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helping pts after del

Ob/Gyn   (2,949 Views 18 Comments)
by jctiabecerra jctiabecerra (New Member) New Member

jctiabecerra has 9 years experience and specializes in L&D.

808 Profile Views; 14 Posts

I am a charge nurse on a postpartum unit. My nurses seem to have the idea that it is rediculous for a patient(c/s included) to ask for help doing things. They get upset if the patient calls for help to get out of bed or get their crying baby out of bassinet. They complain when she requests help in bathroom ect. Is it me or is this not part of our jobs?

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JenRN30 has 10 years experience as a BSN and specializes in Endoscopy/MICU/SICU.

289 Posts; 6,820 Profile Views

Um, no it's not you. Not a postpartum nurse, but when you push a watermelon out of your whooha, it takes a few days to walk normally again. Do they even act like this after an epidural or c-section? Aren't the nurses supposed to help patients to the bathroom and record urine output to make sure the woman is voiding normally after birth?? I'm confused, why would they have a problem helping the patients and doing their jobs? I could see if the patients were not trying to do anything for themselves, but helping them walk to the bathroom shouldn't be a problem. My opinion...

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krissy_mack specializes in cna.

28 Posts; 2,225 Profile Views

Yes it is part of the job. Honestly if they complain that is them just being lazy. It is so aggravating to me when a nurse complains about things that they have to in their job description! If helping patients is o much of a problem then i suggest looking into a new career field!

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BookwormRN specializes in Med/Surg.

313 Posts; 4,878 Profile Views

Having had 3 c-sections personally, um yeah, those nurses should be assisting the patients! I was unsteady, in pain and at times unable to move quickly enough to pick up the babe from the bassinet, let alone get to the bathroom on my own to urinate for the first time after the foley was DC'd. (Not to mention exhausted from attempting inductions prior to the second and third sections and loopy from pain meds!)

While I can sympathize to some degree (I've floated to OB a few times myself) about those patients who think they're at the Hilton vs Hospital, I feel that these are the exception rather than the rule.

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mamamerlee has 35 years experience as a LPN and specializes in home health, dialysis, others.

949 Posts; 5,968 Profile Views

Start rounding on the patients once a day yourself. ASK the patients what they need/want help with, and if they rec'd the help if they asked.

Tell your staff that they have these jobs BECAUSE the pts need assistance. Ask who among them (the staff) rec'd absolutely no assistance after childbirth. Tell them you are going to start rounding on the pts yourself, and every patient should tell you that the staff has met their every need.

Any pt who says the staff didn't OFFER to help, that the staff seemed annoyed about being asked to help, or otherwise reports indifference on the part of the staff -- well, you'll be noting who was assigned. If the same staff person comes up twice in XXX(you set the time period), there will be a verbal warning.

3rd incident - 1st written warning, and etc.

YOU are the charge nurse - - take CHARGE.

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CNL2B has 10 years experience and specializes in multispecialty ICU, SICU including CV.

516 Posts; 6,927 Profile Views

I would agree that yes, it is their job. I have never worked in postpartum but have had two horrible hospital experiences after my two births (even when all the staff knew I was an RN!) I never saw anybody more than once a shift. I do realize another part of the nurses role in postpartum care is to prepare the patient to get ready to get home with the baby and foster some independence with that, but that doesn't mean that you leave them all alone. I had to ask for absolutely everything.

I actually got a snotty look from a nurse after my first child, completely alone and bewildered in my hospital room at 5 in the morning (I had delivered vaginally after 20 hours of labor at 10 the night before), after she had asked me if I had checked my daughter's diaper and I told her "no." It honestly hadn't occurred to me that I needed to start caring for the baby yet beyond feeding. We were also supposed to self-administer our meds and check them off on a sheet (really?) -- Advil, stool softeners, etc. By the time my second child was born at the same hospital, they had done away with that. It was just crazy. New moms have no clue what to do even if they are up and around. They need a lot more guidance I think than they often get.

After baby #2 I was a little more prepared for the delivery/postpartum process but I ended up with an emergency laparotomy after a botched tubal ligation and intraoperative bleeding. Not once did a nurse ever listen to my bowel sounds before discharge. They let me eat. I went home completely constipated. Luckily I knew how to take care of myself in this situation or I would have ended up with a bowel obstruction. I would say in this case my care was completely substandard.

So yes, I think it is your job to make sure standards are adhered to. I delivered at a 700 bed urban medical center with two OB wards. You would think they would know how to do things better, but in my situation, that wasn't the case.

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LoveANurse09 specializes in Cardiac.

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Start rounding on the patients once a day yourself. ASK the patients what they need/want help with, and if they rec'd the help if they asked.

Tell your staff that they have these jobs BECAUSE the pts need assistance. Ask who among them (the staff) rec'd absolutely no assistance after childbirth. Tell them you are going to start rounding on the pts yourself, and every patient should tell you that the staff has met their every need.

Any pt who says the staff didn't OFFER to help, that the staff seemed annoyed about being asked to help, or otherwise reports indifference on the part of the staff -- well, you'll be noting who was assigned. If the same staff person comes up twice in XXX(you set the time period), there will be a verbal warning.

