We do not have nearly as many births as you do. Our average monthly rate is 
about 120. Each nurse usually has no more than 4 couplets and we have 
corpsman on the unit since it is a military hospital. As long as mom and baby 
are both stable, they come together from L&D to the postpartum unit. The 
baby is transitioned in the same room where mom will be staying and the baby 
remains in that room for rooming in until they both go home. All tests (unless a 
venipuncture is involved) are done in the room. We still have a few staff that 
want to take the babies to the nursery for tests, but they are reminded by 
others that by doing all tests in the room in front of mom provides for great 
teaching opportunities. We still have a few staff that tell the moms they will 
take the babies at night and let them rest. Again these nurses are told this 
does more harm than good. The nurses are not going home with the mom and 
baby. We have only a short time to help them learn to provide basic care and 
separating the couplet interferes with that learning as well as breastfeeding. 
FOr the most part, our babies are in the nursery for circumcision or because 
they require level 2 care or are unstable and we are transferring to a level 3 
NICU.
Mary Buskohl MSN, RN, IBCLC
Florida

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