Bedside handoff report on mother/baby unit

Specialties Ob/Gyn

Published

I work on a postpartum unit where we do couplet care from 7 am until 11 pm. At night however, the nursery opens and the nurses there get a patient ration of 6:1 and the nurses on the postpartum unit do likewise. At 7am we go back to couplet care. What we have been doing is that the mom's nurses tape report for the oncoming shift then the nursery nurses come in and give the oncoming nurses report on the babies. Because the nurses on postpartum at night will have to give report to several different nurses on daylight because their assignment needs to be broken up, we have found that the taped report does the trick. All oncoming nurses then listen to the tape at one time and are done in a relatively short time.

We just got a new manager. She wants us to begin doing bedside report. The problem with that as we see it is that many patients have social issues which can not be mentioned at the bedside. If we chose to give a cut and dry report minus the social issues at the bedside then we'd still have to come out of the room and finish the rest of the report in the hall. Now imagine this happening where the night shift offgoing nurse has to report off to 2 or 3 separate nurses and then the baby nurse has to repeat these same steps to report on the babies.

Another problem we see in this approach to reporting off is that, depending on the time, some of these patients are trying to sleep after a day of visitors, fussy baby, etc. It seems like this kind of reporting will take a whole lot longer and could potentially cause frustrations in our patients. The part about this taking a lot more time is important because this new manager is adamant about people leaving on time.

Are any of you doing this at your hospital? If so, what makes it work or not work, in your opinion?

Hmmm at our hospital couplet care is 24 hrs meaning babies only go to the nursery if there is something wrong or if mom requests it. The mother-baby nurses are responsible for 3-4 couplets every shift. We do report then go to rooms to introduce on coming shift. 2 couplets is a slow day for us!!

This is totally us as well.

I think the switching back and forth between couplet and nursery is a bit odd. Do you force your moms to send the baby to the nursery? If mom IS keeping her baby in the room overnight, I'm assuming then both the PP RN as well as the Nursery RN would have to check in with her for cares which would increase the amount of interruptions at a time when they should be minimized.

I would MUCH rather have 3 couplets than have 6 moms to care for.

We're working toward baby-friendly status now so we are supposed to encourage not sending the baby to the nursery also. However, as someone who's had 3 babies and DID send them to the nursery between feeds (and still successfully breastfed for roughly 18months each), I might be a little ticked off if I got a lecture (even a polite lecture) against this. Yes, moms DO need to sleep and this is the only opportunity to do so. They're not going to be able to send their baby off when they get home so why not take advantage of it for the 2 nights they can. Many moms have been awake for well over 24hrs and even the normal little whimpers of a newborn can be hard to sleep through. Just trying to give you a mom's take on this.

A few thoughts from a pp unit who is quite nearly certified baby friendly-

We regularly do bedside report, handing off a 4-5 couplet assignment to multiple nurses. It is nearly always done in half an hour. We only don't go bedside for the report if the pt refuses or if they are asleep. It is completely doable!

The portion of baby friendly which includes making rooming-in the routine recommendation rather than routinely bringing babies to the nursery has changed our unit for the better.

We never, ever tell a mom that the nursery is not available. It is just not routinely recommended. It had led to a more judicious use of the nursery- we watch the moms, try to intercept before there are tears, panic, etc, and offer the nursery in these sorts of cases. I would never suggest it if a mom has good support and is feeling fine. Then moms go home knowing so much more about how their baby is, 24 hours a day. We often have nights with an empty nursery. But all our moms are aware that they may request the nursery, however, I will try to help them settle their baby down first. Without a lecture on rooming in, of course. No lectures around here.

When I had my first, we were feeling fine but our baby was brought to the nursery overnight and out for feeds. I didn't know any different and didnt question it. And I did get some sleep. But I brought that kid home the first night and had NO IDEA what to do with him. I just thought he would go to sleep or.... something... In my opinion, it is better to have the nurses teach the parents how to care for their infants 24 hours a day. The time for solid sleep has passed when the baby is born.

Specializes in L&D, High-risk AP, rural hosp..

We closed our nursery (mostly for staffing reasons) about two years ago and have found very few complaints from patients. Our PP nurses take 3-4 couplets and we do bedside report. First, the off-going nurse writes a shift summary that is printed (patient status report) and given to the oncoming nurse in the report room, where we have a brief (5-7minute) unit report from the charge nurses (these two things usually includes any pertinent issues like social issues, etc). The off-going nurse stands in front of the rooms she has and waits for the starting shift to find her. This can take some time, since nurses are usually assigned any patients they had the day before (if possible) so they don't always match up to the oncoming nurse. For the most part the nurses are able to get out on time. We have complained that it is inefficient and rude to wake the patient in the morning, but management says that bedside report is a JCAHO expectation and it will NOT be going away, so we do our best.

Specializes in Obstetrics.
We closed our nursery (mostly for staffing reasons) about two years ago and have found very few complaints from patients. Our PP nurses take 3-4 couplets and we do bedside report. First the off-going nurse writes a shift summary that is printed (patient status report) and given to the oncoming nurse in the report room, where we have a brief (5-7minute) unit report from the charge nurses (these two things usually includes any pertinent issues like social issues, etc). The off-going nurse stands in front of the rooms she has and waits for the starting shift to find her. This can take some time, since nurses are usually assigned any patients they had the day before (if possible) so they don't always match up to the oncoming nurse. For the most part the nurses are able to get out on time. We have complained that it is inefficient and rude to wake the patient in the morning, but management says that bedside report is a JCAHO expectation and it will NOT be going away, so we do our best.[/quote']

Sounds very similar to us except we have a nursery and it's huge... :-/

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