LDRP care setting

BETSRN · Mar 20, 2005

Helllo! I am new to this forum and very excited to be chatting with fellow nurses!!
I would like some advice....I have recently been offered a positon on a LDRP and I am very excited because this is what I want to do. I primarily am interested in L&D. My question is in a LDRP setting have others noticed whether the same people are assigned to typically the same areas or is it a fairly good mix? I am trying to decide whether this position will fit what I want to do, or if I should wait for a position at a hospital to open in L&D where the postpartum/nursery areas are separate. Any advice would be appreciated.
InfanRN

When we converted to LDRP years ago, EVERYONE had to be crosstrained to all three areas and it is still that way now when we have someone new. Everyone is all crosstrained. We all have our favorite areas and it seems that some are always doing their favorite, but that's okay. We can ALL do it if need be (including charge). We love it!

palesarah · Mar 21, 2005

Helllo! I am new to this forum and very excited to be chatting with fellow nurses!!
I would like some advice....I have recently been offered a positon on a LDRP and I am very excited because this is what I want to do. I primarily am interested in L&D. My question is in a LDRP setting have others noticed whether the same people are assigned to typically the same areas or is it a fairly good mix? I am trying to decide whether this position will fit what I want to do, or if I should wait for a position at a hospital to open in L&D where the postpartum/nursery areas are separate. Any advice would be appreciated.
InfanRN

with the exception of I think 2 per diem nurses who do not work often enough to keep up their labor and level 2 nursery skills, EVERYONE on my LDRP unit is oriented to and works all areas. No one is assigned to the same area every day unless they are orienting, although they try to assign a primary team to growing preemies in the nursery for continuity of care when we have a baby who will be staying longer than a few days (usually 2-3 primaries and an alternate nurse are assigned from each shift). So when a nurse is on a preemie team we may do nursery 2 or even all 3 days a week (most of us do 3 12's a week).

We all get a good mix of experiences each week! I love LDRP, totally the way to go IMO :)

bpobrn · Mar 22, 2005

with the exception of I think 2 per diem nurses who do not work often enough to keep up their labor and level 2 nursery skills, EVERYONE on my LDRP unit is oriented to and works all areas. No one is assigned to the same area every day unless they are orienting, although they try to assign a primary team to growing preemies in the nursery for continuity of care when we have a baby who will be staying longer than a few days (usually 2-3 primaries and an alternate nurse are assigned from each shift). So when a nurse is on a preemie team we may do nursery 2 or even all 3 days a week (most of us do 3 12's a week).
We all get a good mix of experiences each week! I love LDRP, totally the way to go IMO :)

could I ask what is your unit size? how many ldrp's do you have and do you have long term antepartum's on your unit?how do you staff in the ldrp setting, if you have a labor pt that is going to deliver do you also have other pt's assigned to you so when your pt delivers you have more than that mother/baby pair and if you have other pt's how do you acre for them when you have an active labor pt and doing the deliver an recovery of that pt?

would appreciate info.....thanks

bpobrn · Mar 22, 2005

When we converted to LDRP years ago, EVERYONE had to be crosstrained to all three areas and it is still that way now when we have someone new. Everyone is all crosstrained. We all have our favorite areas and it seems that some are always doing their favorite, but that's okay. We can ALL do it if need be (including charge). We love it!

could I ask what is your unit size?how many ldrp's do you have and do you have long term antepartums on your unit? how do you staff in the ldrp setting if you have a labor pt that is going to deliver do you also have other pt's assigned to you so that when your pt delivers you have more than that mother/baby pair and if you have other pt's how do you care for them with an active labor pt and doing a delivery and recovery of that pt?

would appreciate any info .......thanks

palesarah · Mar 22, 2005

could I ask what is your unit size?

we do approx 60-70 births in a typical month, with just over 800 for the 2004 year

how many ldrp's do you have and do you have long term antepartum's on your unit?

All of our rooms are private, and we have 10 LDRP rooms, 4 triage rooms (that are all just barely big enough for a delivery in a pinch), and a smaller room which is also technically an LDRP room but is also just used in a pinch for labor- that room is usually saved for last or assigned to a boarder baby, surgical patient, or antepartum. We do not routinely have long-term antepartum patients, maybe we'll have 1 or 2 every couple months, they seem to come in spurts. We've pretty much outgrown our current set-up and there is a remodel/expansion being planned.

how do you staff in the ldrp setting, if you have a labor pt that is going to deliver do you also have other pt's assigned to you so when your pt delivers you have more than that mother/baby pair and if you have other pt's how do you acre for them when you have an active labor pt and doing the deliver an recovery of that pt?

We usually have 5-7 nurses and an aide/unit secretary on nights. We staff 1:1 in active labor so no, I don't have other pts assigned to me if I have an active labor patient. I guess there are rare nights (like when the moon is full and there's a blizzard blowing, and everyone in town goes into labor) where we may have 2 uncomplicated active labor patients or a labor patient and an outpatient or couplet but it is only for a very short time, until staffing can be adjusted, and never in second stage- if we have a patient pushing, she is our only patient ALWAYS as per AWHONN standards.

Our nurse:patient staffing guidelines:

1:1 for active labor or c-section (we don't scrub or circulate our own sections yet, we're just there for the baby)

1:3-4 mom/baby couples, but typically more like 1:2-3 couples

1:2-3 for outpatients not in labor (SROM checks, pts with hyperemesis or dehydration, stable falls or MVAs needing monitoring, therapeutic sleepers) we try to rotate who takes them as they come in the door, especially if it's a "revolving door" kind of night. When an active labor patient comes in we adjust.

If we're taking a mix of pts a typical pt load might be 2-3 mom/baby couples plus an outpatient/observation, antepartum, GYN surgical or boarder baby.

We also have the Level 2 nursery, which can usually be staffed with 1 nurse, sometimes we need 2 nurses in there. Lately we've been staffing it with 1 very experienced nurse and one less experienced nurse to orient or build on skills. We usually have 1 or 2 stable growing preemies in there, sometimes more preemies or an unstable newborn or 2 needing a little more attention, sometimes no babies at all.

Hope I've answered your questions well enough, feel free to ask again if I left anything out