momredman

In 22 yrs. I have seen my fair share of bad, butchered and bleeding cirs's. The worst case senerio was a fairly new ped, who uses the mogan clamp device cut the tip of the head off. Talk about a horrible mess, not just for the nurses but the baby and his parents. A nice urologist showed up to save the day. One of my coworkers also worked in the peds office and she said within a few months new tissue granulated in and his member looks perfectly normal now. But due to the 70% medicaid pts. circs are not paid for in the state of MO. This has sharply cut into the number of circs done. And its fine by me.

WE also have and infant security system, that lock the doors if trying to exit with a baby and sets off an obnoxious alarm, it is also tied into the hospital operators system and an overhead page goes off anouncing a code black (Infant abduction). But we are still required to chart every two hours. And with a load of 6 or more babies and attending C/S or deliveries, it keeps us very busy.

Our current OB unit has just been informed by our new team leader, we are going to start mother baby nursing the first of June. The unit is built with 15 separate LDRPs a newborn and Nicu nursery and an 6 bed outpt area. We currently have 130 deliveries a month and see around 300 outpts. Mother baby has been attempted twice in the last 20 years but was unsucessful. She has proposed no guidelines, just that we are doing this to help with the staffing shortage. We currently have 7 RN's who work day shift in the nursery and 15 LDRP nurses. The proposal is for the nursery nurses to take over the postpartum care as well as the baby care. Most LDRP nurses are not crossed trained to well baby care. I guess my question is what is the current ratio of mom-baby couples and where do high accuity pts such as new c/s and tubals moms on mag etc fit in? The nursery nurses at varies times have taken care of normal pp care, meaning normal uneventful vag. deliveries or post 24 surgeries. The computer charting system is totally different from what is used in the current nursery setting. She feels 4 shifts of training in adequate. I have the feeling we could be headed for disaster if not implemented correctly. Not to mention we also have our own surgical suite where we do c/s, tubals, s/c and d/c's. We have no techs. My last question who attends the deliveries if we are involved with couple care, and takes care of the NICU babies, does hearing test and helps physicians with circs or other procedures. Looking for answers. Thanks

I just joined your little group today and looking forward to asking questions and getting suggestions concerning and upcoming change to our Ob unit. New team leader to solve staffing has decided we should convert to a mother-baby unit even though the unit of 10 yrs was not designed for that style of nursing. The idea was tried twice in my 22 yrs of nursing and did not work. Our unit currently delivers 120-140 babies a month with at least a 30% C/S rate. We currently have 15 ldrp's and an out pt area which sees 300 outpt. a month. We are a level II nursery and most of the time we are full and send inductions home until bed space allows. We have 7 newborn nursery nurses on day shift and 15LDRP, a third of which is crosstrained to normal newborn nursery. The current solution in the air is to have the 7 nursery nurses do mother baby freeing up the L&D staff. I guess my question is what is the nurse ratio to mom-baby couples, who does the delivery and responsible for the newborn, who takes of NICU babies, and how much cross training is given to care for normal mothers? Our leader seems to think 4 shifts is even training to learn care of babies and mothers. I am trying to keep an open mind because couplet care will work in certain situations, but what happens to the patients who fall thru the cracks like new c/s, tubals, moms on mag, situations where mom is unable at the time to care for newborn and needs, a lot of care herself. Would appreciate any suggestions. Dumbfound in Missouri