Ok, I know there are a lot of threads out there regarding staffing. I've looked at a lot of them and still cannot find an answer. Here's the problem. We are a very small unit: 3 labor rooms, 4 "other" rooms. We have 200+ deliveries a year. We are an all RN unit. We usually staff 2 nurses per shift (12 hour shifts). We have no unit clerk, no aids, the only other help we have is housekeeping to clean the patient rooms.
Our nursing staff has recently voiced concerns about staffing. Our nurse manager thinks it's appropriate for one nurse to have 3 stable couplets. Now I don't have a problem with that at all. But she says that the other nurse can go home on call. Leaving one nurse on the unit with essentially 6 patients.
The other day she sent one of the nurses home when we had one stable couplet and one late post-partum bleed who was receiving blood. That's just not safe!
My other concern is that she just doesn't "get it". She hasn't been a staff nurse for a long time and has never been a staff nurse at our hospital. She also won't help out when we need it, or else she doesn't realize that we need help and will just leave at the scheduled 3pm.
My problem with the staffing guidelines posted is that they don't take into consideration a small unit with total care. And I mean total care as in total care of the whole unit, which includes stocking, making charts, answering phones and all of the other piddly stuff that needs to get done.
Do any of you out there have staffing guidelines for a smaller total care unit? I think we need to get guidelines and stick to them or else our patients are going to be in danger.
Of course the reasoning for this is the almighty dollar.
