Question about xfer of pt from ldr to pp - page 2
I am curious as to how other hospitals handle transferring Mom and Baby from L&D to PP after delivery. How long are Mom and Baby in L&D after delivery and what is the procedure for transferring a... Read More
Aug 25, '02Joined: Apr '02; Posts: 38,756; Likes: 16,283I work in LDRP model......and also LDR, and PP. I stronly perfer LDRP and couplet care model! It avoids all this stuff you are speaking of here. Just my opinion.
Aug 26, '02Occupation: registered nurse Joined: Nov '01; Posts: 1,083; Likes: 14the hospital i was at if the pt was a vag delivery with no complications we kept her 1-2 hours then we would call pp floor tell them we were coming and what room they wanted her in. we personally brought pt to room and gave report personally to recieving nurse. I would give her one last check of fundus and bleeding with pp nurse there just to verify basic report.
where i am at now we are LDRP so we don't have to transfer,
Aug 26, '02Occupation: RN Joined: Aug '02; Posts: 129; Likes: 13I like the idea about the L&D nurse checking the fundus with the post-partum nurse when the patient arrives in her room. I can't tell you how many times I have received a pt still numb from epidural whose fundus is up 4 when the report I received was that she was 2 below. Usually, it is a scrub tech or CNA who brings the pt to the PP unit so I can't verify my findings with the L&D nurse in person. Not all of the L&D nurses send their pts to me like that and if I get a pt who needs cathed and I am getting 1000cc's of urine within 5 minutes of her arriving on the unit, I write it up.
When I started working in L&D last year, I hoped that I could change a few attitudes there and educate them about why the PP unit does what it does. I found that the nurses who always sent there pts to PP in good shape already understood and the ones who sent pts to PP with full bladders, bloody gowns, dry IV's or not medicated for pain (your PP nurse will get that for you when you get to your room) still don't have a clue.
Unfortunately, L&D nurses are in high demand around here and the clueless ones don't get so much as a talking to about how they do things.
Our hospital is not set-up for ldrp's and would require MASSIVE renovation to make it possible. I think I would like ldrp. The reason I work L&D and PP is because I like taking care of both kinds of pts.
Aug 27, '02Occupation: R.N. Specialty: 27 year(s) of experience in cardiac, diabetes, OB/GYN ; Joined: Feb '02; Posts: 1,947; Likes: 418We give them at least an hour and often more than that. Doesn't matter if they want to come over by wheel chair. We give them the option. If we aren't horribly busy we admit baby and mom in delivery and do the orders for the poor post partum person, who is, most likely, delivery backup for the night. Really don't want to offend someone you may be begging to come over and assist. C/sections are at least two hours and maybe a little more if general since the pacu nurses get called in for general, much to their dismay.
We like to get them in and out of delivery, and, though it isn't a requirement to have them pee before going over, I won't send someone over who hasn't urinated, either via straight cath or naturally. I will show them how to set up and do their first sitz bath in delivery so I can be sure they get that done, and I will teach peri care and all that stuff so they at least know the basics...
I get them in and out as soon as they are stable because lately, on our night shift, there isn't any environmental service department, so I will also have to clean up. Not a good thing when people are showing up like we have revolving doors...
Aug 27, '02Occupation: R.N. Specialty: 27 year(s) of experience in cardiac, diabetes, OB/GYN ; Joined: Feb '02; Posts: 1,947; Likes: 418I hate couplet care. Hate it hate it hate it......That said ( and no, I will not reverse my opinion), I will call and also tape report on their tape recorder so they don't have to do anything else but add on in the morning. I have had people drop patients in on me when I have told them I am not ready to take one. Never happens more than once. I am not shy.......
Aug 27, '02Occupation: registered nurse Joined: Nov '01; Posts: 1,083; Likes: 14i agree mother baby, i never send a pt out that has not voided or been cathed, all my pt were taught peri care and how to breastfeed at least once before they got to leave, that is if they were breast feeding. I also changed their gown and pad and did peri care and last assessment before sending them over. Oh and they also got sent out with their ice pack in place.
I really liked to go with my patient that way it helped with continuity of care, and it allowed PP nurse to verify what i was telling them was correct and unchanged. it allowed them to ask any questions i may have missed. i think it is also a nice gesture to the patient from me that i would take the time to personally bring her over to new room.
I release no Pt before they are ready and i have meet all their needs to the best of my ability,
Aug 28, '02Occupation: Level II Nursery RN Joined: Aug '01; Posts: 265; Likes: 3I think that in a busy hospital we all need to work together. I don't get excited is GBS protocol wasn't started. I just want to know so I can draw the CBC and culture.
I am very careful not to create friction between L&D, nursery and couplet.
Aug 28, '02Occupation: rn Joined: Dec '00; Posts: 75; Likes: 1We usually kept the pt 1 hr post delivery- we'd feed the mom( if she wanted- very few didn't!!!) and after she was stable and her VS x4 were completed, we'd ambulate her to the shower. If not steady enough for a shower, quick bed bath, to the BR and pericare. We'd then transfer to PP via wc. We always gave report-either in person or by phone.
Aug 28, '02Occupation: L&D RN Joined: Apr '02; Posts: 956; Likes: 3All this has made me very grateful we do LDRP/couplet care! We take care of our delivered couplets for the remainder of the shift unless we're short on L & D staff and doing the revolving door thing.