L&D as a separate unit.

Specialties Ob/Gyn

Published

I would love to hear feedback on whether your L&D unit is separate or are you required to to work all areas of the birthplace, ie postpartum and nursery in additon to L&D and circulate CS's and OB recovery. I work on a unit where we are required to work everywhere and most of us have our favorite area and would prefer if they separated the units into 1. L&D, circulating and OB recovery and 2. Postpartum and Newborn Nursery. We can't keep people because everyone is overwhelmed at all the areas they have to know. Many new grads we hire end up quitting because it is too much for them to absorb. I used to work at a facility that L&D is separate and that worked much better. I think staff would be much happier working in the area they like instead of being pulled all around. We do about 180-210 births a month on a 9 bed L&D unit and have a 28 bed postpartum and level 2 NICU. We do our own CS's and recover them. Our manager says we don't do enough deliveries to justify splitting the unit. Let me know how big your units are and if they are separate or you must work everywhere in Mother Baby. I would appreciate it.

Specializes in L&D,- Mother/Baby.
I understand why some people prefer the units to be separate, but I feel differently. I've done it both ways and I think it's best for patients and for the hospital for the nurses to be cross trained.

Do you have a L&D unit that labors, delivers and recovers, then the mother and baby couplet are cared for by a different group of nurses? In my unit, the same group of nurses do it all. This is good from the patient perspective in that they have the same nurse for mother and baby that they had for labor and delivery. (We work 12 hour shifts.) We staff with 3 RNs, 1-2 OB Techs and a Unit Secretary. When we have several mother/baby couplets plus inductions and/ or C-Sections, someone ends up not getting the care she deserves. When we are upping Pit q 15 minutes, it's hard to do adequate teaching, help with breastfeeding etc. If we spend much time with the mother/ babies, we can't document heart tones q 15 minutes on the Pit drips. We have no "Postpartum" staff and no well baby nursery staff. It's us. (We do have NICU that will come for C-sections and meconium deliveries, if they can.) We have CRNA coverage 24/7. We do our own C-Sections, too. The OB Techs do not apply the fetal monitor. They MAY help a patient up to the restroom but that is about as far as goes. If we had more nurses per shift, the concept may work well. I just don't see that happening. Our unit is 10 beds with 2 "triage" bays.

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Wow this is interesting to read, our hospital has not had a nursery in years! we have tons of midwifes everywhere, and the nurse's are actually treated like they know nothing when they are around. we have rooming in,, you have the baby and stay in the same room till discharge. the bed breaks down and then every thing is cleaned and you stay there with baby. we only have NICU.. and it is on another part of the hospital..!!! Nice hardwood Floors, VCR's color t.v.'s and jacuzzi in room. Marble waiting area with waterfall and snack area for families and there is even a room that says on the door--- "nipple rejection room"....I guess the babies get psych care if they reject the nipple. Sometimes I think this birthin babies thing has gone way too far..I know the breast feeding thing has... (my thoughts only)

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Specializes in Labor & Delivery.

I work in a hospital that does approx 1100 deliveries/year. Most of the nurses only work L&D but do help out in other areas of the department if L&D is slow. The majority of the L&D nurses are comfortable taking a postpartum assignment. (rarely happens) We also just hired a new grad that will be oriented to L&D only to prevent the feeling of being overwhelmed.

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Specializes in NICU, PICU, educator.

Our L/D is separate as are our postpartum short stays and our detained side (for antepartum). We have a few LDR rooms, but they usually only use those for employees that deliver there.

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Do you have a L&D unit that labors, delivers and recovers, then the mother and baby couplet are cared for by a different group of nurses? In my unit, the same group of nurses do it all. This is good from the patient perspective in that they have the same nurse for mother and baby that they had for labor and delivery. (We work 12 hour shifts.) We staff with 3 RNs, 1-2 OB Techs and a Unit Secretary. When we have several mother/baby couplets plus inductions and/ or C-Sections, someone ends up not getting the care she deserves. When we are upping Pit q 15 minutes, it's hard to do adequate teaching, help with breastfeeding etc. If we spend much time with the mother/ babies, we can't document heart tones q 15 minutes on the Pit drips. We have no "Postpartum" staff and no well baby nursery staff. It's us. (We do have NICU that will come for C-sections and meconium deliveries, if they can.) We have CRNA coverage 24/7. We do our own C-Sections, too. The OB Techs do not apply the fetal monitor. They MAY help a patient up to the restroom but that is about as far as goes. If we had more nurses per shift, the concept may work well. I just don't see that happening. Our unit is 10 beds with 2 "triage" bays.

