When do you move your pt to post-partum?

RNLaborNurse4U · Dec 31, 2005

How long do you keep your delivered pts? Do you have to wait until they can void before you move them? Until the IV is out? Everyone in L&D tells me one hour max, but that just seems too short. Then the postpartum nurses get mad because they have to help the pt to the br for the first time or whatever.

We have an LDR unit, with postpartum on the floor directly above us. We usually keep our pt's for 1.5-2 hrs post delivery before transferring them to PP. However, if they have complications (PP hemorrhage, retained placenta, etc) then we keep them until stable, then transfer to PP.

Doesn't matter if their epidural was so dense that they can't even move their legs....they go up on a stretcher then.

And, by the way, PP nurses shouldn't be complaining about getting them up to void for the first time (if needed) -- it's part of their job as the PP nurse. I will say this though - I will either get my pt's to the bathroom to void, or straight cath as needed, before I bring them upstairs to PP. A full bladder will not only displace the fundus, but will increase their lochia flow post delivery. It's only common sense to me to do one last check on them before transfer.

That being said, sometimes our unit acuity is so high that we have to transfer ASAP - which means barely 1 hour has elapsed since delivery, and the charge nurse is on our backs about transferring them up. I really hate that. :scrying:

Jen

L&D RN

Krojas21 · Dec 31, 2005

Our L&D usually bring pt to the pp side around 1 hour for lady partsl deliveries and two hours for c-sections. If unstable (pp hemm, on mag...) they stay until stable. They always have IV's in (unless they never had one in the first place), but haven't always been up to bathroom yet. I leave IV SL until about 12 hours or they at least prove that they can drink, pee, not nauseated and aren't bleeding excessively.

I'm a pp only RN so I don't mind that they haven't been up yet to pee yet, it's a good teaching time and way to see their bottom, bleeding and get family out of room for a while, so we can talk about their wishes (want to rest, family to leave, plan of care...).

rpbear · Dec 31, 2005

We keep our pt's until stable, no specific time period. It is usually about 2 hours, they have to be able to walk to the bathroom and try to pee, if they don't pee but bleeding is minimal and fundus is firm and midline we will transfer them anyway. C-sections have to be able to transfer themselves to the pp bed. this is susually about 2-3 hours depending on how dense the spinal/epidural was.

It takes us about 2 hours to get all the stuff done anyway, paperwork, breastfeeding, baby admit stuff, so 2 hours it the target time if there is nothing else going on with mom or baby.

SmilingBluEyes · Jan 1, 2006

When I worked in separate L/D and PP areas, it was usually about 2 hours or so. We really tried to get them up to potty first before moving to PP. Sometimes, not possible, as others said. If you have laboring patients and need beds, you have to move them a bit sooner, unfortunately.

Now that I work in LDRP, not an issue. I like it that way.

SmilingBluEyes · Jan 1, 2006

Our csections went immediately to PP after PACU recovery (1 hour).

Marie_LPN, RN, LPN, RN · Jan 1, 2006

2 hour PACU recovery for c-sections.

2-4 hours for VB to move to PP (depending on the "crowd")

Marie_LPN, RN, LPN, RN · Jan 1, 2006

When I worked in separate L/D and PP areas, it was usually about 2 hours or so. We really tried to get them up to potty first before moving to PP. Sometimes, not possible, as others said. If you have laboring patients and need beds, you have to move them a bit sooner, unfortunately.
Now that I work in LDRP, not an issue. I like it that way.

lol i know this is off topic, but when i read this, it made me think of a surgeon who was asking his pt. if he "had gone potty" before coming to the OR. Pt. says in response "so how many kids do you have, sir?"

gypsyatheart · Jan 1, 2006

Pretty standard here....approx 1-1/2 hrs s/p NSVD, and at least 2- 2 1/2 s/p C/S. All depends on how busy we are...if we need beds, the vag deliveries get pushed out pretty quickly....we empty their bladders and tx all epidurals (read: all pt's LOL) out on gurneys.

RNnL&D · Jan 3, 2006

After one hour PACU recovery for CS, 1-2 hours for vag deliveries. We do get them up to the BR, do peri care and dc the IV before transfer. So time wise, just depends on if they had and epidural, how dense it was, if they voided right before delivery, etc.

We generally do LDRP, but when our labor beds are full, we have to move pts out to PP.

OBRN2004 · Jan 4, 2006

How long do you keep your delivered pts? Do you have to wait until they can void before you move them? Until the IV is out? Everyone in L&D tells me one hour max, but that just seems too short. Then the postpartum nurses get mad because they have to help the pt to the br for the first time or whatever.

Our recovery time for vag, c/s, and PPBTL for at least one hour, unless of course they aren't stable and then it would vary. IV's stay in for at least 12 hours post procedure. I always try to take my vag deliveries to the BR to void, it's a really good time to assess, before I send them to the pospartum floor. Even if they aren't able to void at that time, I teach them about pericare and breast care at that time. That way when they are on the postpartum floor, they have a little bit of a headstart and the PP nurse has an easier time.

USA987, MSN, RN, NP · Jan 7, 2006

2 hrs. s/p lady partsl delivery...we try to have them void prior to going down to PP.

Approx. 1-1 1/2 hrs. in PACU s/p c-section.