Recovery for vaginal delivery

I believe our MB unit is 34 rooms. The nurses there do couplet care so 4 moms and 4 babies. L&D RN's and techs float to MB when needed and as staffing allows. MB nurses do not float at this time. We are one of 2 level 3 NICU's in the state, but we do not do neonatal surgeries. All of those OB pts get transferres out or delivered, baby stabilized and flown out. Love working in a high risk unit, but cannot imagine 2 hour recoveries.

Thanks for sharing. We have a 36 bed MB unit and a 12 bed prenatal unit. We don't transport out...we are the ones getting the transports, lol. But it is interesting to me to see that your MB nurses have the same loads as ours (technically, ours can take 5 couplet's but they start asking for an LD float if a few of them start getting 4) but they do much more of the recovery then ours does. In case you can't tell, there is a bit of a disagreement between units at times, lol. For the most part, we do the two hour recoveries b/c several of the MB nurses flat out will refuse to take a patient unless EVERYTHING is done. Basically, when they get a transfer, the pt is expected to be ambulatory, showered, voided, baby TOTALLY done. You basically just tuck them into bed and do a fundal check. Depending on who the charge is that night, there have been times when we have had women laboring in triage (we have a 12 bed triage/testing area) for hours, we are trying to get our delivered pt's to MB to open up rooms. To help with that, we request one hour recoveries...which would mean that the nursery nurse would do baby, and mom's epidural probably hasn't wore off so she would still need some care (not just tucked into bed). Depending on who is there, more often then not, they refuse (unless a manager is there). Our charge nurses have been told to not get into a fight with their charge over taking those patients. Instead, they are supposed to write a unit concern after the fact. Which does nothing really. We end up backlogged and with unhappy patients. The only ones who make out in the deal are the MB nurses, lol. We have brought up the issue of 1 hr recoveries and actually utilizing our nursery nurse for what she is MENT to do (they always insist on having one, but we do rooming in, so more often then not, they do nothing). We are told that it is too difficult for our MB nurses to actually have to recover new vag deliveries with their patient load. We are told it is b/c they do couplet care that it is too much for them. BUT, your unit, with the same staffing ratio and about the same size seems to do well with it. When I float to MB, I really dont' see what the big deal is. You are mostly just orienting to room and going over routine. EVERYTHING else is done. Frustrating when you are in LD and have unsafe staffing and asking for the nursery nurse to do babies to free up LD nurses or asking for a MB nurse to take a one hour post delivery patient with a foley and dead legs and are told no, b/c they are "too busy" and you see four of them sitting at the desk, lol. Ok, that is my vent for the night.

Man....there is so much variation.

Our M/B couplet nurses have on average 4 couplets. Sometimes we start with 3 and get an admit or two, others we keep 4 the whole night, others we start with 4 and get an admit.

After an hour or so, depending of course on how mom and baby are doing, L/D takes baby to the nursery for his bath/assessment etc. Until that time, L/D is responsible for at least getting a set of vitals q30min.

We get mom to mother/baby shortly after L/D takes baby to the nursery. Most of our L/D nurses, since they are getting Mom up to get in the wheelchair, will see if she needs to void, and get her cleaned up. If not, she still comes to us.

M/B is responsible for everything past that. If mom needs to void, we do that. If Mom's legs are still dead from the epidural, so be it.

Once baby is bathed and warmed up afterward, he goes out to Mom and the M/B nurse takes over his care from there on out.

I wouldn't know what to do with myself if I got a postpartum Mom already having gotten up for the first time, voided AND showered!!!

We do 2 1/2 hour recoveries. We are a level 3 facility doing 500+ deliveries. We have 18 labor rooms and 6 antepartum rooms. Our Csections recover until they can lift their hips. But we do baby vs, assesment, meds, skin to skin breastfeeding and bath. We don't shower the mom though, most of them cannot walk well enough. MB has 4 couplets, and about 52 beds on 2 floors.

At our hospital we don't time recoveries. Sometimes the labor nurse does recovery and takes them as a couple for the rest of the shift. When she's done with the busy part of recovering mom and admitting the baby, then she'll offer to help another nurse or take some triage pts. We're flexible, and we help each other.

I'm a baby nurse. I take couples and then come at delivery time. If I have time, I will do most or all of the baby admit. If I don't have time, the labor nurse will finish what I don't do. During births and for about a half hour afterwards, there is a labor nurse recovering mom and a baby nurse stabilizing and admitting baby. (And of course, the doctor or midwife is there until they are done with the placenta, stitching, etc.)

If the labor nurse is needed for another labor, then someone like me will take over mother and baby at any point in the recovery. She tells me what she's done and what is not done. I finish recovering mom and admitting baby.

We only move them out of rooms when it's needed. Sometimes they stay in labor rooms their whole stay, other times we move them out to the postpartum rooms. If they are in the popular tub room, we move them a couple hours after birth, whenever it's convenient. The nurse follows them to the new room.

We have eight labor rooms, and we average two births a day. Everyone does couples and surgeries. Some do labor, others do babies and NICU, a few can do everything. (We only get NICU babies occasionally. We ship out the bad ones.)

Our MB unit would love if the pts were just tucked into bed. Really though after the 1 hr recovery in L&D they only have to do fundal checks q 1 hour for 4 hours then q 4 for 24 hours. They help mom up the first time then the pts are walkie talkies. A few times I have worked MB I have seen the MB nurses running around like they are so busy and I am sitting at the desk waiting for my next check or for a pt to need something. May have something to do with the fact that in L&D things can change so rapidly that we have to have everything just right from the moment we receive report. I love our MB nurses. They are awesome, but we also have unit to unit concerns. Our PCM is over the whole birth center. We have also had nights where out triage is full, (Ours is only 5 beds. We have a seperate 4 bed ATU) and we have pts laboring in the OR and waiting rooms. Those times are when we need to send pt out to MB and at times can't due to couplet care even if there are empty beds. It gets so bad at times that we double 2 delivered pts in 1 room. I love my job and could not imagine working in any other hospital though. I work nights and our nurses are like a huge family. Couldn't be happier even with the frustration.

We are a small unit so it just depends on how my night is going on how fast Pts get moved to PP. If we are slammed I try to get the moms moved as soon as they can walk and hopefully pee. If all the other L&D rooms are empty I am not in such a rush. On average its about 2 hrs.

Our recovery time varies. We typically don't transfer mom and baby until mom has showered and voided. It can take anywhere from 1.5-4+ hours. We also try to have baby bathed during mom's recovery time. If we need the room then we do end up transferring mom and baby without a shower. Part of the reason for this is there are community bathrooms on the MBU! (ick). As in the whole ward has two toilets and two showers, with the exception of the private rooms. We like to have our moms have one nice, shower in a private room. Sometimes the moms luck out and get a private room, but they are reserved for c-section patients.

Our MBU does couplet care, but they tend to get overwhelmed when they have more than 2 moms and 2 babies. In their defense the bulk of the MBU are "butter bars" 2nd Lts. (I work in a military hospital), essentially new grads.

where i work recovery starts 15 min after baby is born. i do not think this is appropriate. at the place i worked in denver the recovery started after the placenta delivered and the repairs were complete.