Couplet Care?

Specialties Ob/Gyn

Published

Specializes in Utilization Review, OB GYN, NICU.

I saw another posting on the frustrations of couplet care. My unit does not do this, we have a nursery nurse. (but things change). I was wondering, how many facilities do couplet care? How do you handle a mom wanting to send her baby to the nursery when she wants to rest?

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Specializes in Ante-Intra-Postpartum, Post Gyne.

Most of the times the baby stays in the room with the parents. If they want a break then the baby will hang out at the nurses station with the nurses. If it is too busy the mom is out of luck and has to keep the baby in her room. We have often had to transport sick babies to a higher level of care simply because of staffing (can not afford to have one nurse in the nursery for one baby) and not necessarily level of care. We try to accommodating as much as we can, babies on bili-light therapy stay in the room with their moms, even babies with I.V.s can stay with their parents, but if the baby need to be under the warmer with O2, I.V. UAC/UAC ect then it has to stay in the nursery and staffing has to be available for that baby to stay.

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Specializes in Utilization Review, OB GYN, NICU.

So, if you have a baby at the desk, and a call light goes off with no one to watch the baby you're with, what do you do? Do you take baby back to mom and say "sorry, I'm being called by another pt, and the baby can't stay in the nursery or at the desk unattended." ?? Because I can very well see that situation happening.

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Specializes in Ante-Intra-Postpartum, Post Gyne.
So, if you have a baby at the desk, and a call light goes off with no one to watch the baby you're with, what do you do? Do you take baby back to mom and say "sorry, I'm being called by another pt, and the baby can't stay in the nursery or at the desk unattended." ?? Because I can very well see that situation happening.

Yup. But honestly, on my unit babies rarely come to the nurses station during the day, and things are a bit slower on the night shift; but even then babies mostly stay in their own rooms. We have a unique culture where I live though. It is rare to see a baby at our nurses station.

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We have been doing couplet care for many years (and also have a well baby nursery on our floor). We encourage moms to keep their babies in the rooms with them, but always have a few who would like to send their babies to the nursery. I don't think we have ever turned down a mom's request because we were too busy to watch their baby. There are times when I feel we should be more strict than we are, but for the most part, we are pretty lenient.

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Specializes in OB, Women’s health, Educator, Leadership.

I am honestly tired of hearing other facilities okay with having an infant stay at the desk. Really? All of this "safety and security" we put in place and then keep the babies exposed for all to see at the nurses station. In what universe does that make sense?

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Specializes in L & D; Postpartum.

All our moms keep their babies, unless the baby is in the NICU (our only nursery.) Occasionally a well baby will be there temporarily to transition properly, but other than that, babies stay with their moms. They have no other choice. (sometimes it's the family members, not the mom, who go weird on us about that.)

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Specializes in Community, OB, Nursery.

Out of curiosity - those facilities that have no nursery, how does the facility handle it when you have a BUFA and mom doesn't want to see the baby?

We don't see this very much - most of our BUFAs spend at least some if not all time in the room with their birth mothers, by mom's choice - but it has happened. I'm curious what happens if there is no nursery.

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Specializes in L & D; Postpartum.
Out of curiosity - those facilities that have no nursery, how does the facility handle it when you have a BUFA and mom doesn't want to see the baby?

We don't see this very much - most of our BUFAs spend at least some if not all time in the room with their birth mothers, by mom's choice - but it has happened. I'm curious what happens if there is no nursery.

Most of our babies in that category already have adoptive parents, and they are usually on site immediately. We put them all into a room, we care for the infant as we any other, and the adoptive parents are considered boarders. Until those parents can get there, the baby does go into our NICU.

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I saw another posting on the frustrations of couplet care. My unit does not do this, we have a nursery nurse. (but things change). I was wondering, how many facilities do couplet care? How do you handle a mom wanting to send her baby to the nursery when she wants to rest?

I work on a small Maternal-Child unit with no specific nursery staff. We take care of mom from admission to discharge and also care for the newborn. We primarily do rooming in. We tell our patients that we are glad to watch their babies, if we don't have a labor patient. If we have enough staff, we can watch the babies until close to delivery. It is understood that we will bring the babies back to mom's room if we need to. Most of the time, the moms are o.k. with this arrangement. Occasionally, mom or dad will act irritated, but that is life in a small hospital!:)

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We have separate units for L&D, antepartum, postpartum and NICU. We also have an observation nursery in the NICU for kiddos who need a little help transitioning. As soon as they are doing better, they come to postpartum.

On our postpartum unit, most babies room in during the day and many do at night also. But we will gladly take babies to the nursery for any mom that asks. That includes new sections on a PCA, moms with complications, and those who are just plain exhausted. We staff our nursery with a specially trained PCA and we nurses help out, too. We can do some of our charting in the nursery so that someone is always in there if there are babies.

Last night I encouraged a mom who was going home to other kids to let me take her wee one to the nursery so she could get a three-hour stretch of sleep instead of the fifteen minute catnaps she'd been getting by on. I promised we'd bring the baby back for breastfeeding and we did. She was really thankful and felt a lot better.

We might do a social service consult if a mom leaves her baby in the nursery most of the time without a medical reason, but that doesn't happen too often.

I do think it's extremely unsafe to have a baby at the nurse's station when the only nurse watching it may be called away. Not just for security purposes but because it doesn't take much for a newborn to spit up and start gagging. Even just a couple of minutes unattended is too long.

We are fortunate that our unit is big enough to allow decent staffing and we also have cross-trained HUC/PCAs who care for babies. I realize this isn't always the case in smaller facilities, but it seems like staffing at least a PCA to help with babies would be cheaper than one bad outcome resulting from unsafe situations.

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