Bedside handoff report on mother/baby unit - page 2

by OBnurseSandy | 13,194 Views | 27 Comments

I work on a postpartum unit where we do couplet care from 7 am until 11 pm. At night however, the nursery opens and the nurses there get a patient ration of 6:1 and the nurses on the postpartum unit do likewise. At 7am we go back... Read More


  1. 1
    Quote from lovelabor
    can i ask why you switch from couplet care at night? i ask because i am a new working manager at a hospital that always has a "nursery" nurse and a mom nurse. i am a big advocate for couplet care (we are a small hospital, about 135 deliveries a year, so majority of staff do all aspects of care. i also struggle with convincing my staff that an assignment of 2 couplets is totally reasonable (i think, anyway). and another question.....when you start pitocin on a pt, what does everyone have for a time limit for a provider being "readily" available?
    Hi Labor-

    2 couplets is a breeze!!! it also depends on the acuity of our moms. Occasionally we get a mom who needs more care (like I had a sickle cell mom or those with PIH issues) . Like I said, we are usually around 2-3 couplets with room to admit one more. Again- it depends on the patients. I've had 8 Pts and my day was a breeze and I've had 4 and it's been terrible! Couplet care makes sense as well because we do so much teaching with the moms and babies- hope this helps!
    PinkNBlue likes this.
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    Hmmm at our hospital couplet care is 24 hrs meaning babies only go to the nursery if there is something wrong or if mom requests it. The mother-baby nurses are responsible for 3-4 couplets every shift. We do report then go to rooms to introduce on coming shift. 2 couplets is a slow day for us!!
    HappyrockRN likes this.
  3. 0
    2 couplets is a downstaff for us and we'll distribute those patients to another nurse. Our usual is 4 couplets; unless mom's on Magnesium, then it's usually 2 couplets, same with infusing blood. But otherwise it's 3-4, usually only 3 if L&D is busy and we anticipate we'll get a lot of admissions. There are days I've had 5. We also keep couplet care 24/7 but we're a baby friendly hospital so we encourage moms to keep their babies in the room with them overnight. Maybe bring up the idea of keeping couplet care overnight so that you're not delaying report. We've found bedside report has made everyone leave on time, if not early.
  4. 0
    Quote from PinkNBlue
    2 couplets is a downstaff for us and we'll distribute those patients to another nurse. Our usual is 4 couplets; unless mom's on Magnesium, then it's usually 2 couplets, same with infusing blood. But otherwise it's 3-4, usually only 3 if L&D is busy and we anticipate we'll get a lot of admissions. There are days I've had 5. We also keep couplet care 24/7 but we're a baby friendly hospital so we encourage moms to keep their babies in the room with them overnight. Maybe bring up the idea of keeping couplet care overnight so that you're not delaying report. We've found bedside report has made everyone leave on time, if not early.
    Good lord I wish our pp nurses would run mag! Our mag moms stay in LD until it's discontinued with 1:1 or 2:1 care depending on unit acuity. Then again, we also do the majority of IVs for our pp nurses and god forbid you don't catheterize your natural delivery if she can't pee (I refuse to do that, it irritates the heck out of me).
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    I've heard that a lot of places do not transfer their patients to PP until they're off Mag. We have mag patients all of the time on PP. There are times they're on mag, discontinued after 24 hours and then we have to restart it. Or we'll get a PP readmit with high BP's and they'll have to be started on Mag. It's a pretty common thing.

    Sometimes they cath the patients after delivery, depending on their fundal checks and if they're still super numb from the epidural and it'll be a while before they're even able to feel their legs.... but the vag deliveries are always DTV when they come to us in PP. And we'll only call L&D to help us with our IV's if the patient is a known 'hard stick' or we've attempted the max amount. I like to do it as much as possible to keep my skills up... same with catheters.
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    We do what I like to call modified bedside report. We give report at the nurses station that includes things like social issues and then we take the next shift nurse into the room to meet the patient and we usually go over how the baby has been feeding, any special concerns, and what the goals are for the next shift. A exception to the bedside intro would be if mom has stated that she doesn't want to be woken.

    We do couplet are with usually 3 couplets per nurse. Our nursery is used mostly for sick babies and procedures, however we will take babies if the parents request it.
    RN520 likes this.
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    "Hmmm at our hospital couplet care is 24 hrs meaning babies only go to the nursery if there is something wrong or if mom requests it. The mother-baby nurses are responsible for 3-4 couplets every shift. We do report then go to rooms to introduce on coming shift. 2 couplets is a slow day for us!!"

    Same with our hospital. We are Baby Friendly as well and the mag patients stay with us in L&D until it's d/c.

    Fyreflie - I would refuse to do that to a naturally delivered mom too!
    RN520 likes this.
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    What is the scripting that you guys use for moms who request their babies go to the nursery overnight and be brought back to them for feedings? We get a lot of moms who want to send their babies to he nursery so thy can get some sleep.... Understandable but in a baby friendly hospital, we're trying to not send babies away from their moms. I'm not about to argue or refuse to take their baby but that's the tricky part. I always say it's most beneficial to have baby with them at night and explain why but not everyone gets it.
  9. 1
    PinkNBlue, I can relate to that! It's kinda funny how new moms expect to get a decent night's sleep in the hospital. They'll be going home with that new baby in 24-48 hours, and last time I checked, we didn't go along for the ride! Although if someone offered me big bucks to be a private duty nurse in that kind of situation, I'd do it in a heartbeat! (I think.....)
    PinkNBlue likes this.
  10. 0
    In my opinion a full bedside report only works if you are giving report to one nurse, and also for units that care for a smaller number of patients (like L&D and ICU). It makes sense in those types of units with more critical patients to go over details face to face, make sure you don't miss anything, and discuss in front of the patient. However, when you care for 8 patients (4 couplets) and each patient is going to a different nurse at shift change, it is way too stressful and time consuming to give bedside report. You have to find the oncoming/leaving nurse, wait for her to finish report with someone else, and it just takes too long. It messes with the oncoming nurses organization and thought process and causes the leaving nurse to stay late. I've experienced both face to face report, and recording report, and I am by far a fan of the recording... at least when it comes to 8 patients and multiple nurses taking over their care.


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