Mother/baby organization

[LuvofNursing, BSN, MSN, RN]

i will be starting my nursing career in mother/baby, and i wanted to get started on the right foot.

we have been advised that a normal day is 4 moms and 4 babies. when i did my preceptorship, you were either a nursery nurse or a postpartum nurse.... not necessarily both. so, i am wondering how a normal day would progress.

do you assess the mom and baby together or do you do all the moms first? babies first?

how do all of you do a general pp assessment or general neonatal assessment?

also, i have found a few threads talking about assessment/report sheets for m/b, but none were actually posted. do any of you have assessment/report sheets that you wouldn't mind sharing?

any information would be appreciated. thank you.

:heartbeat

[JaneyW]

I can't speak for everyone, but I do my moms and babies at the same time. I prioritize with the info I am given in report. I go around and say hi to everyone and see if they need pain meds, then I start with the couplet that needs me the most and move on. I try to have all that done by 9 am med pass and then start in on teaching (actually, you kind of teach all of the time in M/B. You may want to look into joining AWHONN (AWHONN.org). Good luck!

[LuvofNursing, BSN, MSN, RN]

thank you janeyw!

so, do you visit those who had problems with labor first (ftp, epis, etc) or a mom who had pregnancy issues first or the mom most at risk for complications?? and babies, how do you generally prioritize them?

sorry so many questions, but so little time is spent in ob, and it is so different than m/s.

i appreciate your input, and i have been a member of awhonn for about 15 months (joined 1/2way through nursing school), and i have purchased the perinatal book that they had available. i have read the postpartum section.

i have also had a hard time finding lab values for pp patients/babies.

thank you!!

[tanyalynne]

During report, you will generally get an idea for those who need assessment first. After peeking in at all the pts you will have, you will also get a better idea of those who need immediate attention. I also do moms and babies at the same time. Usually I take a quick look at babe to make sure he/she is stable, then a good head to toe on mom. After which, I typically assess baby. Good luck!

[McBx3]

Just following this thread b/c I tend to apply for a MB job soon :)

[NurseNora, BSN, RN]

When you start working, you will have a preceptor to help guide you. During that time you will begin to get a feel for who needs to be seen first. If all other things are equal, I start with the room farthest away and work back to the desk. When you make your first rounds you will get a feel for who will need the most immediate assesment.

Some things that would be a priority: very young mom, breast feeding problems, fresh C/S, increased bleeding, mom not showing signs of bonding, history of drug use, patient with greater than usual pain. These are just a few.

I usually do my assesments of mom and baby at the same time. I hate to separate mom and baby. You can do a lot of teaching while you're assesing the baby. You can show mom how to do cord care, how to swaddle tightly and why to do so (babies like it), normal reflexes, the list goes on forever. I work nights and when I do my second infannt assesment, I usually do that in the room too. Most of the other nurses I work with will take the baby to the nursery for the midnight assesment. Recently I've rethought that position. In the morning, with the sun coming through the window I noticed that one of my babies looked like a carrot. I don't turn on really bright lights in the room at night during the repeat assesment, but I'm sure If I had or if I'd taken the baby to the nursery where the lights are bright I would have seen the jaundice sooner.

Anyway, good luck. You are not expected to be an expert immediatly. Use your preceptor, ask questions, ask for feed back, give your preceptor feedback about what she does that helps you learn and what doesn't.