Thats the real reason most hospitals require two RNs on at all times. I've seen smaller hospitals where the supervisor comes down to relieve them but it really is a liability issue.

David Carpenter, PA-C

[classicdame, MSN, EdD]

I see opportunity for risk mgmt to be involved. Who witnesses drugs or events? Who manages other patient if one has emergent situation? Get MD's involved. If they insist on at least two nurses then maybe someone will listen. Personally, I feel someone should be in the nursery 24/7.

[klone, MSN, RN]

That's insanity. I have nothing more productive to add. Everyone else has already said it. But holy cow.

[DougMusic]

Depends on the state you live in. Here is a link to the ANA that offer you some guidance.

http://www.nursingworld.org/MainMenuCategories/ANAPoliticalPower/Federal/LobbyDay/safestaffing.aspx

http://www.ncsl.org/default.aspx?tabid=13817

[OBRNinTN2010]

thanks everyone

[LDRNMOMMY, BSN, RN]

At the military hospital I worked at (quit last week b/c I'm 37 weeks pregnant). Even if we had no patients 2 RNs and 1 medical technician must be on the floor. The bed manager at times has floated the tech, but we have had to call them back if we end up getting patients admitted.