Staffing Issue

[L&DRN2008]

I work at a small, rural hospital that does about 350 births/year. I recently started working there and am concerned about staffing. I often come in the morning and there has been only one nurse who worked the 7pm-7am shift (or the two scheduled nurses split the shift 6 hrs each). We don't use nursing assistants or any support personnel. There is no unit secretary either. They technically "staff" two nurses per shift, but one of the nurses is usually put on call at home and either comes in if a delivery is likely or splits the shift with the other rn. At this hospital anesthesia is also not in house on the off shift! I feel as though I am setting myself up for disaster by working here. I don't have a ton of experience either. At this point, I feel like I would be better off driving the hour to the closest large city to work where they staff using AWHONN guidelines! Thoughts? My family thinks I should talk to the mgr and see if they are open to change, but I find it hard to believe that over the years no one has ever brought this up!

[Conejita, BSN]

Yikes. It does sounds like a disaster waiting to happen. I also work in a small rural hospital- we do 500-600 births a year....so maybe that amount makes the difference. We always have two RNs on at all times trained to do labor and work with sick babies. We also do not have any support staff so we do all the non-nursing stuff too. And no in-house anesthesia on pm/noc shift either. I would not be comfortable being on the unit by myself ever. OB is a pregnant-person ER a lot of the time, and you just don't know what (and how many!) is going to walk in your door. And grabbing a nurse from another unit in an emergency doesn't cut it (although they could help). You need someone with solid OB skills to back you up. I don't think having a ton of experience is the issue- if you had a ton of experience you probably wouldn't even consider working at a place that staffs like that because you would be able to easily imagine all the ways it could go wrong wrong wrong.

I don't think it would hurt to talk to the manager- I'd like to hear the justification myself! If I were you, I'd look for a job elsewhere.

[RNBelle]

I also work in a small rural hospital. We have one big unit - L&D, PP and Nurs. We usually staff with 2 RNs and 2 LVNs. We are suppose to have 2 RNs on the floor at all times but that doesn't always happen. I am a nervous wreck on the nights when I am the only RN. How is the staffing on days vs nights? Maybe if the staffing is better on days you should stay on that shift. I have very limited options for other employment so I am kind of stuck.