Patient types on postpartum units

Specialties Ob/Gyn

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We have a 17 bed postpartum unit where we take low risk antepartum, postpartum, well baby and gyn patients. We often back up into Labor and Delivery. A proposal has been made to include medical surgical patients to include male patients. I am trying to find standards/ethical considerations/ or other reasons why care of adult male patients on postpartum would not be the right thing to do. I have queried AWHONN and am actively searching for articles related to this.

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It wouldn't concern me that there would be male patients on the floor as much as I'd be concerned about what a general med-surg population could track into your unit. Do you really want a patient with Cdiff in a room next to a new mom & baby?

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Specializes in NICU, PICU, PACU.

Our hospital stopped this many years ago when we instituted our safe baby protocol ie infant security.

There is no where else to turf these patients too? I just don't think it is appropriate!

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C-Diff and babies.....no!!!!!!

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Specializes in Med/Surg & Hospice & Dialysis.

Our gyn pts are on a med/surg unit. I think mother/baby should be a "closed unit". If I'm inpatient with an illness I wouldn't appreciate the baby crying. I wouldn't want any infectious diseases on the mother/baby unit.

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Specializes in Antepartm and Mother-Baby.

Where I work as a PCA it's an all women unit, but we have med-surg and couplets. It drives me nuts.

Beginning in January I am switching to a different hospital that has couplets, high risk antepartums, and a healthy baby nursery. They on very, very rare occasion will get a gyn surgery pt but only if the rest of the hospital is completely full.

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Specializes in OB (with a history of cardiac).

We're a closed unit, but we have an overflow unit that's on cardiac- a wing of that unit is reserved for low-risk lady partsl birth patients only. At first I was a little skeptical, especially since this was the unit I came from and we saw a lot of stuff there, including people withdrawing from everything under the sun, to dementia patients who would scream and yell all night long. Then they said we were going to be a closed-off separate wing.

As for bringing med-surg to your floor- I'm thinking about how that would look on our floor with 21 beds and I'm thinking no. We encourage mom's to walk in the halls- especially after a c/s. We also encourage mom's and dad's to walk the halls with the babies in their little crib-buggy things. Not to mention all the people in transit from room to nursery and back. Add to it that we have a high volume of visitors- many with other kids who tend to wander out of their rooms. We allow visitors past the visiting hours time just because nobody is sick on the floor and often the visitors are very helpful for mom. To have a new mom/baby in a room adjacent to a dementia patient screaming all night would be horrible for both parties involved. I think the crying babies would become a problem as would the screaming. And as for male patients...well, even though women tend to stay in their respective rooms, there's still a lot of lady bits...especially with us being so pro-breastfeeding now.

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This is an old post, but we’re facing a similar issue and I would appreciate some insight. The proposal is to combine L&D, Recovery, Postpartum and Med-Surg. What was the outcome of this proposal at your hospital?

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.
8 hours ago, Algernon455 said:

This is an old post, but we’re facing a similar issue and I would appreciate some insight. The proposal is to combine L&D, Recovery, Postpartum and Med-Surg. What was the outcome of this proposal at your hospital?

The recommendation is that OB/mom/baby should be a "clean" unit. As such, it precludes a lot of med/surg patients. You would essentially need to have TWO med/surg units - one for "clean" patients, and another for patients that have an infectious condition. It does not make sense, fiscally. The only time it would make sense is if it's a critical access hospital that only does a handful of deliveries a month, and it's not feasible to have a separate OB unit. Out of curiosity, how many deliveries does your facility do a month?

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We usually have about 20 deliveries per month +/- 5. This is a remote location with a critical staffing shortage for both L&D and Med-Surg. Although presented as a temporary solution (not sure how long), I have a lot of concerns and want to present them to leadership. I’m looking for guidance on this subject from a reputable source, but can’t find it. I have highlighted the AWHONN and ACOG staffing guidelines, but nothing to address the combination of Med-Surg and L&D. I am also trying to find a hospital that does something similar so that we can learn from their policies, in case there really is no other option. I haven’t been able to find another hospital...

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

I'm pretty sure that AWHONN's paper on staffing guidelines does address this issue. When I'm in the office on Monday, I will look it up.

It definitely makes it more challenging to staff appropriately and meet productivity expectations when you don't have a high volume of OB patients.

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Awesome! Thank you!!

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