The last unit I worked on was LDRP, so one group of nurses did it all. But, we staffed accordingly so patients got the care they needed. Active labors were 1:1.

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Specializes in 4 years peds, 7 years L and D.

We deliver about 3500 a year. Our L and D is separate from post partum. L and D does not do PP at all, and visa versa. (I am L and D) We do our sections (circulate) and recover them. We have OB techs that scrub. the techs also attend vag deliveries to assist. We have a separate perinatal unit also that we do float to (we hate to go there). We do one on one care in our L and D unit..we actually sit at the bedside. We have 15 labor rooms, one obs room, 4 recover stretchers for section pre and post ops, and 3 ORs dedicated just for us. We also have our very own anesthesia doc at our fingertips 24 hours a day. (in house..on our unit except for night and weekends when he may be off unit but still in house)

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Specializes in StepDown ICU, L&D.
We deliver about 3500 a year. Our L and D is separate from post partum. L and D does not do PP at all, and visa versa. (I am L and D) We do our sections (circulate) and recover them. We have OB techs that scrub. the techs also attend vag deliveries to assist. We have a separate perinatal unit also that we do float to (we hate to go there). We do one on one care in our L and D unit..we actually sit at the bedside. We have 15 labor rooms, one obs room, 4 recover stretchers for section pre and post ops, and 3 ORs dedicated just for us. We also have our very own anesthesia doc at our fingertips 24 hours a day. (in house..on our unit except for night and weekends when he may be off unit but still in house)

Just curious: How many L&D rooms do you have and how many nurses per shift for the labor hall that you can do 1:1 care? I wonder because we have 15 rooms and we very rarely have staffing to do better than 1 nurse to 2 patients (usually 3 is more the case).

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Specializes in 4 years peds, 7 years L and D.

We have 14 labor rooms (I stated 15 but forgot that we skipped room 13 in the numbering of room LOL). We usually have a staff of one charge nurse and 11 or 12 RNs, 2 to 3 OB techs. Weekends we have about 6 RNs staffed. IF we don't have a nurse handy, we put an induction on hold until we get one free.

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Specializes in OB.

The hospital I work at as a unit secretary has 12 L&D beds, i think 6 or so antepartum beds, and 23 postpartum beds with overflow to another floor (gyn/surgical) if necessary. L&D and antepartum and the nursery have one manager, the other units have another. I believe L&D and AP nurses float back and forth if necessary because L&D and antepartum are kind of like one unit. Postpartum nurses don't float to L&D or AP but nurses between PP and the gyn floor float if necessary; generally its the gyn nurses floating to PP. Nursery nurses stay in the nursery and don't float anywhere. It can get quite confusing. Essentially there are 4 seperate units, no one knows what is happening in the other and there is a lot of miscommunication, arguing over beds and pts, etc.

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We have 14 labor rooms (I stated 15 but forgot that we skipped room 13 in the numbering of room LOL). We usually have a staff of one charge nurse and 11 or 12 RNs, 2 to 3 OB techs. Weekends we have about 6 RNs staffed. IF we don't have a nurse handy, we put an induction on hold until we get one free.

That is fantastic for such a big facility. We do one on one too. We only have 650 deliveries/yr. I think it is great you are able to give your patients such good attention. Everywhere I have been w/ that # of deliveries, the nurses get 2 or 3 patients.

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We have 12 beds in LDRP/Antepartum. And 14 beds in PP/GYN. Plus a SCN. We circulate and recover our CS's. Nurses are generally assigned to one area. Everyone is cross trained for PP pts because we do LDRP in L&D until we are full. The new hires however, are being trained for 2 areas, either L&D/PP, or SCN/PP.

We do around 100 deliveries/month with 4 RN's scheduled in L&D.

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Specializes in 4 years peds, 7 years L and D.
That is fantastic for such a big facility. We do one on one too. We only have 650 deliveries/yr. I think it is great you are able to give your patients such good attention. Everywhere I have been w/ that # of deliveries, the nurses get 2 or 3 patients.

Our patients really love it, when they find out we sit with them they are so impressed! Plus our nurses love it, well most days. :uhoh3: Some days like yesterday I couldnt get my patient delivered fast enough. She was fine, but her DH threw a fit and I sure hated to be in the same room with him for those 4 hours in a row that I was. :angryfire

Speaking of that..I think i will start another thread on that topic...

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