Looking for info on antepartum units

rn/writer, RN · Jul 29, 2005

Let me clarify. I'm open to hearing from anyone who has any kind of antepartum experience, not just someone who works an antepartum unit exclusively.

I don't want to spend a year or so, waiting patiently to look into antepartum with a clear conscience, only to find out that it really isn't what I thought it would be. And I have no other way to find out anything now except to ask here.

I'd be grateful for any information.

Thanks,

Miranda

SmilingBluEyes · Jul 29, 2005

I do LDRP, myself. So I do it all...not sure I can help you much here. I am sure there others who work at larger hospitals that can more accurately tell you what you need to know. Good luck.

mstigerlily · Jul 29, 2005

I am interested in hearing from others on this thread too! I also am a new grad working on a busy postpartum unit at an urban hospital. Our units are separated: mother/baby, antepartum, L&D and there is no floating or crosstraining but I would love to learn more!

Melissa

I started on a great postpartum unit about two months ago. I work noc shift in a busy urban hospital and have had a good experience so far with classroom time, floor time, and a great main preceptor.
The thing is, I don't know if I want to work this unit forever. I think I want to end up on antepartum eventually, but I'd like to hear from those who know something about it.
I like postpartum and plan to work there a while. But other than the occasional melt-down, very few of our well mom/well baby patients have emotional needs that are not being met by their own support system. Last week, we had a Perinatal Principles class that covered high risk moms, perinatal risk and loss, and familiy-centered bereavement support. I felt like those were areas I could work with till I finish my nursing career. I have years of psych background (working it, not needing it . . . although . . .), personal and professional experience with grief and loss, training as a treatment foster parent, etc, and felt drawn to a unit where my emotional skills could be as useful as my nursing ability. I should also mention that unwell moms and moms of unwell babies are sent to antepartum, not postpartum at my hospital. Just about anyone who comes to my unit is tired but generally okay. Yes, there are those who needed social services and the occasional psych consult but most of what we do is physical care and a ton of teaching. This hospital delivers 5000+ babies a year and antepartum, L&D, and postpartum are completely separate units.
I'd like to find out more about antepartum and would love to be able to eavesdrop at my own hospital but there is virtually no cross training and even floating is rare. I don't want to appear ungrateful for my current job or give the impression that I am thinking of bailing on them in the very near future so my information-gathering options are limited.
Here are some of the things I'd like to know. What kind of staffing ratios are considered the norm? What kinds of patients come to antepartum? What do you like most/least about the unit? In addition to learning about FHM and tocolytic and anti-PIH pharmacology, what other kinds of training might I need to make the transition?
I'm sure there are other questions I should be asking--feel free to share anything that seems important.
Again, I feel very blessed to have found my current job and intend to keep it in the short term. But I'd like to know if antepartum is something I should eventually aim for or if there are things I need to know about it that would tell me it isn't the right place after all. I'm hoping it is a good fit down the road.
Thanks for your help,
Miranda

kellyo, LPN · Jul 29, 2005

I am interested in hearing from others on this thread too! I also am a new grad working on a busy postpartum unit at an urban hospital. Our units are separated: mother/baby, antepartum, L&D and there is no floating or crosstraining but I would love to learn more!
Melissa

Same! I just finished up on a PP, Antepartum and gyn surgical floor in clinicals. I absolutely loved my high risk anepartum patients and am very interested in this field of nursing...

RNnL&D · Jul 30, 2005

Here are some of the things I'd like to know. What kind of staffing ratios are considered the norm? What kinds of patients come to antepartum? What do you like most/least about the unit? In addition to learning about FHM and tocolytic and anti-PIH pharmacology, what other kinds of training might I need to make the transition?

