My patient dropped her baby!

Specialties Ob/Gyn

Published

I took care of a patient today who was post op day one still on a PCA. I went in this morning and said hi. We chatted for a minute because her older daughter was the same age as my daughter. Then she asked for her baby from the nursery. I had someone bring her the baby. Then I continued on my rounds.

About 45 minutes later I heard a cry from the hallway. I ran into the room and the patient was hysterically crying holding her baby. She was crying, "They left me alone! Why did they leave me alone?" She said she was sitting in the chair holding the baby when she suddenly dozed off and the baby rolled onto the floor. I grabbed the baby and brought her to the nursery.

The baby was fine but when the patient's husband showed up he was ******. He said, "How could you leave her in the room alone with the baby? She was on morphine. She can't take care of the baby by herself." He made a big stink about it. Supervisors were involved. I was up to my knees in paperwork. Now the nurses are starting to question non-separation. But have you ever had a mother drop her baby on postpartum? Who's ultimately responsible when a postpartum mother drops her baby?

Specializes in OB.

Okay, now how do we reconcile "never leave the mom alone with the baby postop" (sensible by the way) with "Baby Friendly" initiatives to never separate mother and baby and the trend NOT to have a normal newborn nursery? Unless you want to staff to be able to have 1 to 1 care.

Okay, now how do we reconcile "never leave the mom alone with the baby postop" (sensible by the way) with "Baby Friendly" initiatives to never separate mother and baby and the trend NOT to have a normal newborn nursery? Unless you want to staff to be able to have 1 to 1 care.

Exactly. That's what we're pushing for in our hospital. So how do we have non-separation with 7 couplets? We can't be 7 places at once.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Okay, now how do we reconcile "never leave the mom alone with the baby postop" (sensible by the way) with "Baby Friendly" initiatives to never separate mother and baby and the trend NOT to have a normal newborn nursery? Unless you want to staff to be able to have 1 to 1 care.

It's definitely a tough one. The only solution I can come up with is that mom needs to have another adult in the room with her at all time. I dunno.

Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
Exactly. That's what we're pushing for in our hospital. So how do we have non-separation with 7 couplets? We can't be 7 places at once.

You're joking, right? 7 couplets per nurse?

Okay, now how do we reconcile "never leave the mom alone with the baby postop" (sensible by the way) with "Baby Friendly" initiatives to never separate mother and baby and the trend NOT to have a normal newborn nursery? Unless you want to staff to be able to have 1 to 1 care.

From my experience, the vast majority of women have some support people in the room… especially when they're still on a PCA. But, yes, the AWHONN guidelines and Baby Friendly initiative do not always gel… the beginning of that same paragraph states,

After cesarean birth, patients need assistance with newborn care, especially in the immediate recovery period. They should not be required to keep their babies in their rooms if they do not feel up to it and/or a support person is not available to stay with them.

IMHO, we have to use our best professional judgment for the situation. I personally would want to make sure that my pt. has a support person in the room if they're on a PCA or have an epidural, and I can site AWHONN guidelines for a reason if I bring baby out. But, if they're on percocet I'm going to use my professional judgment and if I feel like they're safe then I'll just make sure I'm rounding on them regularly and watching out for problems.

You're joking, right? 7 couplets per nurse?

You think that's a lot? I work day shift. The night shift is worse!

Good grief. You'll get in more trouble not leaving babies with mom. How can anyone supervise 7 mom's at once. Impossible.

It's definitely a tough one. The only solution I can come up with is that mom needs to have another adult in the room with her at all time. I dunno.

That's what my colleagues were saying. The husband didn't come to the delivery. He showed up for a few hours after he got off work and then went back to work the next day so she was alone all night. She spent most of her hospital stay alone. He left work when she dropped the baby, complained for about an hour and then went back to work. I guess that's why this has never been an issue before. The family is usually around. It's unfortunate that her husband couldn't take off from work to be with his wife and newborn. I

7 couplets +.... (((Shudders))). Totally unsafe... that's why AWHONN came out with their guidelines!

Dont you you have any other options? Working at a hospital like that is putting your license on the line... not to mention putting the patients at risk. How can you possibly do all that you are supposed to do?

7 couplets +.... (((Shudders))). Totally unsafe... that's why AWHONN came out with their guidelines!

Dont you you have any other options? Working at a hospital like that is putting your license on the line... not to mention putting the patients at risk. How can you possibly do all that you are supposed to do?

Luckily I don't work here. I'm a traveler. And I'm an L& D traveler at that! The staffing is really bad at this hospital. There are only 2 postpartum nurses for an 18 bed unit during the day. I've seen a few times when the census is 10 or less and there'd only be one night shift nurse. Can you imagine 10 couplets and you're by yourself???? I'm out of here in a few weeks. I can only pray things get better here after I'm gone.

Specializes in OB.
Luckily I don't work here. I'm a traveler. And I'm an L& D traveler at that! The staffing is really bad at this hospital. There are only 2 postpartum nurses for an 18 bed unit during the day. I've seen a few times when the census is 10 or less and there'd only be one night shift nurse. Can you imagine 10 couplets and you're by yourself???? I'm out of here in a few weeks. I can only pray things get better here after I'm gone.

I'm an L&D traveler also and would really appreciate a private message as to where this is - I want to be sure I never go there!

I'll understand if you want to wait until you finish to name the place, even in a pm.

Specializes in Reproductive & Public Health.

SBAR: S- mother holding a baby, B- she just had the baby, A- she's holding the baby successfully, seems to be doing a good job of it... for now, R- we just don't know what could happen, recommend we administer the AHBE test (Ability to Hold a Baby Exam), provide safety cushions, and q 1min. safety checks until discharge, when continuous home safety monitoring can be arranged until adulthood.

hahahahaha! q1 minute safety checks. I love it.

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