What do you think about these staffing ratios?

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Specializes in Physical Rehabilitation.

Hi,

I am not in OB, but have recently found out about an opportunity at a local small hospital who has approx 450 deliveries a year. Since I have no experience in OB I was wondering if I could run some info by you all to get your opinions as to whether this hospital has staffing issues or not.

They are a Level I hopsital and on all shifts they have one nurse in L&D (two beds), one nurse on PP (10 beds) and one nurse in the nursery. Antepartum is considered L&D. They said they pull in nurses from other areas if things get critical. They also said there isn't a doc in house for all shifts, when he/she leaves they can have the ER doc cover. I was also told nurses are also specially trained in delivering babies due to the fact that there isn't always a doc in house (two nurses present at the delivery). They said training for new nurses is following one of these nurses in each of these areas for approx. four weeks, and new nurses are trained in all areas because they go where they are needed. Does this sound odd? I'd love to get into this area, but not sure if this is the right place to do it.

Also, could you suggest a few important questions to ask potential employers about working in OB?

I'd appreciate any insight and wisdom you may have to offer.

Thank you.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Let me get this straight. ONE Nurse for 10 PP couplets????? That is TOOOO MUCH!!! PP is NOT "easy", as some might think. Just WHO will teach these moms to breastfeed? Just who will do discharge teaching, paperwork and monitor 20 patients? What is one mom begins to hemorrhage? Who watches the rest while you deal with her? ONE nurse? Nope.

Also consider: do they guarantee the employees they would "pull" to help out would be able to just jump in and help (do they specifically have OB/Newborn experience???)

See, I have done the small rural hospital OB gig....and the thing that bugs me most is, there is VERY little backup in these hospitals. You never mentioned Anesthesia services. How quickly can you access these in an emergency? Best ask that question, too.

I am sorry, the ER docs do NOT always know what to do in cases of severe dystocia or other emergencies. Yes, precips can come in and then have shoulder dystocia, then WHAT? Do the nurses even know what to do??? How about those employees they "pull" to help out if it's crazy? Do THEY know the drill for obstetric emergencies? Are they NRP-certified?

If the answers to these questions are not all yes, then I would not want to work there as an L and D nurse. OB is too high-risk to take such chances, even in tiny rural hospitals. You never know what gets wheeled into your doors at any given time and is too unstable to ship to a higher level care hospital!

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Specializes in Maternal - Child Health.

Run, run like the wind!

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Specializes in Physical Rehabilitation.

SmilingBluEyes,

Thanks for your detailed reply. I'm sorry I forgot to mention they said nursery cares for the infant, so there is no couplet care in PP. Even so, I think 10 PP patients is heavy, especially if you are alone. You brought up some valid points about if the nurses they pull are up to date in their ob/l&d skills. I think this job smells fishy. I live in a rural area so I don't have many options for hospitals, but I guess I'll have to look into other areas they may have open or find another hosp. Do all rural hosp have staffing like this? What about no oncall OB doc? What do you think about nurses delivering babies? Aren't they called Midwives??

Jolie: I read you loud and clear!

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Bad, bad, bad!!!!! Do NOT go there.

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Specializes in Psych, Med/Surg, Home Health, Oncology.

Hi

I have very little OB experience & that was years ago, so I am, perhaps not the best adviser. HOWEVER--I think these ratios have the potential to be extremely unsafe!!

Does NOT sound like a good situation.

Sorry,

Mary Ann

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

Even with a nursery, it sounds bad to me. (I do not like well-babies spending the night in the nursery for staffing convenience at all, but that is another thread).

Like I said, I have worked in a rural hospital OB setting, as well as a more urban one, so I know what questions to ask---- and what ratios are acceptable and what are not. Ask a lot of questions like the ones I mentioned above, before you even think of working there. OB is one of the most litigious areas of nursing (or medicine) you can work.

Be careful where you choose to practice OB nursing, or you may regret it. It sounds to me as if you would have little to no qualified backup in an emergency. Not a good way to go, in my opinion.

Good luck to you!

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S C A R Y. No way jose. Not my license.

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