Bedside handoff report on mother/baby unit - page 3

by OBnurseSandy 12,836 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


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    I do agree with the fact that it does mess with the incoming nurse's organization and thought process. Sometimes the patients, when we're giving report in their rooms, ask for things they need right away which can take some time. We used to do report one at a time where the nurse leaving would give report to all of the nurses in the report room. If it was your patient they were reporting on, you'd obviously pay the most attention, while the other nurses would organize their report sheets etc. Now, we do bedside or individual... it does take up time finding the nurse to give/receive report but ironically enough, it's been quicker, at least for our unit. Most of the time, unless it's a higher acuity patient and a report that takes longer, they're out of there before they need to swipe out.
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    Quote from PinkNBlue
    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.
    That's pretty much the most you can do... once the mom is exhausted and wants the baby to go to the nursery, she's made up her mind. Just like mom's who want to bottle feed... you can try to tell them all the pros and reasons why to BF or room-in, but they are going to decide what they want to do anyway.

    I recently had a BF only mom who wanted her baby in the nursery between every single feeding. It was frustrating, because the baby wanted to start cluster feeding, which meant going back and forth between nursery and room. I told the mom that it's probably easier to keep baby next to you, so that you can pick-up on early hunger cues; if the baby starts acting hungry in the nursery we are going to bring him back anyway, so he might as well be next to you sleeping. She still wanted the baby to go to the nursery anyway.
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    I've had patients like that as well and you're right, it's frustrating. I just end up charting that I've educated mom and she understands but is requesting infant to nursery. It's all we can do, you're right.
    debsgreys and RN_BSN09 like this.
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    We do bedside report, 24 hour couplet care, and average 4-5 couplets on night shift. It gets crazi but it is doable. I could not imagine getting a taped report. I always have questions!
    debsgreys likes this.
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    Quote from kwest210
    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!!
    This is totally us as well.

    I think the switching back and forth between couplet and nursery is a bit odd. Do you force your moms to send the baby to the nursery? If mom IS keeping her baby in the room overnight, I'm assuming then both the PP RN as well as the Nursery RN would have to check in with her for cares which would increase the amount of interruptions at a time when they should be minimized.

    I would MUCH rather have 3 couplets than have 6 moms to care for.

    We're working toward baby-friendly status now so we are supposed to encourage not sending the baby to the nursery also. However, as someone who's had 3 babies and DID send them to the nursery between feeds (and still successfully breastfed for roughly 18months each), I might be a little ticked off if I got a lecture (even a polite lecture) against this. Yes, moms DO need to sleep and this is the only opportunity to do so. They're not going to be able to send their baby off when they get home so why not take advantage of it for the 2 nights they can. Many moms have been awake for well over 24hrs and even the normal little whimpers of a newborn can be hard to sleep through. Just trying to give you a mom's take on this.
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    A few thoughts from a pp unit who is quite nearly certified baby friendly-

    We regularly do bedside report, handing off a 4-5 couplet assignment to multiple nurses. It is nearly always done in half an hour. We only don't go bedside for the report if the pt refuses or if they are asleep. It is completely doable!

    The portion of baby friendly which includes making rooming-in the routine recommendation rather than routinely bringing babies to the nursery has changed our unit for the better.

    We never, ever tell a mom that the nursery is not available. It is just not routinely recommended. It had led to a more judicious use of the nursery- we watch the moms, try to intercept before there are tears, panic, etc, and offer the nursery in these sorts of cases. I would never suggest it if a mom has good support and is feeling fine. Then moms go home knowing so much more about how their baby is, 24 hours a day. We often have nights with an empty nursery. But all our moms are aware that they may request the nursery, however, I will try to help them settle their baby down first. Without a lecture on rooming in, of course. No lectures around here.

    When I had my first, we were feeling fine but our baby was brought to the nursery overnight and out for feeds. I didn't know any different and didnt question it. And I did get some sleep. But I brought that kid home the first night and had NO IDEA what to do with him. I just thought he would go to sleep or.... something... In my opinion, it is better to have the nurses teach the parents how to care for their infants 24 hours a day. The time for solid sleep has passed when the baby is born.
    LibraSunCNM and PinkNBlue like this.
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    We closed our nursery (mostly for staffing reasons) about two years ago and have found very few complaints from patients. Our PP nurses take 3-4 couplets and we do bedside report. First, the off-going nurse writes a shift summary that is printed (patient status report) and given to the oncoming nurse in the report room, where we have a brief (5-7minute) unit report from the charge nurses (these two things usually includes any pertinent issues like social issues, etc). The off-going nurse stands in front of the rooms she has and waits for the starting shift to find her. This can take some time, since nurses are usually assigned any patients they had the day before (if possible) so they don't always match up to the oncoming nurse. For the most part the nurses are able to get out on time. We have complained that it is inefficient and rude to wake the patient in the morning, but management says that bedside report is a JCAHO expectation and it will NOT be going away, so we do our best.
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    Quote from gemininurse71
    We closed our nursery (mostly for staffing reasons) about two years ago and have found very few complaints from patients. Our PP nurses take 3-4 couplets and we do bedside report. First, the off-going nurse writes a shift summary that is printed (patient status report) and given to the oncoming nurse in the report room, where we have a brief (5-7minute) unit report from the charge nurses (these two things usually includes any pertinent issues like social issues, etc). The off-going nurse stands in front of the rooms she has and waits for the starting shift to find her. This can take some time, since nurses are usually assigned any patients they had the day before (if possible) so they don't always match up to the oncoming nurse. For the most part the nurses are able to get out on time. We have complained that it is inefficient and rude to wake the patient in the morning, but management says that bedside report is a JCAHO expectation and it will NOT be going away, so we do our best.
    Sounds very similar to us except we have a nursery and it's huge... :-/
    debsgreys likes this.


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