LDRP opinions or advice?

babyktchr, BSN, RN · Apr 16, 2008

I work in an LDRP and it kinda depends on the number of deliveries you have to determine if it is right for you. We find , for the most part, that it works...though we have been so busy lately that the moms/babies get moved to the unit up the hall (part of our unit as a whole). We do get jammed up quite often, not having labor beds because all of our spaces are full. If we are busy, and I have labored the patient, then a mom/baby nurse will take over the care. If that is my only patient, then I try to keep that patient until a new laboring patient comes.

3-4 couplets is the standard according to AWHONN. It isn't a difficult load, and often times we do have more, again depending on the census.

BlueRaiderBSN · Apr 16, 2008

Thanks for the reply, I thought that crowding might be an issue.

The hospital I'm going to tries to maintain the 1:4 couplet ratio. Glad to hear that is a feasible pt load. I thought nurses who had not been in LDRP may be used to having a nursery, I was wondering if it was a big change. I guess it wouldn't take long to refamiliarize yourself with caring for the newborn.

So, the unit functions well together? The units I've seen (separate) dont communicate well between L&D/PP.

mommy2boysaz · Apr 17, 2008

LDRPs are the only thing I've ever worked with, so I don't have the opposite experience to compare, but I can't imagine working any other way. I admit a woman, labor her, deliver her, and care for her and her baby until dismissal. Can't get any better continuity than that!:wink2:

I would be bored, I think, if I only worked in one of those areas all the time. It's nice to get the chance to do it all. As nurses, we kind of take turns taking the labor patient. For instance, if I had a labor and delivery last night and tonight we have one in labor and a few postpartums, I'll take the postpartums tonight and the other nurse will take the labor. If another labor comes in, I'll probably take it. We just try to split the labor that way. We're a small unit and work pretty well together most of the time.

There are some cons to LDRPs. :down: When we get really busy, we don't have the staff necessary sometimes. Plus, we don't have designated nursery staff and no NICU, so if we get a mildly sick baby that needs to be in the nursery, that immediately requires one nurse to remain in the nursery. We usually only have 2 nurses and 1 aide on per shift, so if 1 is in the nursery... that leaves 1 nurse to do everything else! :uhoh3: That's when we get on the phone and start begging people to work extra shifts!

I'm sure there are different issues wherever you go.

Overall, I love working in an LDRP unit:heartbeat!

Good Luck to you!

BlueRaiderBSN · Apr 17, 2008

it sounds like you have had a great experience. how big is your unit?

i will actually be starting in an ldrp unit this summer and just wanted to know what i was gettin myself into:)

i'm sure there are pros/cons everywhere, but it sounds like you're saying why work strictly in ld, pp or nursery when you could really work in with families in all three capacities?

one hospital i interviewed with said that the ldrp concept is on the way out; is this true?

Elvish, BSN, DNP, RN, NP · Apr 17, 2008

one hospital i interviewed with said that the ldrp concept is on the way out; is this true?

don't think so. think it depends on where you are.

what a lot of hospitals are doing, and this may be what the hospital you went to is referring to, is ldr and then strictly couplet care afterward, no nursery. or maybe a nursery but still encourage rooming-in.

NurseNora, BSN, RN · Apr 17, 2008

I worked just L&D until I moved to a small rural hospital about 5 years ago where LDR is practiced. I wasn't thrilled about being expected to do it all, but this is the only hospital in the community. So, with the understanding that I would happily do couplets, I would not be expected to stay in the nursery or work with infants even a little bit sick, I started working LDRs. I was surprized to discover that I love it. Everyone has their individual strength and likes, but when the pregnant bus pulls up, everyone jumps in and helps everyone else. L&D is still my favorite, but I've found that I also enjoy couplet care. I've always liked teaching and teaching is such a huge part of post partum care. I really like it that we're all a very close knit group without the usual gripping between nursery, PP, and L&D that I've experienced elsewhere.

Give it a chance. You may find yourself as happily surprized as I was to find how enjoyable it is.