"Short Staffed......."

SneakySnake · Jul 18, 2011

I think it depends on where you are. When I worked L&D there was only one nurse on duty. This was a small rural hospital but it was the norm. We also did all the post postpartum care. If we were lucky a LPN would be called in to take care of mom and baby if we had another labor patient.

adpiRN · Jul 18, 2011

I think it depends on where you are. When I worked L&D there was only one nurse on duty. This was a small rural hospital but it was the norm. We also did all the post postpartum care. If we were lucky a LPN would be called in to take care of mom and baby if we had another labor patient.

This is crazy to me! What if there was an emergency like stat c/s, shoulder dystocia or a code on a baby?

Were you expected to do baby care after delivery in addition to mom care and assisting the OB with repair?

To the OP, yes it is common. I work in a large facility in L&D. 11 labor rooms, 4 ORs, 11-15 nurses per shift.

But we often are short-staffed or have an overflow of patients - laboring in triage or recovery room and not enough nurses to watch them.

Ideally we have a labor nurse and the baby nurse at deliveries, but if we're short-staffed, there is sometimes no baby nurse (but someone will always show up for a bad baby!)

On busy days the charge nurse will be watching a few patients herself which is also dangerous.

And with c/s we try and just run 1 room at a time, but sometimes 2 if we have the staff, or if it's a real emergency. But yes it's VERY common for a scheduled c/s or even an unscheduled that's not an emergency (like failure to progress) to have to wait hours to go to the OR b/c of not having enough nurses or anesthesiologists available. The other day our first scheduled c/s at 8AM didn't go back until after 8 PM (!) because she kept getting bumped for other emergencies and adds on all day. Crazy!

lindarn · Jul 18, 2011

If only these Moms to be, were aware of how their safety and the safety of their unborn baby were put at risk for the hospitals's bottom line, how things would change.

Teachers immediately go out and scream to the public if the teacher-student ratio drops below a certain level. Here in Washington State, the student numbers in each classroom are maximum of 25. If there is a student who has medical problems, ADHD, etc, that student is counted twice. Therefore the maximum number of students allowed in the classroom are 23. Because these students need more attention from the teacher. Imagine that.

Yet, no one has ever died because they could not do long division, or diagram a sentence. How many people die due to deliberate short staffing? Food for thought. JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

L&DRNJenn · Jul 19, 2011

lindarn,

Excellent post! So very true. Not to take away from teachers and the struggles that they face, but we are talking lives (mother and baby) in our hands.

My husband was asking me the other day to explain nursing staffing to him to L&D. I tried my best to describe how things change so fast and before you know it, you are in an unsafe situation. He didn't understand how there are not hard and fast rules on how many nurses are required. Yes, we have the AWHONN recommendations. But with the way we are encouraged to "flex down" to meet our budgeted staffing ratios, we aren't even close. I guess that is where being unionized nationwide would be a great advantage.

Just frustrating....

Nicole2010 · Jul 20, 2011

We are always short staffed. Plus they just took away on-call pay, so who wants to come in if someone calls in sick. I work in a high risk unit. We have 11 labor rooms, 2 ORs and a 3 bed triage. We can usually meet core staffing which is 5 nurses (a charge & 4 RN's). Some days we only have 4 on. Now we are all worign 4 days a week to cover the staffing problem and I'm 30 weeks pregnant!

Queen2u · Jul 21, 2011

I am working in a relatively small hospital in a border town....women always "cross over" to deliver. We have 4 l and d rooms, 3 triage beds and 4 labor rooms, but it is always just so busy!!!!!! The last 4 nights I worked were crazy. There are always supposed to be 3 RN's there, but 2 of the 4 days it was me and another RN, and being that I am on orientation, technically I did not count! We took care of 9 patients total. I plan on moving to a larger city in about a year or 2 and I am hoping I do not face the same issue there. I know of corse every facility has staffing issues every now and then, but it seems like an every other day issue here!

MKS8806 · Jul 22, 2011

I work nights, and we run into this problem sometimes. We are required to have at least 2 labor nurses on the floor at all times, regardless of if we have any labor patients, or any patients period! However, I think we all have seen how fast you can go from 1 couplet to 1 couplet and a crisis. We do not have a surgery team in house, nor do we have anesthesia or an OB doctor in house at night. It is very possible for a emergency situation to come in and it take a little while to get everyone there. Its a scary though....one that I am fighting frequently. I believe if we could at least have anesthesia present at all times, that we could avoid some ... less than ideal situations.

I take this kind of situation as more than enough reason to be knowlegable and sharp with my skills, so that I can do the best I can in any situation.