couplet nurse patient ratio

Jolie, BSN · Nov 19, 2003

Do you mean that you are switching from a traditional post-partum and nursery set-up to mother-baby care?

If so, I would hope for everyone's sake that this would be done gradually, with inservicing, cross-training, and policies and procedures in place. But with the pitiful state of health care today, I guess it wouldn't surprise me to hear of it being done overnight, with no preparation at all.

California is the only state I know of with mandated nurse:patient ratios. But, it is my understanding that the legislation has holes large enough to drive a Mack truck through that allow administration to violate the mandated ratios in "emergencies".

Check the AWHONN website for more information, but it is my opinion that 3 couplets is ideal, 4 is workable, and any more than that is bordering on unsafe. I would personally refuse an assignment of any more than 5 couplets, and I would not accept 5 couplets on a consistent basis.

aaox3slg · Nov 19, 2003

There was no inservicing or procedures put in place and we found out yesterday at 10am which was obviously 3 hours into our day. The nurse manager and vice president of nursing came to our unit to enforce this, so we were forced to take 6 couplets each, apparently the nursery nurse is now suppose to be for transitions only, which is fine but she is also responsible for catching babies in c/s, so what happens to the transition babies while she is away?

I had 2 fresh c/s who didn't want there babies, so who watches these babies if it is not the nursery nurses responsibility?

Jolie, BSN · Nov 20, 2003

Wow! That's unreal! It's a shame you can't post the name and address of this awful institution so that your potential patients could run the other way!

Bottom line, I'd get out of there. Any administrator, nurse manager, or risk manager who would operate this way is not worthy of your license, which is what will be on the line when something goes wrong. And something will go wrong.

6 couplets is unacceptable under any circumstances. Since your assignment included 2 fresh C-sections, and I assume, 4 post-partum moms, all with infants, you were responsible for the total care of 8 patients, along with the care of 4 more stable moms. All of whom needed frequent assessments, teaching, help with care and feeding, medications, etc......Just not possible to give even mediocre care to that many patients, let alone practice to the level that would enable you to uncover problems or intervene early with poor breastfeeders, babies with mild respiratory distress, recognize early signs and symptoms of infection, deal with social issues, etc.

Such a set-up is an injustice to you and your patients!