Re: LDRP's vs. LDR's

[Guest guest]

I am in FLorida. Our unit started out as a 6 bed LDRP unit in 1992 when it opened. The past 10 years it has operated as an LDR with a separate PP unit. We deliver 1200-1600 babies a year.

Currently we have 2 triage rooms, one antepartum room (most of out high risk pts are transferred to the Level 3 unit downtown) and the 6 labor suites. They are double room size, with one half being the patient area and the other side a living room like area for family with a foldout bed for dad. Each room has a jacuzzi tub. Occaisionally we will keep a VIP or one of our staff members in a labor room post delivery.

OUr unit is in the shape of a cross...the elevators are in the central part, one wing is LDR, one wing is triage on one side, nursery on the other side (we have a room with 2 special care warmers, keep short term oxyhoods, phototherapy, IV abx, and another large room where we admit c/s and keep little visitors during the night. Well babies are admitted in the ldr and stay with mom)the next wing is postpartum. There are 6 private rooms and 2 rooms currently being used for offices, the other wing has 4 more private rooms for pp, and 5 semiprivates that we use for our inpatient gynes or OB overflow.

Our staffing is separated. We always have one level 2 nursery nurse (me being one) WE go to all deliveries and take care of the sick babies. If we have more than 6 babies (1 scn baby= 2-3 depending on acuity)there is a second nurse in the nursery. On postpartum/gyne they have (we work 12's) a ratio of 1:6 patients. they also have a tech 7-3 and 3-11 and a secretary because we have a dedicated OB line that fields incoming patient call for one of our MD groups all night long. SHe also does birth certificates and charts, orders forms and supplies.

If for instance we only have 8 babies, they will sometimes have one person do mother/babyon 3 couplets (6 pts)

L & D has the charge nurse for the entire floor(she usually traiges if the labor nurses have pts) and a scrub tech/unit assistant(who might be an RN..she also helps with triages) and 2 or 3 labor nurses depending on census. No dedicated triage nurse.

Our staffing patterns are the same for days and nights.

Laurie

We usually hav 7-9 nurses on most days and nights.

[Guest guest]

.. Each MB nurse is responsible for 3-4 dyads.I personally am not a big fan of the dyad concept unless the babies are actually WITH the moms.

I agree. Usually I only have one transition baby at any point, but if I have a level 2 baby on an oxyhood in the back room, I have one one other person with me if there are more than 2 other babies sleeping over. I can usually handle one or two feedings, anything more than that is crazy. I have suggested that they hire a night shift tech who could do vitals, etc on the floor and be stationed in the nursery to help babysit. We'll see what happens.

Laurie

[Guest guest]

i can't seem to see any of your posts Beth..just a blank page! Anyone else?

sue

Re: [OBnurses] LDRP's vs. LDR's

[Guest guest]

My main reason for leaving on my resignation will reflect clearly the poor staffing patterns for the nursery.

Beth, we get this attitude also. The charge nurses seem to think that once the babies are assessed in the beginning of the shift that anyone can chart a feeding. WE have also had a case where a baby who was in the nsy for the night had a problem, and it's assigned nurse was not there at the time and the nursery nurse got involved in depositions on a baby who was not her responsibility. Very few of our moms want to room in during the night,even tho they have the father or grandma there to "help" them. Reality is the dad/so gets really grumpy if their sleep is disturbed. If we do have a mom/baby nurse at night, she tries to stay in the nursery with her babies if they are in, and the pp sec calls her if the patients need something. AT least we have a small unit and can do that most nights.

LAurie

[Guest guest]

We do more births a year (4000) but we use LDRs and a separate PP floor. We have one non labor room and 14 LDrs. We have over 50 PP rooms, and about 12 perinatals rooms also on another floor. We staff our labor floor one on one and our perinatal floor 4 patients to a nurse. I am really not sure about the PP floor, I know they do mother/baby couplet care. The moms do have the option of using the nursery so I will ask them who is responsible then for the babies in the nursery. There is a nursery RN that comes down to assess/bathe the infants in L and D as well. Our labor nurses float as necessary to perinatal when the census goes up. We HATE to float up there!!!

sue

[OBnurses] LDRP's vs. LDR's

Hello everyone, I am new to the group and hope this isn't a repeated question. I am curious to know of those of you whose hospitals do around 1200-1700 births annually, who has LDR's and who has LDRP's? What about nursing staffing-do you do mother/baby care or does a nurse do just Postpartum/antepartum and then a seperate nurse to take care of the baby/s? Is this on all shifts or does nocs differ? Do you have a triage nurse that only does triage patients? I am from midwest Wisconsin, where we do Mother/baby couplet care on all 3 shifts currently. We have 12 LDRP's. We are discussing in our quality counsel options for staffing and with a new hospital opening soon also discussing going back to LDR's. Thanks for any input,eWelcome to the OBnurses list!You have the freedom to change your membership settings at any time you choose. Go to the Yahoogroups Home Page at www.yahoogroups.com and sign in with your e mail address and the password you used to subscribe to this list. You will then see a list of all Onelist lists you are subscribed to. You can then easily choose the settings you would like--unsubscribe, digest, or Web-only.

