staffing ratios for post-partum/couplet care in CA

Nursecathy123ca · May 17, 2003

I just left a hospital where the ratio was 4 couplets to one nurse. That was hard enough--it only took one baby who wasn't breastfeeding well or one mom who was 'trying' to bleed heavily, and that shot my time management.

Can't even imagine 5 couplets to one nurse.

Our standards were obtained from AWHONN, which advised "3 to 4" couplets per nurse. So 4 is maximum, 3 is optimum.

sbic56, BSN, RN · May 17, 2003

Three or four mother/baby couplets is plenty. Primips need so much teaching and assistance with a newborn. There is no way one nurse could do 5 couplets justice unless they were all multips with no concerns.

SmilingBluEyes · May 18, 2003

I don't know about STATE mandates, but you are bound by AWHONN standards of practice when it comes to staffing issues as well as personal practice. Failing this, I would think, could get you in some hot water if/when something goes wrong. That and really, what nurse can do justice for 5 couplets as stated above? with all the teaching and recognizing potention complications, it is UNFAIR to nurses and patients alike.

easyrider · May 24, 2003

Thank you all so much for your responses, I just resigned from a postion where not only was I responsible for couplet care for 5 moms/babies but I was the clinical supervisor. So, I was also responsible for staffing, sick calls, room assignments, staff counseling, handling any problems on the unit and making the "numbers" for that day. I can't begin to tell you how impossible this was. I feel validated for leaving, now that you all have expressed how unsafe this practice is. I only stayed for three months. I can't believe how the nurse manager can get away with this, but she is. P.S. I wasn't union because I was considered management, even though I was out on the floor taking care of my patient assignment, but the other staff nurses were, and the union was not helping them at all.

teeituptom, BSN, RN · May 24, 2003

You expect help from a union.

The Lord helps those that help themselves

pickledpepperRN · May 24, 2003

Originally posted by easyrider
Thank you all so much for your responses, I just resigned from a postion where not only was I responsible for couplet care for 5 moms/babies but I was the clinical supervisor. So, I was also responsible for staffing, sick calls, room assignments, staff counseling, handling any problems on the unit and making the "numbers" for that day. I can't begin to tell you how impossible this was. I feel validated for leaving, now that you all have expressed how unsafe this practice is. I only stayed for three months. I can't believe how the nurse manager can get away with this, but she is. P.S. I wasn't union because I was considered management, even though I was out on the floor taking care of my patient assignment, but the other staff nurses were, and the union was not helping them at all.

GOOD FOR YOU!

No patient should have to share their nurse with so many other duties.

In California the State mandate for 4 or fewer patients per nurse in couplet care will be implemented starting January 1, 2004. NOW the nursery ratio is 8 or fewer healthy newborns. The DHS interperts this to mean any nurse assigned a newborn may have a maximum of 8 patients. My hospital has been cited for both the assignment of 9 patients (twins) and for high acuity with a post C- section febrile Mom.

You could have been included in a lawsuit and even worse had to live with allowing harm to come to a new life because of your failure to advocate for your patients. I hope you told the hospital why you left. You can also make a complaint to the DHS (listed under State of California in the front of the phone book, ask for licensing and certification).They will not reveal who complained.

I have taken advantage of education with CE credit by my union.

http://www.calnurse.org/gr/aanestad.html

http://www.calnurse.org/cna/np/qa.htm

http://www.calnurse.org/cna/np/np1101599.html

http://www.calnurse.org/cna/cal/junjul99/9cnjj99.html

http://cna.igc.org/cna101/top5-2.htm

http://cna.igc.org/cna101/top5-4.htm

http://cna.igc.org/cna101/nursingpractice.htm

http://cna.igc.org/cna101/govrel.htm

http://www.rn.ca.gov/complaint/complaint.htm