6 Couplets on Postpartum

Specialties Ob/Gyn

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Specializes in BSN, RN.

Lately, we have been getting 6 couplets on my postpartum floor. Over the past year, administration has also added a lot of new policies which means more work for us. This includes measuring 2 voids after admission (used to be 1 of at least 500), more frequent vital signs and postpartum assessments of mothers with high QBLs (500mls or more for lady partsls, 1000mls or more for sections, half hour vitals and assessments for 2 hours, then hourly for 2 hours), we are also charting postpartum hemorrhage risk for all patients, Temps of sitz bath, q hourly respiratory rates for patients who got duramorph, and new protocol for new BPs of over 140/90. We are also charting if the patient had is vaccinated against covid but not offering vaccines. This is all great and all but it's too many changes to dump on us too fast. This is all on top of all the entitled parents who treat you like a servant and complain about you, and all management cares about is press ganey scores.

 

This is all just becoming too much. I've been here for just under a year and I'm don't. At first I was so excited to be working in acute care, to finally be a "real nurse". That has worn off and I am so glad I am leaving soon. Took me working here to appreciate that I am a real nurse even if I work outside of the hospital. 

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Specializes in OB.

Good lord!  You chart the TEMP of a Sitz bath?!?!  That takes nitpicking to a  whole new level.  Six couplets is double the amount recommended by AWHONN, I don't know how you're doing all that and keeping your sanity.

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Wow, six is a lot! My unit tries to keep us at 3. Doing half hour vitals and assessments is a lot too. Our c-section patients get vitals and a fundal check q4h for 24 hours and patients that had duramorph get respiratory checks q2h for 12 hours. lady partsl deliveries get vitals and a fundal check q4hx2. It’s interesting to read how other hospitals do things.

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On 9/10/2021 at 2:09 AM, RUNBNursing said:

Lately, we have been getting 6 couplets on my postpartum floor. Over the past year, administration has also added a lot of new policies which means more work for us. This includes measuring 2 voids after admission (used to be 1 of at least 500), more frequent vital signs and postpartum assessments of mothers with high QBLs (500mls or more for lady partsls, 1000mls or more for sections, half hour vitals and assessments for 2 hours, then hourly for 2 hours), we are also charting postpartum hemorrhage risk for all patients, Temps of sitz bath, q hourly respiratory rates for patients who got duramorph, and new protocol for new BPs of over 140/90. We are also charting if the patient had is vaccinated against covid but not offering vaccines. This is all great and all but it's too many changes to dump on us too fast. This is all on top of all the entitled parents who treat you like a servant and complain about you, and all management cares about is press ganey scores.

 

This is all just becoming too much. I've been here for just under a year and I'm don't. At first I was so excited to be working in acute care, to finally be a "real nurse". That has worn off and I am so glad I am leaving soon. Took me working here to appreciate that I am a real nurse even if I work outside of the hospital. 

No, no, and no. I would report the census to someone. I don't know what state you're in surely they have a patient to nurse ratio. That is a recipe for burnout.

I am most worried about the quality of care the patients are getting.

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I agree w/ all comments, seriously checking sitz temp?  and what the heck w/ all the void checks.  Our vag deliveries we check time and amount for 12 hours.  C/sections it is time and out for 24 hours after a foley is pulled.  Bless your heart.  

 Our couplet nurses do a MAX of 4 and that is actually one over what they are supposed to be doing.  Where are you girl?!?  your hospital needs to do some reevaluating!!

 

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Specializes in BSN, RN.
On 10/14/2021 at 6:04 PM, NurseGuru said:

No, no, and no. I would report the census to someone. I don't know what state you're in surely they have a patient to nurse ratio. That is a recipe for burnout.

I am most worried about the quality of care the patients are getting.

I'm in NJ. When I was hired I was told that the ratio at this particular hospital is 5 couplets and if I would be able to handle that. I wasn't sure what was "normal" so I said it was fine. No I know it was a red flag.

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Specializes in BSN, RN.
On 10/12/2021 at 10:15 AM, KimchiQueen said:

Wow, six is a lot! My unit tries to keep us at 3. Doing half hour vitals and assessments is a lot too. Our c-section patients get vitals and a fundal check q4h for 24 hours and patients that had duramorph get respiratory checks q2h for 12 hours. lady partsl deliveries get vitals and a fundal check q4hx2. It’s interesting to read how other hospitals do things.

That sounds a lot more reasonable. The half hour vitals was insanity and I felt bad for the moms that just wanted to rest. Our duramorph patients would get q1h respiratory checks for 24 hours,  it was so dumb. Measuring 2 voids of 500 was dumb too because sometimes you would end up measuring like 4 times because the patient would void say 200ml the first time, 100ml the 2nd time, 200ml the 3rd time, it and we still needed to keep measuring because none were over 500.

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Specializes in BSN, RN.
21 hours ago, momschatz said:

I agree w/ all comments, seriously checking sitz temp?  and what the heck w/ all the void checks.  Our vag deliveries we check time and amount for 12 hours.  C/sections it is time and out for 24 hours after a foley is pulled.  Bless your heart.  

 Our couplet nurses do a MAX of 4 and that is actually one over what they are supposed to be doing.  Where are you girl?!?  your hospital needs to do some reevaluating!!

 

Supposedly we were checking sitz bath to avoid burning the patients (??). 

The worst was if I started off with 3 couplets because then I would get 2 or even 3 admissions. 

This hospital is a catholic hospital in Central Jersey where the pay is $5 less than the nearest hospital. They were big on being a magnet hospital and trying to get some sort of perinatal certification which is why they were making all these changes.

Another thing I forgot to mention is that after 6 months they "train" you for 2 shifts on the step down NICU and then they can float you there. I was floated twice and it was a nightmare. I left for a postpartum home visiting job that pays me $4 more.

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Postpartum home visiting sounds like a great job and $4 more an hour is awesome too.  As a point of reference I am in the midwest and at a Catholic Hospital as well!!

 

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Specializes in Women’s health, Labor and Delivery, OBGYN.

Absolutely not. This is too much of a workload for one nurse. Run. 

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6 couplets? Absolutely not!

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