Staffing for c/s for a small unit

[Honeychild]

Hello all,

I work in a small unit (500-600 deliveries per year) that does L&D and post-partum. Recently we have had some issues arise with our c-sections. We currently staff 2 nurses on floor at all times, with 1 or 2 people on call at home if we do not need them for census. OR does cover our scrub and assist at night for c/s, but not during the day. Our on-call staff, including OR, have a 30 minute response time.

The problem is that we have done stat sections with 2 nurses (one scrub and one for mom AND baby) because we could not wait for staff to arrive. I know this isn't safe, but administration is saying this meets AWHONN guidelines. Can anyone tell me if this is the case? Is anyone else experiencing this elsewhere? We do try to follow the current staffing guidelines fairly closely otherwise.

Thanks!

[Jolie, BSN]

I can't speak to AWHONN guidelines, but no hospital in which I've ever worked staffed with a single RN for mom and baby, even for a lady partsl delivery. I can't imagine that it meets professional guidelines for a C-section.

My most recent OB experience is getting admittedly distant, but we were required to have a surgeon, first assistant, scrub nurse (or scrub tech), circulator, anesthesia provider and infant care provider. A surgeon, anesthesia, and 2 nurses is not an acceptable team.

If administration is not willing to have additional nurses available in house, then one of them needs to don scrubs,participate in the next emergency C-section and sign the surgical report.

[monkeybug]

I've worked in some bad situations, but never this bad. Our base staffing is 3 RNs (our NICU is staffed separately). That way if we do have a stat section, one RN can scrub, one can circulate, and 1 can handle whatever is on the floor. I'm not positive about AWHONN, but I know NRP specifies there must be a nurse dedicated to the baby. This sounds like a disaster waiting to happen.