We keep our antepartum patients in L&D; PIH, PTL, post MVA, pyelo, Previa, mild abruption, oligo, etc. We are required to have EFM, NRP, and ACLS. We generally due 1:3 at most, if they are stable, usually an ante with a labor, or PP patient. If it's an unstable preeclamptic, it's 1:1. We do AP, L&D, and PP together so I can really say what I like most or least. All of our L&D nurses are crosstrained to PP. Some of our PP nurses are cross trained to SCN. And all of our new hires are required to be cross trained in at least two, if not all 3 areas.

mugwump · Jul 30, 2005

I've work on an antepartum unit for 5 years separate from L&D. We have 16 (monitered beds) beds with centralized EFM and 14 non-monitered beds (beds we can wheel around a moniter for NST's and non-continuous monitering. Staffing is done by acuity although pretty much every nurse on the monitered side has 4 patients while a nurse on the non-monitered side can have up to 5 patients. Each patient is assigned an acuity Single or IMC. an IMC patient for instance could be (someone in their first 48 hours on magnesium for PTL, continuous EFM, any PIH on magnesium(thought is they only get worse not better) sometimes it is also nursing judgement to be IMC someone who is for some reason taking a lot of time, for instance we had a pregnant mom who had cancer who was working through feelings getting pain meds TPN, a port a cath and some days chemo.

I love it I am challanged as a nurse. I see pregnant concerns, PIH, PTL, HELLP, fatty liver disease, twin to twin transfusion, IUGR, one twin died in utero the other baby is born 2 months later. Two moms with cancer, lots of pyleo's, hyperemesis, The single most thing I like about my job is getting to know the patients. It helps me do my job, there have been many times that i have noticed something "off" before anything becomes physically clear. I have moved on my "gut" feeling that something wasn't right and most often I am right. This is made possible with knowing your patients. It is a lot easier to do if you have cared for them for a month than if it the first time you see them. I wouldn't trade it for anything in the world.

I do however need to add a side note. I love antepartum and long-term that is where my heart is. I am going to transfer to L&D soon not that i don't think I'll like it, but I want the experience. I do know that where I work I will make a much better L&D nurse with my Antepartum experience.

SmilingBluEyes · Jul 30, 2005

Wow mugwump, you gave an excellent clinical picture of how Ante works----thank you. I have never worked in a unit like yours, but just based on your thorough description, I can see very clearly how it works.

judyblueeyes · Aug 1, 2005

Wow mugwump, you gave an excellent clinical picture of how Ante works----thank you. I have never worked in a unit like yours, but just based on your thorough description, I can see very clearly how it works.

I'm also in an exclusive APU unit. We have 30 beds. Ours are all private rooms and most rooms provide and extra bed for the family. We keep an extra 'fridge and small kitchenette for the fanilies to use.

Our pts most commonly have PIH, brittle diabetes, PTL, PROM, multiples or high-order multiples, hyperemesis, or may be getting or have gotten a cerclage...stuff like that.

They stay with us for as little as a few days or as long as 4 months.

The patient's all get very frequent EFM (as few as two or as many as six unless they are continuous) and PO med or mag.

Staffing is generally 1:4 and sometimes 1:3 or 1:5 depending on acuity. 1:1 goes to L&D.

New nurses must complete the AWHONN EFM course (hospital pays) and complete a minimum of 3 months orientation which can be extended (without recrimination) as needed until she is comfortable and competent.

rn/writer, RN · Aug 1, 2005

Thank you all for your replies. The more info I get, the more I think AP is where I want to end up long term. I'll miss the bambinos but maybe I'll get my fill during the next year. That's how long I figure I'll have to wait to fulfill my obligation to the postpartum unit I'm on now.

That's another question. Do you think a year is sufficient time for me to wait before openly expressing a desire to look into AP? I don't know how often 8-hour noc shift openings come up on AP. It could be longer than a year. But that seems a respectable minimum to me. Any input?

I really appreciate the detailed answers on staffing ratios, patient acuity, and other details. I'd love to do a stealth job-shadow but I think I'll just bide my time and learn whatever else I can discreetly.

Thanks again,

Miranda