To be more specific, these are patients that have been discharged after delivery and then show back up a few days later with postpartum pre-eclampsia in the ED. Our protocol is that they are suppose to go to Neuro ICU, if they are full the patient is suppose to go to any ICU unit, and if they are also full or if the OB absolutely insists, the patient can come back to L&D. I HATE when the ED tries to send me a 7 day postpartum pre-e patient. Yes we can do Mag, yes we are a specialized unit, but this is LABOR and DELIVERY. It is always a battle when this happens because the ED is so terrified of preggies and OB patients that they immediately want to shove em up here to us without even bothering with protocol.
Jul 6, '13
Wow, it is nice that you have that option. Our PP mag pt's, whether they are newly delivered or out a couple days stay in L&D until therapy is completed. Our PP unit does not handle that level of acuity (although they certainly could). Do the babies get to room in with the mom in your ICU's as well? I would think not, but eveyone has different policies.
Jul 6, '13
We get them if there isn't any HELLP syndrome issues, etc onto our women's health/postpartum unit. If they're really bad, super crappy labs, they'll go to neuro ICU until they stabilize then they come to us. Does your hospital not have a women's health unit?
Jul 7, '13
They go to our antepartum wing til mag therapy is complete
Jul 7, '13
Anyone who needs to be on mag goes to L&D, ante- or postpartum, regardless of how far out she is, unless she is actively seizing or in DIC.
Jul 8, '13
We get postpartum maggers back into L&D even if it is several days post delivery.
Jul 8, '13
I'm not sure if the babies are allowed to room in in the units or not, but I can tell you that if they are sick enough to have to be readmitted and on mag, their babies are not staying here with them in L&D either. We would let them pump, but not have the baby in the room. But once again, I'm only reffering to re-admits. If they are continueing mag therapy after delivery, immediately postpartum, then they would of course stay with us. Our postpartum unit does NOT handle mag at all. They do not have the staffing required to handle a 1:1 acuity.
Jul 10, '13
We obtain an order to board baby in order to have baby with mom when they are readmitted with postpartum preeclampsia. In order to have baby board, another adult must be with them. I can't think of a worse hell than being sick AND being separated from my baby. Any hospital whose policy is to separate mom and baby like that should really reevaluate. Our mag patients are never 1:1, more like part of a three or four pt assignment. Hourly vitals, q2hourly assessments, and they are carefully monitored. It's totally doable.
Jul 11, '13
And as with a previous poster, baby could board as long as another adult takes responsibility.
Jul 13, '13
I suppose it is possible that there could be an order to have baby boarding if another adult was with the mom. That hasn't come up. As I said, we rarely take re-admitted pre-e's because we have a neuro ICU in which they are suppose to go. Patient's on mag aren't always a 1:1 here, but our order set is that for the first 2 hours of mag therapy, vs q15 with continuous pulse ox. Then hourly vs and strict I&Os with DTRs and respirations assessed at that time. That's a pretty high acuity if one is truly following the orders. I know many nurses who just empty the foley after 3 or 4 hours and divide the total output by the total hours. I don't do that. It isn't accurate and it surely isn't "strict". I suppose it just depends on protocol and order sets.
Jul 15, '13
Wow, we get those admits directly to postpartum... we also care for postpartum mag patients; not after mag has completed but usually right after it has begun. We've bolused ER admits with PP pre-eclampsia on postpartum. It's all us on postpartum.
Jul 26, '13
I have previously worked in a larger facility and we had 2-3 PP mag patient's in our 6 patient assignment on PPU... VERY, VERY SCARY... did not feel safe caring for so many high acuity patients at one time. So found another job...
Love being a mother-baby nurse and really enjoy the family centered environment and being a part of educating new mom's and dad's about caring for their newborn... Such a fun job to be a mother-baby nurse. Obtained my Maternal Newborn Nursing Certification; which was well worth it. Now RNC-MNN.
Must Read Topics