Questionable staffing in L&D vs Nursery

[new2manage]

I am going to work in a unit where staffing has recently been overhauled. The nursery nurse is not utilized on a regular basis at all. The nursery nurse is only staffed if there is a special care baby that is not stable enough for mother/baby care. The Labor and Delivery nurse is responsible for admitting her own infant and the baby is taken to postpartum with mother following immediate (1-2 hour postpartum) recovery. I am not OK with this at all. Espcecially considering that L&D if frequently short-staffed. What are the thoughts on this? I understand the notion of saving money but I find this absurd. Am I out of line?

[shortstuff31117]

what do you guys do when there is a c/s? Our minimum staff at night is 5 and a c/s takes 4 of them off the floor, leaving 1 person to watch the whole floor.

Only 2 nurses go back for the c-section, one to circulate and one for baby. Why do you guys need 4 nurses for your c-sections?? Does one nurse scrub? We have an OR tech at all times for this...

[shortstuff31117]

Let me clarify. We have been doing couplet care for 2 years now and typically this works well and I do agree that this is best for mom and baby. My concern is that the nursery nurse is not being staffed at all on Sundays and placed on call whenever the House Supervisor sees fit- if there are not any designated special care babies. Nursery nurses placed on call have a 30 minute window on average to get to the hospital. If a laboring patient goes bad (and we all know they do without warning) you have a 30 min delay getting specialized care to that infant other than what the the trained NRP/L&D nurse provides. I want a trained nursery nurse in house at all times whether she's bedside at delivery or not- she/he should be available. Am I being unreasonable?

Got it...no I don't think that's unreasonable. Where I work, we are required to have a nursery nurse present at all times. There have been times where we haven't had one and it makes me nervous...

[dscrn]

When my gandson was born in California 4 years ago, there also was no nursery. My daughter had had a lousy labor/e/c/s. Rooms were semi-private, and there were no accomodations for a family member to be at bedside 24/7. The roomate had an infection, a crying baby...and no response to call bell. When I asked what would happen-who would treat a choking baby, the nurse asked me why a baby would choke *fresh c/s,,,needless to say, I was more than uneasy leaving to shower/change my clothes....I an all for bonding/rooming in-if mom is ABLE.

[melmarie23, MSN, RN]

Let me clarify. We have been doing couplet care for 2 years now and typically this works well and I do agree that this is best for mom and baby. My concern is that the nursery nurse is not being staffed at all on Sundays and placed on call whenever the House Supervisor sees fit- if there are not any designated special care babies. Nursery nurses placed on call have a 30 minute window on average to get to the hospital. If a laboring patient goes bad (and we all know they do without warning) you have a 30 min delay getting specialized care to that infant other than what the the trained NRP/L&D nurse provides. I want a trained nursery nurse in house at all times whether she's bedside at delivery or not- she/he should be available. Am I being unreasonable?

yeah I wouldnt be comfortable with that at all. On any given shift (day or nights), we have at least 2-3 RNs who are "core" meaning that they are trained in the special care nursery and could take a sick baby at any time a shuffle is needed in the assignments. If there are babies in the nursery, then the core RNs stay in the nursery. Then we have one RP (resource person) who is essentially the charge RN. Then 3-4 RNs who take labors or mom/baby assignments. That way We are an LDRP unit. We staff 7-8 nurses total for a 12hr shift. Then we have 3 LNAs.

[esrun1962]

BEST PRACTICE FOR WHO??!!!Since when did common sense go out the window and we all forgot that the family unit/bonding is not our primary concern here but the mom as well as baby!!The mother too is a pt whose body has been through something! She is often tired may have 1 or more young kids at home and needs to REST for both healing and SANITY!! I am just saying the nursery should be available at night! You will BOND with your child, I am sick to death of that BONDING argument! Look at all the NICU kids and adopted kids in our society they have bonded!!!!