Couplet care - how do you handle float pool nurses?

[klone, MSN, RN]

Our unit switched to couplet care on February 1. Prior to that, we had one nurse who took a team of postpartum moms, and another nurse who took a team of newborns. We would often have nurses float into our department from med/surg or ICU, and we would always assign them a team of moms. However, now that we've switched to couplets, it has caused quite a bit of trouble, and nobody is really certain how to handle it. Because these float nurses are not NRP certified or trained in caring for newborns, we have to split up the couplets and give the moms to the float nurse. It's kind of thrown a wrench into the works and makes it really troublesome when trying to make assignments.

So how do other facilities handle this?

[direis09]

Wow, no answer, just sympathy. I also work postpartum. We are a small 13 bed mother/infant unit and we generally do couplet care. The only med-surg nurse that floats to us has been cross-trained and has taken NRP. This is why so many L&D, LDRP and MIU units have gone to closed units; a nurse from another area can't just walk in and take an assignment. Staffing is often an issue for us. How big is the unit at your hospital?

[blaquediamondzRN]

Where I work we do couplet care and very rarely have floats on our unit but we have in the past and we have just assigned the float nurse the moms and the regular nurses would split up doing her assessments on the babies. It worked out fine.

[klone, MSN, RN]

How big is the unit at your hospital?

It's a 16 bed unit and we do about 100 births/month. We're moving to a brand new unit in May, and will be doing Level 2 NICU there.

[lifetimern]

As you know first hand, Nursing is becoming increasingly specialized. L&D, Postpartum, and NICU are prime examples of areas that require specialized training and experience. It is unsafe for nurses not specifically trained to care for new moms and newborns to do so. I encourage you to advocate for a closed unit. In the short term, this may be a trial for your hospital and your unit, but it is a necessary step to ensure patient safety.

[direis09]

I agree with lifetimern, to ensure patient safety, a closed unit is in everyone's best interest. Many of our labor nurses don't even like to come over and help out with babies.

The hospital where I work opened two years ago and includes a six bed NSCU or level 2 NICU with 24 hour in house NNP. I love it! Good luck with your new unit.

[babyktchr, BSN, RN]

We closed our unit for patient safety purposes on both ends. No nurse floats to us because they are not trained to take care of newborns and my nurses are not trained specifically to work anywhere else. Most of my staff have only worked OB their entire career and simply would not know how to take care of med/surg or any other kind of patients.

[klone, MSN, RN]

For those of you who have closed units, how do you handle staffing issues if you have sick calls?

[blaquediamondzRN]

For those of you who have closed units, how do you handle staffing issues if you have sick calls?

Just suck it up and work short staffed and or call in staff and offer bonus pay. That usually gets one or two people in.

[SmilingBluEyes]

Just suck it up and work short staffed and or call in staff and offer bonus pay. That usually gets one or two people in.

Same here!

[canoehead, BSN, RN]

What about the obvious? Train your most frequent floaters.

[rn/writer, RN]

The postpartum unit where I work does couplet care. When our float is from NICU, she will take the babies and the pp nurse will do the moms. With floats from L&D, antepartum, and general pool we do the reverse as these folks don't have NRP or other baby skills. Works quite well.