deliveries who attends

Caseyrnbsn · Jun 8, 2000

Usually just the delivery Nurse attends the delivery along with the OB DR. if it's a problem delivery we call the PEDS DR and the CRNA but usually it's just the RN

MercyAngels · Jun 9, 2000

"Policy" is that two nurses are to attend every delivery, but in the real world sometimes it's just one nurse! If mom is preterm, or there's meconium, etc, then sometimes a nursery nurse will attend (sometimes even the pediatrician). We're seriously short-staffed most nights, but the crew I work with is really good about pitching in and helping out!!

MaryP · Jun 20, 2000

THe DR nurse handles the delivery unless there is mec or another anticipated problem and then the peds resident with a NICU nurse or mother baby nurse will come to help with the baby while the DR nurse handles the mom.

Originally posted by jama:
who attends deliveries besides labor nurse? do you have person to recieve baby? Who is the person-- whoever is available, nursery nurse, admission nurse or mother baby nurse?

lsmo · Jul 18, 2000

Thankfully, the nurses at our hospital are very active in practice issues--as it should be. The standard of care on our OB unit is to have 2 RNs in the room at the time of delivery. A L&D RNs focus is on the mother, while an RN with Special Care Nursery skills is present to triage and perform an admission assessment on the baby at birth. Consider this: What other patient comes into a hospital without a timely RN assessment and attending physician present? At the moment of birth even the most promising fetal strip and uneventful labor can become complicated and require immediate intervention. Is it not in the best interest of our patients to place the most qualified staff at the bedside at this crucial moment? The RN is designated by licensure to provide the admission assessment. RNs should be adequately prepared through education and experience to assess and intervene at this crucial time. It is not adequate to rely on "calling for help" after problems arise. By then it isoften too late. Time is of the essence and quality of life can be dramatically dimminished without proper care providers in place at the time of birth. If this is not the measure of staffing your institution is willing to "BUDGET" for I would encourage you to seek out guidance and support from AWHONN's practice specialist. During our work redesign process the intent was to have LPN's care for "low risk" labor patients and be the second at deliveries. It is not appropriate to assign these staff members to this phase of patient care knowing all that can ensue during the course of labor and delivery. A review of the delegation matrix provided by ANA can help demonstrate this fact to leary administrators. Many of the clinical observations, evaluations, judgements and interventions in labor and delivery scenarios require ongoing evaluation as is designated the responsibility of the RN per licensure. LPNs on our unit are perfectly suited to provide care to the stable postpartum patient and newborn. Techs or LPN's can provide appropriate assistance in many ways on a labor and delivery unit as well-- but are very limited in their versatility when a barrage of high risk antepartum or labor patients present (typical)and an RNs skills are required. In our contract, we posted the role of the nurse first. It states that we should work to ADVANCE the profession of nursing and standards of nursing care. It was pretty difficult for me to understand how anyone could argue that to decrease the skill level of our staff we would improve the quality of care for our patients and advance our practice standards! I encourage you to require appropriate staffing no matter what resistance you meet and to be a part of advancing nursing practice standards and advocating for quality patient care!

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L.Smo RN

jama · Jul 24, 2000

Thanks to all for the replies. Our committee is still meeting so when all is finalized i will let you know how it turns out.

suzzinbob · Jul 26, 2000

iwork in a med.ctr that delivers 300/month. in every ldr delivery we have an rn for the mom and an rn from nicu......i cant imagine having to care for a hemorrhaging mom and resucitating a baby at same time....sometimes just the 2 of us is not enough!

HazeK · Aug 22, 2000

A Medical/Legal caution to all:

When setting your Standards of Care, be sure it meets National Standards, as per AWHON, ACOG, & American Association of Pediatrics...for these are what a jury will judge you by, not by what staffing/budget allows for!!!

I must applaud & restate several comments by Ismo:

" A L&D RNs focus is on the mother, while an RN with Special Care Nursery skills is present to triage and perform an admission assessment on the baby at birth.... At the moment of birth even the most promising fetal strip and uneventful labor can become complicated and require immediate intervention.

Is it not in the best interest of our patients to place the most qualified staff at the bedside at this crucial moment? ... It is not adequate to rely on "calling for help" after problems arise. ... Time is of the essence and quality of life can be dramatically dimminished without proper care providers in place at the time of birth.

. . . we should work to ADVANCE the profession of nursing and standards

of nursing care....! I encourage you to require appropriate staffing no matter what resistance you meet and to be a part of advancing nursing practice standards and advocating for quality patient care!

another point: If one RN attends the delivery, and the baby "crumps" & the mom hemorrhages....would not the RN be guilty of patient abandonment if she left one pt to care for the other?? Hmmmmmmmmmmm!

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On busy, low-staff, crazy days (we've ALL had them) the delivery team is an RN, an MD & a tech (paperwork, cleanup dude-ette) with a second RN at b/s briefly during moment of delivery and initial stabilization of infant (1st 10") ...if everything still OK, she's off to other tasks.

Hope this helps! Haze

twentyyears · May 7, 2008

I work in a small rural hospital, we do approx 170 deliveries a year, but we have 2 rn's at every delivery. we staff with 2/shift. If 2 people are delivering at the same time we call in another staff member or our manager is present or we have a respritory therapist who is nrp avalible. Because even in small hospitals you can have a sick baby and a mother with a pph

Elvish, BSN, DNP, RN, NP · May 7, 2008

There are supposed to be 2 NRP certified people at every delivery. That's the standard of AWHONN, NANN, and the AAP.

We are lucky to have a level III NICU right across the way so if something goes bad, we call them & they come. But if not, there is still another L&D nurse there to help out.

twentyyears · May 7, 2008

all of our ob rns' and doctors are npr we have 2 nrp instructiors in our dept myself being one, plus all of our rt dept is nrp, along with er staff and parametics. we are all acls also. We are a level 1 nursery but we have all taken stable, also, and pcep because the closest level 2 is 1 hr away and the level 3 is 3 hrs away

OzMW · May 8, 2008

We are different because we as mws in Australia take responsibility fo the normal births. If all has been well then only two of us are at the birth. Best place for baby is on the mothers chest, not on a resuscitaire. The second MW gives the oxytocic and then goes. If anything untoward happens then one presses the emergency buzzer! Instrumentals have a MW or two to help the dr, and a paed dr and nurse from SCN for the baby.