3rd incident - 1st written warning, and etc.

YOU are the charge nurse - - take CHARGE.

I dont work OB, but our charge does daily rounding too to address the pt's concerns if any and make sure their needs are being met. It seems to work well.

Not only have these moms gone through possible intense, long, painful labor/c-sections, but some are new moms that maybe need to be TAUGHT how to pick up their baby or sooth, nurse, change diapers. This is a part of the job!

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35 Posts; 2,607 Profile Views

I'm not an RN yet, but am in nursing school and working as a CNA (not OB), but often feel that the nurses do get peeved when asked to do things associated with ADL's. I know the RNs are very busy but I think it makes the patient feel really bad when the nurse won't help or makes them wait for the NA.

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babyburperrn has 10 years experience and specializes in L&D,postpartum,acute rehab/medsurg.

23 Posts; 1,400 Profile Views

I am a postpartum staff nurse that provides couplet care, and yes, I believe that the things you mentioned are a part of the job and should be done with a smile. Otherwise, these ladies would just go straight home after delivery. They wouldn't need us and we would be out of a job!

That being said, I do find it frustrating when I have a patient or family that doesn't want to learn how to care properly for their baby. I spend extensive time with my patients trying to teach them the basics they will need to know to care for their baby. Imagine my dismay when one couple I had( Postop Day 3) had avoided changing any diapers on their first baby! Yes, they admitted avoiding it to me. I made sure that they both could adequately perform a diaper change before going home!

Sorry for the small rant- I actually really love my job and my patient population is wonderful!

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cb_rn specializes in CT stepdown, hospice, psych, ortho.

323 Posts; 4,386 Profile Views

omg. we're expected to do...patient care?! What is this??

OK, I am all for prodding patients to take care of themselves when they are able but labor is called labor for a reason. I have had 3 babies and even after the 3rd one was born, I was a little slower to get up and move around than I am normally. Is it unreasonable for a tired, aching, or nervous (or all 3?!) mother to want a little help, supervision, or reassurance?

I always tried to not be a bother when I was in the hospital but just because they knew I was a nurse upstairs didn't mean they shouldn't take care of me just like I was any other patient. If anyone ever performed an assessment on me, it was observation only. I had to reset my own IV pump because the poor nurse was new and couldn't figure out how to troubleshoot the alarm and then she blew my IV out flushing just a little too virgorously but I smiled, was nice, wasn't even annoyed. I felt bad for her because I think she was nervous to be taking care of another RN and friends from my floor kept coming down to visit. She was sweet and new and I remember being a mess on the floor myself when I was new so I was sympathetic and it just wasn't a big deal.

But my son's nurse was not so nice to me...After hard labor all I wanted was an hour's nap once I had breastfed my son. I'd been up since 2 am and it was almost four in the afternoon. Didn't think it was too much to ask as I had fed him, changed him, and swaddled him for a nap. It was not shift change and I have no idea what was going on in the nursery but you would have thought I was asking the nursery nurse to pay his college tuition the way she huffed and puffed and caried on. And so I said to her, "If its really that big of a deal, why don't you just leave him here with me." She immediately lost her attitude in the room but I bet she was cursing me all the way down the hall.

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525 Posts; 6,393 Profile Views

Start rounding on the patients once a day yourself. ASK the patients what they need/want help with, and if they rec'd the help if they asked.

Tell your staff that they have these jobs BECAUSE the pts need assistance. Ask who among them (the staff) rec'd absolutely no assistance after childbirth. Tell them you are going to start rounding on the pts yourself, and every patient should tell you that the staff has met their every need.

Any pt who says the staff didn't OFFER to help, that the staff seemed annoyed about being asked to help, or otherwise reports indifference on the part of the staff -- well, you'll be noting who was assigned. If the same staff person comes up twice in XXX(you set the time period), there will be a verbal warning.

3rd incident - 1st written warning, and etc.

YOU are the charge nurse - - take CHARGE.

Not defending lazy nurses...but, there are some pts on OB...just like any floor...who are never satisifed...:lol2:

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ShiphrahPuah has 3 years experience.

91 Posts; 4,273 Profile Views

As an L&D/postpartum nurse, I would agree that you should expect your nurses to be helping patients. Yes, we do want them to become independent, but I always figure I'd rather err on the side of being too helpful than not helpful enough. Women who have had c-sections or a large perineal tear especially can be moving slowly and really do need the help. I like to take every opportunity to turn things into a teaching moment, especially for those who are very nervous about baby care. I have been told by coworkers that I am "too nice," and to be honest on super busy days I spend a lot of time in patient's rooms and may not discharge patients fast enough, but I think the postpartum teaching is very important. I was not a nurse when my kids were born, and I almost hemorrhaged at home after leaving the hospital with little teaching (and very few fundal checks while I was there).

To be honest, in this economy, there are plenty of nurses who would like the jobs of lazy nurses. To be fair though, there are times that our patient-to-nurse ratios make it very difficult to be the kind of nurse I like to be. I am not sure if that is the case on your unit, but you are correct in thinking the PP nurses should be assisting patients. Some of them might do well to float to a med-surg floor on occasion!

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