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[Just-floored]

Does anyone work at a facility that pairs you two labors to one nurse until complete? The system I'm in is making a change to this and it seems unsafe to me. Currently we are two early labors to one nurse and then move to one on when when active.

[klone, MSN, RN]

Many facilities do this, but it goes against AWHONN standards. Any time a woman is in acitive labor, needs pain management assistance (whether that's an epidural or coaching for NCB), is on Pitocin, or has significant comorbidities, she should be 1:1.

[AZBlueBell]

Yes, my facility does that. And even at that, it's not even that we report off our other pt to another nurse completely, we just give a quick rundown and they watch them while we deliver/recover the other pt. Only ones we are usually kept 1:1 is if they are a TOLAC (but I've been paired 2:1 even with a TOLAC before, learned my lesson and that won't be happening to me again!) and an all natural labor pt. But sometimes we get so maxed out we have to still have 2:1 with a natural and we just make it work until we can't. Our natural labor pt's are typically intermittent monitoring so it's ok until they get to the 7cm or so, then they really require 1:1.

[mtnviews]

We are 1:1 most of the time for most patients, provided staffing allows. Stable antepartums maybe 1:2. Sometimes if it's busier, early labors get paired up. Once in a rare while 1:3 stable antes. When stuff has to get paired up, charges are pretty thoughtful about not just labor status but emotionally needy and high anxiety patients to make sure their assigned nurses are able to give them the care they need.

As a new grad, I was trained to do 1:2 labor patients because my preceptor wanted me to be prepared to work at other places. I can count on one hand how many times I've had 2 labor patients at my main job in almost 3 years. There was even one time the charge kept offering to reassign one because she felt bad I had 2 early labors with nurses open, but I kept telling her I was fine.

Someone else tends to do baby at least through the first few sets of vitals, first breastfeeding and meds, if staffing allows. There's an assigned baby nurse, but if that person is busy, early labor nurses or people with 1 stable ante will catch babies too. So we're usually 1:1 for recoveries too.

My PRN job tends to not staff as uh, generously, but still super appropriate and manageable. More 1:2 early labor. 1:2 or 1:3 stable antes. And usually just a baby nurse for initial vitals and whatever can get done before they leave the room and then you care for the couplet.

[babeinboots, MSN, NP, CNM]

We are 1:1 most of the time for most patients, provided staffing allows. Stable antepartums maybe 1:2. Sometimes if it's busier, early labors get paired up. Once in a rare while 1:3 stable antes. When stuff has to get paired up, charges are pretty thoughtful about not just labor status but emotionally needy and high anxiety patients to make sure their assigned nurses are able to give them the care they need.

As a new grad, I was trained to do 1:2 labor patients because my preceptor wanted me to be prepared to work at other places. I can count on one hand how many times I've had 2 labor patients at my main job in almost 3 years. There was even one time the charge kept offering to reassign one because she felt bad I had 2 early labors with nurses open, but I kept telling her I was fine.

Someone else tends to do baby at least through the first few sets of vitals, first breastfeeding and meds, if staffing allows. There's an assigned baby nurse, but if that person is busy, early labor nurses or people with 1 stable ante will catch babies too. So we're usually 1:1 for recoveries too.

My PRN job tends to not staff as uh, generously, but still super appropriate and manageable. More 1:2 early labor. 1:2 or 1:3 stable antes. And usually just a baby nurse for initial vitals and whatever can get done before they leave the room and then you care for the couplet.

OMG, your facility sounds like a dream! My facility is pretty much what AZBlueBell described. I've even been pulled out of my recovery before because a nurse who was watching my other pt kept having questions. It's definitely not safe and as a result we have a pretty high turnover rate and actually hire 2 new grad groups each year.

[Just-floored]

I so wish I worked at your facility. Mine has been pretty good with manageable assignments but all that is changing now. They are saying two active labors until complete which to me seems so unsafe. We are a super small unit with maybe 6-7 nurses on a shift. Soon we won't have a nursery or a neo in-house.

[jennylee321]

I so wish I worked at your facility. Mine has been pretty good with manageable assignments but all that is changing now. They are saying two active labors until complete which to me seems so unsafe. We are a super small unit with maybe 6-7 nurses on a shift. Soon we won't have a nursery or a neo in-house.

What's the current purpose of your misery ? Is it a NICU ?

[Just-floored]

I am assuming you mean nursery, not misery, lol. It is an SCN. We mainly treat NAS babies but do have some that have respiratory issues, preterm at 33 weeks or greater or babies that need a 7 day course of I.V antibiotics.

[AlleeBooRN]

Ours has a strict 1:1 for labor