I'd like to give my opinion on this topic. My background is that I have a year of experience in a very busy trauma stepdown unit with overflow of med/surg (throw in lots of psych and an underserved population to boot). On a good day you have 4 patients, on a good night you have 5. On a bad day you have 5 patients and on a bad night have 6. Trend 4-6 patients and you're good. It is a difficult floor - from the trauma/wound care to adding in psych and comorbidities - just a busy, difficult patient population. That is what I stepped into out of school. I think the difficulty of the unit coupled with the amazing team environment helped me to become amazing at time management. When I was brand new I had several seasoned nursing from other units say to me "If you can work here, you can go literally anywhere." Difficult unit. That being said, my dream was always L&D. So fast forward to a year later, I landed my dream job on L&D. We actually float to PP when we are needed there and slow in L&D. And yes, we can take up to 5 couplets there as well. Which is actually 10 patients, right? I was a little shocked at first, but my training on my trauma floor taught me such great time management that transitioning to 5 couplets was a breeze. In fact, 2 laboring patients is sometimes WAY more than 5 patient's (something I never would have believed before I had that experience myself!). However, without my previous experience I would have to say that the initial learning of how to care for 5 couplets would probably be quite overwhelming. The learning of assessments, charting and time management is a lot on 10 patients. Coming into that already knowing assessment, how to chart and how to manage time takes a load off. Where I work, they really try to staff you so that you have 4 couplets or less.
So, I know that one poster said that 5 couplets is unsafe, but I would disagree. I think it does matter what experience the nurse has and I also think that what kind of environment (co-workers and leadership) you're walking into matters as well. Being able to ask for help and get advice when you need it goes a long way. Having a tech for every nurse?? That is seriously golden. Especially if they can do things like blood sugars on babe's and 24 hour tests, etc. I wouldn't shy from the job - but again, my experience definitely colors the glasses differently for me. 😃 GL!