Animosity between L/D & Postpartum

[IrishItalianRN]

I have been working in Postpartum since 2007 when I graduated nursing school.

Recently I started noticing a division between our labor & delivery staff and our postpartum staff. I noticed this when I was in nursing school between these two units at several different hospitals but was surprised when I started at my job that everyone seemed to be part of the same team.

The only reason I can come up with for this (because we pretty much have the same staff we did back when I started) is that management has come down harder on us in the last few months regarding the budget. They are calling staff off to save money and what it comes down to is we all feel the burden of being somewhat short staffed.

I was sitting here trying to think of things I could do to bring the moral between the departments back up. I was thinking about emailing the director (I have a pretty good relationship with her) and sharing my thoughts about the moral between the departments being down and that I've noticed it happening since the budget came into focus. I don't want her to feel that this is a complaint about the budget but rather a sincere concern about the staff. I would like to have some ideas to take to her and our shared leadership team.

Do any of you have the same problem on your units and what ideas do you have to bridge this gap that is starting to form?

Thanks!

[klone, MSN, RN]

No, there doesn't seem to be morale issues, because pretty much everyone is expected to float between L&D and PP/MB. So there isn't a division.

Now, divisiveness between day shift and night shift, that's another story...

I guess to address the issue, you would need to figure out what specifically people are having problems with. Is the postpartum staff annoyed because L&D aren't fully recovering their pts before handing them over? Are there things L&D could be doing, such as pulling epidural catheters, getting them up to the bathroom, doing pericare, moving them to their PP room, etc, before giving them over?

[IrishItalianRN]

Klone,

The postpartum nurses sometimes feel like the report they receive is less than adequate. Sometimes we go into the patient records to find the patient was Gestational diabetic, had elevated BP's, blood sugars were never done on the infant when it was appropriate such as with the GDM mom ... things like that.

I probably need to talk to my friends in L/D to find out specifically what it is that bothers them from their standpoint, but from my observations some L/D nurses get irritated when they want to bring the patient to the floor and there is resistance for one reason or another. I think sometimes L/D thinks that all the hard work is over and postpartum has the easy job. On the other side I don't think all PP nurses realize the pressure L/D is under at times to get the patients to postpartum. Management pushing them because they need the bed, the nurse wanting to get dinner (understandable!) , sometimes there is no reason...

BOTH departments have a very important role in the patient experience and I'd like to get the departments to appreciate each others role. We are a busy unit we deliver around 300 babies a month sometimes less, usually more. Our nurses don't float for the most part. Sometimes Postpartum helps with recoveries if we have an extra nurse and sometimes L/D is floated to PP if we are short but other than that there is no consistent floating between departments. We are hired for our specific department.

[klone, MSN, RN]

Klone,

The postpartum nurses sometimes feel like the report they receive is less than adequate. Sometimes we go into the patient records to find the patient was Gestational diabetic, had elevated BP's, blood sugars were never done on the infant when it was appropriate such as with the GDM mom ... things like that.

I can definitely understand why that would be annoying. That's just poor nursing.

Do you have a standardized SBAR form that your nurses use when giving report? Perhaps that might help - on the form might be boxes to be checked that would address common L&D complications such as elevated BPs, GDM, etc.

[IrishItalianRN]

We do have a report sheet that has a lot of information. At the bottom of the moms side it has medical hx and that is where elevated BP's, GDM, etc goes. On the baby side we have 4 spaces for blood sugars to be entered so it should be a reminder to them that it needed to be done. right?

I know that the poor report needs to be brought up to management so that we can get that straightened out but I think I'm going to talk to some of my L/D friends and see what their complaints are so I have both sides of the problem. I know some of the problem is the budget like I mentioned before. Staffing issues and the pressure to move patients. I'd like to take it to management objectively as a concern for both units not just my own... for the most part we have a really great team (antepartum, L/D, postpartum, NICU, well baby) and I would like to see intervention now before it's total division! lol

I was thinking about getting this one friend in particular together to order some small items like nursing pens, pins, bookmarks and putting together appreciation bags that PP would give to L/D and vice versa... I would get PP involved and she could get L/D involved. Maybe making up a quick poem that would describe L/D thoughts on us and PP on them... does that make sense? Sounds a little corny now that I wrote it all out! lol

[klone, MSN, RN]

One thing our department does is has a star board. It's a bulletin board with a pocket full of paper cut-out stars. If a coworker does something you want to recognize, you write about it on a star and pin it to the board. At the end of each month, people who got stars get a little goody bag full of candy.

[crissrn27, RN]

I always thought this was a nurse thing but my husband works in production and they have the exact same thing with cursing involved! They have the shift thing, and problems between mixing and material handlers and what not. I think its just a people thing. Not that you shouldn't try for the best possible relationships at work!

[cherokeesummer]

We have the same issues and for the same reasons. It sucks for both sides that sometimes the other side doesn't get what the other needs, but yes we have the same problems and same underlying causes.

[AllThingsPink]

Totally the same thing in our unit too. I almost feel the L&D nurses think the PP nurses are slackers... and while there are definitely slackers (on both units), there's no need to assume the entire floor is. Both units have hard working nurses, techs and staff all in one. It irritates me that one unit thinks they're better than the other.

We don't have shift issues as much... although when we do, day shift seems to have issues with the PM and night shift. Makes no sense to me and it gets very old hearing the same people complain about the same stuff all of the time.