Staffing for LDRP, Antepartum, Triage, and Peds

[melanianne]

Hi all,I currently work as an RN in a medium sized regional medical center where we average 1400'ish births per year. Our births have increased by about 20-30/month and staffing has gotten a little hairy with this change. Our facility is a little different than most because we are cross-trained to triage, antepartum, labor, delivery, recover, scrub and circle c/s, PACU, and Peds. With that being said we have about a 6 month orientation timeframe. With the more recent influx of patients we have struggled with maintaining appropriate staffing or needing to call in for additional staffing in the middle of the night. I was wondering what other medical facilities do or how they handle their staffing in these types of circumstances? Do you have on-call shifts, stagger shift times, or do they over-staff then call you off if it doesn't look like you will be needed, etc.? If you do get called in is there an incentive to accepting this shift? I'm looking to provide some constructive feedback to management on how other medical centers handle their staffing.

Thanks!!

[dianah, ASN]

Moved to OB/Gyn Nursing forum

[ashleyisawesome, BSN, RN]

Our facility is similar to yours. We are all trained in L&D, antepartum, PP, OR/PACU, triage, and nursery (but we don't do peds!) Our census has been through the roof and it has caused problems lately. We do take call. All nurses who are contracted at less than 40h a week must take 16 hours of call time per 6 week schedule period. We pick our call when the schedule comes out and are obligated to come in for those shifts if they call us. We get paid $5/hr while on call, and get our normal rate if called in. They have also been paying a temporary "double bonus" to come in for extra shifts ($20/hr on top of your rate/overtime). This is working to get more people to sign up for extra shifts, but many people are getting burnt out and not signing up for extra anymore, because even with a call nurse and an extra nurse who came in voluntarily, we are still short staffed.

We asked admin if we could get agency nurses temporarily, but they shot it down. Something's got to give, because having two active labor patients, plus manning triage, or having 5-6 couplets is getting old quick (and unsafe).

[not2bblue]

Seems like it is time to not do PACU (for main OR? or for your c/s?) and peds. Staff each unit and not spread so thin. We do 2500+ births a year, only LDRP. Some nights they are begging for help but when you are always begging, people get tired of coming in. We only get called off it the census is low. Otherwise, come in ready to run!