L&D and PP - same or different floors?

3 of 4 places I have experience with were smaller size community hospitals, and so did LDRP----labor/delivery/recovery and post partum in the same room........and it's how I like it. THe bigger one was a teaching hosp and they did separate labor/delivery and postpartum units. Each flanked the NICU/Nursery on the 3rd floor of the hospital. I think they did about 200del/month....

Anyhow you will notice the larger hospitals do separate Mother/Baby and Labor/Delivery units and the smaller ones tend to do single-room maternity care (LDRP). Some prefer the first; others like me, the latter.

In the (large teaching) hospital I work at L&D and Maternity Urgent Care is on 8th floor, Mother Baby is on 9th, NICU on 8th (the opposite tower from L&D) and antepartum is on the 12th floor.

So a preterm labor patient could go into the emergency room on the 4th floor, be transfered to MUC on the 8th floor, be transfered to the 12th floor (ante) for observation...live there for 3 weeks, transfered down to 8 for labor and delivery, then do to 9th floor for PP, while preemie baby is on 8th.

OR a cervidil induction checks in on 12 where the cervidil is placed. Down to 8 when the resident sees significant cervical changes. Then they stop progressing, so back up to 12 to be re-cervidiled....then down to 8 when ready to really labor. Then 9 after they've delivered. Unless 9 is to busy! Then they might end up back on 12 with the baby still in the NN on 9.

Confused yet??

Happens *all the time*. Well, minus the ER. Most ob pts just go directly to the MUC (which is really part of the L&D unit). But all the shuffling thereafter is so real.

And it's a real PITA--not to mention a danger--to bring a hemorrhaging abruption from the 12th floor to the 8th floor when minutes count and an elevator takes at least 2 on an excellent rare day.

Thank god we're getting a new "womens health pavillion" (or is it "centre"? they're still deciding) where L&D, PP/MB, Ante and NICU will all be on one floor. I just worry where the TOPs, IUFDs and neonatal deaths will go--I'd hate for them to be in ante down the hall from the NN. And most don't like the gyn floor because there's so many infections going around....

Kelly

The hospital where I had my kids has L/D and PP on the same floor. Those were the only things on that floor. The nurses said that it was nice because they could lock the floor down if need be (baby alarm, etc.) because there was only one elevator and stair case to worry about. It was also nice for patients because it was easy for visitors to find you.

Both of the hospitals in my town have LDRP units. The one where I just finished my preceptorship does about 1,000 deliveries a year, the other probably does about 1/2-2/3 that amount. (In my vast experience - LOL) I like it that way, I think there is more continuity of care.

At our hospital it is Labor and Delivery in one unit, with Newborn Nursery connected. You then go out double automatic doors and go to the PostPartum unit on the same floor. However, the PP unit also houses overflow Med-Surg patients, so...never know what you will have out there. I have dropped NG tubes, worked with chest tubes, had CPAPs, admin TPN, blood, gammaglobulin, dealt with epidurals and on and on and on... A lot of different experience although Joint Commission really beared down on the "infectious patients" out there with the moms and babies.

I have serious issues w/postpartum floors that take medsurg patients. Did it myself and it's not good. Another reason I prefer LDRP.

I have serious issues w/postpartum floors that take medsurg patients. Did it myself and it's not good. Another reason I prefer LDRP.

I do too, but it doesn't seem that my opinion counts a whole lot... Just add it to the list of things I have an issue with.. lol