[CTGIN]

I would like some feedback on staffing patterns at hospitals with approx 500 births/yr. If you have central monitoring how many RNs do you staff with for labor patients and do most places cover their own C/S duties? Thanks for any input

[gramma00]

I'm really sorry no one has replied to your question before this. Staffing is one of the major problem areas in L&D, even more so for LDRP. Unfortunately I think AWHONN staffing recommedations, although fair, are unrealistic. Functionally 1:1 in active labor is ideal. The problems start when you are trying to assign new labors while the PP phase is increasing faster than planned. I think 4-6 very stable M/Bs is not difficult, but throw in one patient with issues of any kind and the whole thing can start to come apart.
In 20 years I have never worked in an L&D that did not face a staffing crisis now and again. It's when staffing is consistently bad that it becomes a real issue. Patient safety has to be the bottom line. There are so many variables, sick patients, 'bad' babies, inexperienced staff, that have to be taken into account. Ultimately you have to have a dedicated staff and management that is willing to step up and keep everything from becoming dangerous to the patients (and the nurses licenses).
That doesn't seem like much help, but it is how I see it.