Tips and tricks of Postpartum Nursing

PetiteOpRN · Oct 7, 2010

Based on my experience as a patient, try to be understanding to moms of NICU babies. My PP nurse told me that I was a bad mother because I refused to fill out a form that might hinder my 3lb daughter's ability to get a bank account someday (and yes, she took the time to point out the importance of the bank account).

That's all I got.

Testa Rosa, RN · Oct 7, 2010

I can't offer you much but this was given to me from a veteran PP Nurse (I voluneteered four years in PP as the baby photographer, filling out birth certificate forms and front desk help--fun!)

1) Round regularly and anticipate their needs for water, peri pads, diapers, etc. and ask if they need anything, then let them know that you will be busy in another room for awhile and let them know when to expect you back.

2) Respect Post Partum Pain for the Multip--it can come on suddenly usually as soon as that baby starts nursing so you want to anticipate and respond quickly if you've missed the opp to premed.

3) Always assess -- even if you are just running in to give an ice pad -- while PP moms and babes are usually healthy, every now and then you will get one that will turn on a dime.

She was right too--I caught a baby who had stopped breathing on a large breasted mother who was trying to nurse and talk on her phone at the same time. I hit the call bell and the nurse saw it instantly upon coming into the room. Baby pinked right up again in the nursery tho. It was scary for a minute.

PP--how fun for you!!!

ccrnmomnb · Oct 12, 2010

I'm new to PP, but here are some things I'm learning.

-Be diligent with fundal checks, monitoring for postpartum hem. is important.

-About 2 hours after admiting a c/s, help pt with a sponge bath. It helps them turn, deep breath, and helps you have a good look at their skin and perineum.

-Help them to the bathroom until they can do it alone. (I know from personal experience. My nurses let me lay there, I felt numb and helpless.)

-Change linens when they are in the bathroom. PP hormones can make you hot and sweaty!

Elvish, BSN, DNP, RN, NP · Oct 12, 2010

Because our new moms are with us for such a short amount of time, grab hold of EVERY opportunity to do teaching. People retain their info so much better if it's given in little bits rather than sitting down all at one time and giving a 45-min lecture (and what nurse really has time for that?). While doing a fundal/lochia check, talk about expected uterine involution and how long the lochia should last. While helping to the BR for the first time, talk about PP diuresis. While giving a Colace or Motrin (or whatever med), talk about taking meds at home. While doing any kind of assessment, talk about what's abnormal and what to call the MD for once they're home. When you do it like that, it's so much easier to fit it all in during the 24-48hrs most moms are there.

One other thing I've learned is that just because a mom says she doesn't feel like she has to pee, doesn't mean she doesn't have a full bladder. After a couple hours postpartum, even if she still says she doesn't have the urge, I encourage her to get up and go sit on the toilet. At the very least we get cleaned up, and more often than not she'll void as well. Keeping an empty bladder while awake helps with cramps sometimes too, as bladder and uterus don't have to fight for space.

Queen2u · Oct 13, 2010

Wow, these are all good tips! I am a new grad in postpartum and I am learning new things every day. All of these tips are helpful! There is another new grad on my unit who I will share these tips with--we always help one another out. :nurse:

alohagirljam · May 4, 2011

Thanks! these are great tips! I'm a new graduate on Postpartum and would love to get as many tips as possible.

The ones provided are great! I also had a question about Postpartum pain management, do you veteran nurses have any tricks as to how to deal with pain... like alternatives to pain meds? thanks!

caregiver1977 · May 4, 2011

The only thing I can think of for now is don't be surprised if you PP patient sometimes cries for no reason. The change in hormones and all the excitement of the baby can be overwhelming. And sometimes problems from home follow patients to the hospital. I know I freaked my PP nurses out a little (my eyes swell up very badly when I cry myself to sleep), but the nurses tried to be as understanding and comforting as possible.

NurseNora, BSN, RN · May 10, 2011

Tell your moms to void according to the clock for the first coupld of days rather than waiting to feel the need. After passing a baby down there, they don't get the signal as clearly for a while. Go to the BR q2h while awake.

If a baby is fussy and rooting like mad, but won't latch on, get mom and babe skin to skin. It calms the baby and helps it organize itself so it can nurse. Skin to skin is also great for a cold baby too. And remember that dads have skin too.

Remind multips that afterpains tend to be stronger and more uncomfortable with each baby (uterus is now older and more used and has to work harder to get back into shape).

If you have trouble finding the fundus, be sure the bed is completely flat. With a "fluffy" patient having it up even a little may make it harder to find.

Remind your patients that if they get their pain under control and keep it under control by taking medication when needed they will use less medication in the long run than if they wait until they just can't stand it anymore.

A hot pack is helpful for cramping if it's not time for more medication or mom wants to not take any.

I like Motrin for cramps and T3 for perineal pain (but remember the codeine can be constipating). Sometimes you really have to work to get a mom to agree to a sitz bath, but most love it once they try it the first time.