What would you do - couplet care?

Specialties Ob/Gyn

Published

I have to know this. If you walked in and had six or more couplets and no ancillary staff, what would you do?

This is a true scenario that does happen sometimes. I am just trying to figure out what is the best thing a nurse can do in that situation. Management already knows about this problem. I've seen this happen a lot and it always makes me wonder what is the appropriate nursing response. Should they deal with it, should they refuse, should they tell anyone? Just looking for some feedback here.

Thanks everyone.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I would continually file unsafe staffing paperwork and if anything untoward happens, make sure you have written up the incidents completely, as well. Document all the actions you have taken to try and changing staffing as well. Unfortunately, a lot of places are seeing staffing like this----I think more than 5 couplets is too much. No one can get the care they need at all. Forget anything extra like teaching them anything. Ridiculous.

And I would question whether continuing to work there is at all worth it.

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Specializes in Community, OB, Nursery.

And even 5 couplets is pushing it, esp if one couplet has breastfeeding or other issues.

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Yes very true. And thats the sad part, not all of the couplets are "normal" there are those receiving IV abx, those receiving blood, etc. etc. the list goes on. It's not safe. Sadly I don't think there are many other job options in the field around here. It is supposed to be improving, with more nurses being hired but it is still scary. I'm just glad to know that I am not the only one that thinks it is a bad thing.

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Specializes in L&D, Orthopedics & Public Health.

I'm an LPN at a Birthing center, and of course I can not do labor, but I do take care of pp and nbs, with exception of pp on MAG. In our policys it states that we can take 5 patients by ourselves and if we have any more than that, than we have to have a CNA on board. We always have CNA's in our facility, so its not that bad, but there have been days that we need more than one CNA to help with vitals, phones, etc. We are all taught how to assist with breastfeeding issues and we have a Certified Breastfeeding consultant on staff 24/7, if shes not there, we call her on the cell phone to come in. There have been times that it has been very crazy as many of you know. And if we are to the breaking point, we bring in extra staff, even if they have to float over from Med-Surg.

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Our state has guidelines on how many couplets you can have. It's 4 couplets. Occasionally we have more, but it's rare. Since they are guidelines and not LAW, we can have more. The key is to follow the guidelin MOST of the time. I would check with your state to see if there are guidelines, and go from there.

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On our pp unit our max is 6 couplets and yes it can get to be overwhelming especially when we are short tech support. But for us 6 is the norm. We never get anything over that because our pp unit only has 12 beds and 2 nurses and a tech scheduled to work the unit. Any couplets beyond that are transfered to the antepartum floor for their recovery. In the event that we are short support staff we usually pull a tech from the L&D or ante floor to come and at least do our 8pm VS. Another option is if the NBN only has 1-2 babies we will coordinate with the Nrsy nurse and have her do some of our baby assessments.

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