Couplet care/ discharge nurse/ baby friendly

[PediatricRNTX]

Hello,

I currently do post partum and newborn nursery but in an effort to move toward baby friendly they are initiating couplets. Are four couplets manageable? That's eight patients essentially!

I've also seen job posts for a discharge nurse to improve pt satisfaction. Anyone have one nurse designated to dc only? How does that work?

Thanks all.

[melmarie23, MSN, RN]

We don't have discharge nurses. We try to distribute the discharges evenly and based on patient load. Would a d/c nurse just go home after pts are d/c'd? Never heard of that, but I'm a new grad. :)

We flex down staffing accordingly. So sometimes someone will get sent home or called off. But usually as we discharge patients more labors or antepartums and surgicals are coming through the doors.

[RunBabyRN]

We flex down staffing accordingly. So sometimes someone will get sent home or called off. But usually as we discharge patients more labors or antepartums and surgicals are coming through the doors.

If you have a slew of deliveries, does the D/C RN then end up with 3-4 new admits?

AWHONN Guidelines... Mmmmm... I so hope to see our unit go to 3 couplets, especially since so many of our patients are high risk. It seems like regardless of acuity, we end up with 4.

[PediatricRNTX]

Well guidelines are just that ....guidelines. The trend seems to be squeeze the patient with any Nurse you have on staff. Anyway, i can imagine of the Nurse dc several patients the other nurses will be open for the admits. Im guessing.

[PediatricRNTX]

I got the scoop. Discharge nurse is still mother/baby nurse they just get a "lighter load" on the days they teach the discharge class.

[iPink, BSN, RN]

I got the scoop. Discharge nurse is still mother/baby nurse they just get a "lighter load" on the days they teach the discharge class.

That's for your unit. Doesn't work like that on mine.

On another note, I didn't think you could be a dc nurse on a mother/baby unit and not be a mother/baby nurse.

[klone, MSN, RN]

Like Melmarie, the OB unit I most recently worked for tried to always follow AWHONN's guidelines. Of course, once in a while we had to do 4 couplets, but that was uncommon, and there was never more than two nurses that had 4 couplets, and that was only when staffing was stretched super thin. Staffing was always done by acuity, as well - if there was a fresh C/S, or a baby on lights, then that nurse would get a lighter load for her other patients, or only had two couplets for that shift. Management took AWHONN's staffing guidelines very seriously.

[ladysweetpea]

On our unit in a very busy urban area, we typically start off with 4 couplets. In addition to the normal Mother/Baby duties, we also do our own labs on moms and babies and our own discharge and admission paperwork. There is a discharge class, but we are expected to sit down with the mother at discharge and make sure she understands her instructions. We are also expected to help with breastfeeding which can be very time consuming, although I am all for it. It becomes difficult when many of our mothers want to "do both". Requires lots of patience and teaching. AWONN standards would be awesome and I feel we could really give the amount of time to each patient that they deserve!

[melmarie23, MSN, RN]

If you have a slew of deliveries, does the D/C RN then end up with 3-4 new admits?

AWHONN Guidelines... Mmmmm... I so hope to see our unit go to 3 couplets, especially since so many of our patients are high risk. It seems like regardless of acuity, we end up with 4.

They'll take a labor if there is a new one admitted or be triage RN. Or the couplet assignments get rearranged. Sometimes someone get sent home to down flex or will be floated there is no assignment to take. It all depends on what is going on on the unit at that point in time.

[BSNbeauty, BSN, RN]

Once the D/C nurse D/C the patients. She is done and helps other nurses on the unit. Either way, she leaves at 1500. The D/C nurse at my job works from 7-3 since our discharges happen mainly between 10-1400