[Guest guest]

At our hospital we have 6 labor rooms...although 2 of them are commonly used at post-partum since they are down that hall. If all of the PP rooms are full, the pts. can stay in their labor roomsp; if there are empty rooms, they are moved down the hall to a different room. Our staffing is usually 1 to 1 for labor (if understaffed, sometimes we have to do 2, but not very often) and PP you can have 4 couplets. Our babies stay in the room with the mom at all times, so we do mother/baby care. The only time that baby leaves the room is to do PKU's, hearing screens, etc. The only time our nursery is 'open' and staffed is if there is a sick baby that needs to be in there. Otherwise, it is closed. So, no babies can get sent out of the room in the middle of the night, or the day for that matter. The hospital is very strict about rooming-in. We always have one 'nursery nurse' staffed every day/night though (we work 12 hr. shifts), even if the nursery is not open (they can all also do labor & /or PP) in case we have a baby that is born bad & the nursey needs to be opened. Our charge nurse is the 'triage' nurse. We have a whole seperate outpatient area where pts. go if they think they are in labor. There are 5 rooms with sepreate monitoring for down there. The charge nurse takes care of outpt. and is in charge of getting a pt. admitted if they are indeed in labor.

So, that's the way it is for us!

le

[Guest guest]

Hi,

At the tertiary care centre I work at we do about 4,000 deliveries a year. We have 5 triage beds that is staffed with a L & D nurse. 5 perinatal beds that is staffed by 1 RN. The triage nurse and the PNAU nurse will help each other out when they need to. Triage is 24hr but PNAU is 07-2300. Our L & D unit has 7 labour rooms, 2 caserooms(on of these is equiped to do surgery if need be) that we will transport our patients to should we need a "high risk" delivery that requires the newborn team and we have 1 OR. Our unit is staffed with 1 charge and 5 labour nurses. I believe our LDRP has 16 beds,,,,,they have specific criteria for who can deliver on their unit. Obviously low risk, BMI <40, on no meds and depending on the attending previous c/s with certain criteria may or maynot be a candidate. On our l & d unit patients stay with us approximately 60-90 mins post delivery as long as their bleeding is

ok and they have nursed their baby. I am not sure the ratio of mom/baby to nurse on that unit.

One of the big problems is that very often patients who were labouring in our beautiful LDRP rooms end up coming to "the other side" to our L & D unit for thick mec,nonreassuring tracing, instrumental delivery etc and are not permitted to return. Our unit is less that esthetically pleasing and very often end up in a semiprivate room on our pp unit. Yes I know it is all about a safe delivery but some people get upset about this happening.....

How involved are midwives in your facilities?

kristine hanke wrote:

Hello everyone, I am new to the group and hope this isn't a repeated question. I am curious to know of those of you whose hospitals do around 1200-1700 births annually, who has LDR's and who has LDRP's? What about nursing staffing-do you do mother/baby care or does a nurse do just Postpartum/antepartum and then a seperate nurse to take care of the baby/s? Is this on all shifts or does nocs differ? Do you have a triage nurse that only does triage patients? I am from midwest Wisconsin, where we do Mother/baby couplet care on all 3 shifts currently. We have 12 LDRP's. We are discussing in our quality counsel options for staffing and with a new hospital opening soon also discussing going back to LDR's. Thanks for any input,eWelcome to the OBnurses list!You

have the freedom to change your membership settings at any time you choose. Go to the Yahoogroups Home Page at www.yahoogroups.com and sign in with your e mail address and the password you used to subscribe to this list. You will then see a list of all Onelist lists you are subscribed to. You can then easily choose the settings you would like--unsubscribe, digest, or Web-only.

[Guest guest]

.. Our labor nurses float as necessary to perinatal when the census goes up. We HATE to float up there!!!

sue

I hear you Sue. We are working where we work for a reason......I am not a PP nurse and I give them alot of credit for the work they do. I cringe when I have to care for any PP patient for too long. THe breast feeding issues being the biggest problem. If time permits we will do newborn assessments but generally unless there are no PP beds and patients are backlogged on L & D our care is minimal......

[OBnurses] LDRP's vs. LDR's

Hello everyone, I am new to the group and hope this isn't a repeated question. I am curious to know of those of you whose hospitals do around 1200-1700 births annually, who has LDR's and who has LDRP's? What about nursing staffing-do you do mother/baby care or does a nurse do just Postpartum/antepartum and then a seperate nurse to take care of the baby/s? Is this on all shifts or does nocs differ? Do you have a triage nurse that only does triage patients? I am from midwest Wisconsin, where we do Mother/baby couplet care on all 3 shifts currently. We have 12 LDRP's. We are discussing in our quality counsel options for staffing and with a new hospital opening soon also discussing going back to LDR's. Thanks for any input,eWelcome to the OBnurses list!You have the freedom to change your membership settings at any time you choose. Go to the

Yahoogroups Home Page at www.yahoogroups.com and sign in with your e mail address and the password you used to subscribe to this list. You will then see a list of all Onelist lists you are subscribed to. You can then easily choose the settings you would like--unsubscribe, digest, or Web-only.

[Guest guest]

In the hospital where I work, we currently have seven LDR's and 14

private PP rooms. We also have another 10 bed overflow unit. We

have a nursery staffed by RN's. We do traditional PP/nursery care.

Mother/baby did not work for us. Although, currently we are in the

process of building a new birthing center which is going to have 16

LDRP's and two OR's.

Tabby

> Hello everyone,

> I am new to the group and hope this isn't a repeated question. I

am

> curious to know of those of you whose hospitals do around 1200-

1700

> births annually, who has LDR's and who has LDRP's? What about

> nursing staffing-do you do mother/baby care or does a nurse do

just

> Postpartum/antepartum and then a seperate nurse to take care of

the

> baby/s? Is this on all shifts or does nocs differ? Do you have a

> triage nurse that only does triage patients?

> I am from midwest Wisconsin, where we do Mother/baby couplet

care

> on all 3 shifts currently. We have 12 LDRP's. We are discussing

in

> our quality counsel options for staffing and with a new hospital

> opening soon also discussing going back to LDR's.

> Thanks for any input,

> e