postpartum mother/baby unit staff ratio

  1. Hi all,
    I have a question about patient ratios for postpartum mother/baby units that have one nurse for the mother and baby. I recently interviewed for a position that assigns 5 couplets to each nurse. 5 mothers and 5 babies. That is 10 patients total and seems like a lot to me. Is this the norm? Tell me what you guys think about this.
    Bessie
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  2. 16 Comments

  3. by   finallyRN
    At my hospital the norm is 4 couplets, 4 moms 4 babies. If we have a few moms with babies in NICU then you could get 5 moms and 2 or three babies. On rare occassions when we are desperate you could get 5 couplets.
  4. by   emily_mom
    Ours depends on census and wheter or not they can get coverage. We've have 6 couplets a few times d/t call-ins and such, but they like to keep it at 4 max...
  5. by   OBNURSEHEATHER
    Well, 3 is supposed to be our ideal, 4 max.

    But more often than not, we have 4. And we're talking primary care. Everything. We don't utilize aids (like they're supposed to be utilized) on our unit.

    5 is a bit much on a regular basis.

    Heather
  6. by   Dayray
    I work at 2 hospitals at one I only take care of moms at the other I do mom and baby.

    The most I think I could handle would be 7 moms (total patient care no CNA's on this unit) or 4 maybe 5 mom/baby couplets (with CNA's) and on a heavy day.

    I wouldn't take more then that I don't think it would be safe at least not at my skill level maybe more experienced nurses could do better.

    I don't really like to have more then 5 moms or 3 couplets because with more I don't have the time to do the little things I enjoy with my patients.

    I wouldn't take a job where a patient load like the one you describe is the norm. For me not only would it be dangerous but it would keep me from spending the extra time with each patient and that would take the fun out of the job for me.

    P.S. if 10 patients is the norm imagine what a busy day with call offs would be like
  7. by   fergus51
    We do 5 couplets each.
  8. by   mark_LD_RN
    one hospital i worked it it was usually 4 to 5 couplets
  9. by   Bessie
    Thanks for everyone's helpful info. I have not had experience in this area so I didn't know what the norm was. I knew I could come to the message board for honest opinions and accurate up to date info. I am sure the five couplets depends on census and staff on duty.

    How is couplet care more rewarding, harder or easier then working with just babies or just mom's? Any info you can provide will be helpful. I was thinking of another position that is only mom's or babies and not both. Just trying to weigh my options on the best place to get my feet wet in women's health.
    Bessie
  10. by   fergus51
    I prefer couplet care because it is best for breastfeeding and gives moms time to learn about caring for baby (especially important if she is a first time mom because they are only in the hospital for 2 days). We take well babies out to the nursing station or the NICU ONLY if mom really needs a few hours of straight sleep or if she is a c-section and has no support person to stay and care for baby or if she wants a shower or a smoke. I don't really like the idea of using a well baby nursery all the time. You had the kid, now you need to learn to take care of him/her. I already know how to care for a newborn.
  11. by   TennRN
    I'm new to allnurses.com.

    I work Mother/Baby and we typically have 4-5 couplets. I've had as many as 6 and as few as 3 but norm is 4-5.
  12. by   Dayray
    I like taking care of the moms more then the baby's but I'm starting to like couplets better for several reasons.

    Your patient only has 1 nurse and this seems to be more comfortable for them.

    Everyone seems to have a different style of teaching breastfeeding and it really confuses mom and baby when two people teach them completely different techniques (although sometimes it helps too)

    (Hope this doesn't start a debate) I get so frustrated with nursery nurses giving my babes bottles when mom is trying to breastfeed. Unless the baby has a low sugar I don't bottle feed for the first 24 hours.

    I've had a few incidents where nursery has made comments to Doctors or referrals to the social worker, claiming mom isn't responding to baby properly when I know this not to be the case.

    I had an incident this week that forced me into confrontation with a nursery nurse. She had told the doctor that mom was over mothering baby, wouldn't send baby to the nursery and not sleeping. Then later that day she told the social worker that the same mom wasn't paying attention to the baby. Mom was in tears because the social worker and the doctor had both talked to her and now she was confused and thinking she was a bad mom. What really pissed me off was that the nurse had only been in the room 4 -5 times for like 3-5 min. everything ended up okay and the patient was a wonderful first time mom. She was just a little high strung (but I think anyone would be after having a still birth at 32 weeks 2 years before).

    Even though I like moms better I'm starting to see that mom and baby are really one patient together. Taking care of both allows you to provide better patient care.

    But if you're into babes I think you would like nursery better. When I do couplets most of my day centers on caring for mom.
  13. by   OBNURSEHEATHER
    Originally posted by Dayray
    (Hope this doesn't start a debate) I get so frustrated with nursery nurses giving my babes bottles when mom is trying to breastfeed. Unless the baby has a low sugar I don't bottle feed for the first 24 hours.
    Why is it that dayray? At my hospital also, the nursery nurses seem too quick to give bottles. I'm not sure what it is about the nursery, but that seems to be an easy habit for them. It does undermine breastfeeding. And contrary to popular belief, I do support breastfeeding.

    I also like couplet care for continuity reasons. At my hospital, days and evenings shift do couplet care, and nights separates them. It makes it hard in the morning when I'm getting reports, and nights can't tell me a stinkin' thing about the baby. I get out of report to find that the baby is on a cardiac monitor, under bili lights, or went to NICU. Sure woulda been nice to know that before!

    All and all, I think it makes fo rless confusion for the patients.

    Heather
  14. by   Dayray
    Nurses who graduated during a certain era were taught that the baby must eat A.S.A.P. and at regular intervals, regardless of the BG. I think other nurses picked it up after school from orientation. What's funny is that the really old timers will tell you babes don't need to eat during the first 24 hours this is also what is now being taught in nursing school. There is a generation of nurses in between the old timers and newbie nurses that was taught it was essential for babes to eat eat eat.

    Also I've been told by allot of nursery nurses that nipple confusion is a myth. I personally believe in nipple confusion but to argue is pointless. Better to chalk it up to professional disagreement, do what you think is best for your patient and let others do what they think is best (maybe it works for them).

    Personally I take a BG on all my babies as part of their initial assessment after birth. If the BG is over 40 I don't worry and only recheck it if mom cant get them to nurse or if they get jittery. If its under 40 or close to it I recheck a little while after they have been breasted and supplement only if still low.

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