TOO soon to be Stressed in Postpartum

[maesam1]

I have been on a mother baby unit and well baby nursery for 3 months, For the most part I like the staff, the patients we care for and am very eager to learn. However since I started all the nurses complain all the time about staffing issues. I decided to still give it a try, I have been off orientation for 2 weeks, I have been charge nurse twice, and this pass week I was on the floor with an agency nurse, we both started off with 7 couplets, and by the morning we had 6 admissions, she had a total of 20 pts, and I had 19 bc one was an antepartum. I feel really discouraged and don't want to continue this way, this is a constant problem and the nurses on my floor deal with it and just see it as the "norm" One nurse told me well thats not too bad the other night we had 12 couplets each..

[Dolce, RN]

Oh my goodness! 7 couplets!!!! Yikes! I wouldn't want to have a baby at your hospital!

I don't do OB (I run and hide from it, in fact). Is this the norm across the country? I thought the rule was 3 couplets to 1 nurse for post partum.

[beachmom]

At our hospital we can have up to four couplets, but usually we have less than that. There's no way I would work where I take 7.

[Nicky30, BSN, RN]

Our hospital (being considerably smaller) runs a bit differently. The most I have heard of is 6 couplets per midwife (don't have L&D nurse option in Aust.) but the midwife also has to be "present" for any new labouring patient.

Effectively the midwives all do antepartum, labour ward and postpartum and this can happens every shift.

Anyway you look at it the numbers are excessive, and not safe.

Nicky.

[mom2michael, MSN, RN, NP]

4 couplets is the max where I work - after that - another nurse has to be called in.

[Belinda-wales, RN]

We work really hard at my unit to keep to a max of four couplets - sometimes it mightbe five if one is being discharge and admission is already across.

[Elvish, BSN, DNP, RN, NP]

The most I have ever had is 5 couplets, and I would not take more than that. It is indeed a safety issue. People hear 5 couplets and think 5 patients, when it is in reality 10 patients you're responsible for. That's hard enough, and to add any more is risking my license and my patients' wellbeing.

I know it's a tough situation to be in, and it seems like there has to be some sort of adverse outcome before things will change. If they don't, you may have to vote with your feet and go somewhere else where your license isn't being endangered. You have my sympathies, hon.

[cherokeesummer]

I've seen 5-7 couplets where I work but generally they try to keep it at 4 or 5, but it has been up to 6 or so generally if there are discharges.

[cnovice]

I am surprised to see this article. I thought I was the only one to notice such overload. I too was hired to work on a postpartum floor at a teaching hospital in a city near by. In orientation I felt the need to observe the usual patient per nurse ratio. So everytime I went on the unit I would make it my business to notice how many pt.'s each nurse on average was caring for. This floor had no on call nurses and each nurse seemed to start with about 7 couplets. The unit secretary was shared between the floor and the nursery, which meant sometimes the nurse had to put together her own charts and put into the system the new orders. With only one nursing assistant for the floor if any, I wondered how these nurses did it. I found the nurses to be extremley stressed, tired, and unhappy. The pt.'s seemed that way too. Any way..... Always check the protocols for the specific unit of the hospital and challenge the manager or even the nursing director on their own policies. I spoke to the manager about my concerns but was told, "this is a business" and I got the message.

1. Pt. saftey was an issue for me.

2. Inability to perform quality pt care ( spending time teaching seemed impossible)

3. My licensure could be at stake ( if a mistake was made due to being soooooo... busy)

This job wasn't worth it so I resigned after just 2 weeks.

Whats important to you?

[JenTheRN]

Ok, please help me understand this. Do you guys do total care? Like doing couplet care means you do everything for the couplet?

I work on a very small unit, and could not imagine taking more than three couplets. But then, we do total care plus all of the other business on the unit (no aids, no desk clerk).

How can you get teaching done? How do you get all the babes washed?

Just curious!!

[cnovice]

On this floor there is an admission nursery. There babies are washed and monitored for the first few hours and then they are handed over to the floor nurse. At least this is a plus for this particular unit.

[LKG6]

We usually have 4-5 couplets per RN, 1-2 aids for about 20-25 couplets and one unit clerk. We also have an admission nursery where babies get their first shots and bath, also there are some well-baby nurseries where neonate nurses take care of babies if it's needed. This is a large teaching hospital.