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dcampbell 3,484 Views

Joined: Jan 13, '07; Posts: 130 (32% Liked) ; Likes: 111

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  • Sep 29 '10

    On the postpartum unit where I work (separate from L&D) we have babies in the nursery just about every night, and that's fine with me.

    As others have mentioned, the moms are our patients, too. Some have labored on and off for several days. Some have labored on and off for several days and then had a section. Even the ones who have had relatively quick, complication-free deliveries may have slept poorly toward the end of the pregnancy. Many of them are just wiped out with fatigue, relief, drowsiness from medication, visitors, and the whole shebang.

    We'll take care of babies who are "out on demand," so the mom can catch a few hours. Sometimes we'll give one bottle feeding and that's the only one in a 24-hour period. That 5-6 hour chunk of sleep can provide more rest and restoration than 8 hours with three interruptions. We'll also take formula-fed babies for the night.

    We do keep an eye on women who leave their babies in the nursery for a good portion of the day and night. Or those who want us to do most of the feedings and changings. If we think there may be a bonding issue or some other problem, we nurses can call for a social service consult.

    Many of our moms have other kids. If they want to sleep enough to feel human before going home, I'm all for it. I did it myself, and was grateful to have the chance.

    There is one other reason I will gladly take a baby to the nursery if mom asks. I've had two scary incidents where mom fell asleep with the baby in the hospital bed with her. In one case, the child slid down beneath the blankets and ended up wedged under the large mom's hip. In the other incident, the baby was stuck between mom and the bedrail. Both of these women were in a heavy exhausted sleep and only woke up when I was working to find and free the babies.

    These women were horrified at what they had done, and I was pretty shook up as well.

    I was more than willing to take both babies to the nursery.

  • Sep 29 '10

    After coming in early for induction, going through that, keeping the baby all night and the next day...that 2nd night I was exhausted. I may have had 3hrs of sleep in 48hrs, and even that was broken up. About 3am I called the nursery to take the baby because if I didn't get any sleep I was going to go crazy. They took him, my husband came in about 8am and got him, and I felt like a whole new person with my 5hrs of sleep.

    Lazy mom, raising her hand her also.

  • Sep 29 '10

    Thanks for clarifying.

    I have to admit, with my second son, he spent the nights in the nursery unless it was feeding time. He was with me the rest of the time. With my first I insisted he stay with me and by the time I was released I was a mess. I had terrible PPD and felt like I'd been hit by a train but was afraid to send him to the nursery because I didn't want to be one of "those" moms.. I struggled with breast feeding and didn't sleep most of the time I was there. It was not the beautiful experience I expected it to be. Expecting new moms to be super mom right out of the gate, imho, is ridiculous.

    With #2, the nurse said to me on day 1, (I had c-sections with both) that I needed my rest as much as he did and that it would be best for him and me if I sent him to the nursery at night. I didn't argue, by that point I didn't really care if I was viewed as a "lazy" mom for trying to get some recovery time in for myself too. I think I even let them keep him for the whole night my last night there allowing them to feed him formula (gasp) that night. Do I feel bad? Not even a little. I had a one year old at home and major surgery to recover from.

    Lazy mom, raising her hand.

  • Sep 29 '10

    Quote from kidsnstudyn
    We don't make the patients take the baby, if they ask for the baby to go to the nursery we take them to the nursery... they are encouraged through all RN teachings and Lactation [if it applies] teachings that the baby does best with mom in the room, but people are people and sometimes their lazy - but that's just my opinion....
    I don't work OB, but I think that's a harsh comment. I don't think people don't take their newborns due to laziness (sure, maybe that's some people's motivation) but rather a chance to get some much needed rest or a mental break - especially first time moms.

  • Sep 15 '10

    Okay, just an idea that whacked me up side the head...

    Do you get that irresistible sleep urge anywhere else OTHER than the car? I had a coworker who was having that kind of problem, kept getting his CPAP tweaked, thinking it was his sleep apnea. Turned out his car actually was burping something back into the car's passenger compartment -- carbon monoxide, I think -- and he was actually suffering from carbon monoxide poisoning. His mechanic found it during some engine work.

  • Sep 13 '10

    Of course I would. They have a right to know. Their child is sick enough to be admitted to a CCU, they need a nurse who remembers normal pediatric vital signs IMO. No, I have never gotten into trouble for it.

  • Aug 22 '10

    Quote from elizabeth321
    We don't tell the patient we are short staffed because it is not their issue and it is neither professional or fair to burden them with this information.
    I do not tell the pt we are short staffed, when we most definitely are, because we were warned in the strictest way NEVER to say those words. Instead, I allow pts and families to believe I'm lazy and incompetent because it took me 30 min to an hour to provide the pain med they requested. I've stood in rooms and had pts berate and demean me for not getting to them fast enough. How fair or professional is that? How can being short staffed not be their issue, when ultimately they are the ones to pay the most when hospitals run short staffed. Mistakes are mostly made when nurses are tired, overworked and stressed. Why shouldn't the pt be made aware, and then make an informed decision about whether or not to stay at a facility that puts a dollar before their well being?

    I don't like protecting my employer, by keeping quiet about short staffing. I really don't like taking the blame for a situation over which I have no control.

  • Aug 22 '10

    Quote from elizabeth321
    We don't tell the patient we are short staffed because it is not their issue and it is neither professional or fair to burden them with this information.
    Personally, I'd rather know my nurse was overworked than wonder if she was incompetent or inefficient.

  • Aug 22 '10

    When I first heard we were NEVER to say we were short-staffed my mouth dropped open. What we were supposed to tell the patient when his tray was two hours late, or it took me 30 minutes to bring in his pain shot? This is a new phenomenon. A few years ago it was acceptable to tell the patient that we were short-staffed. After all, it was the truth.

    I'll make a deal with all the administrators who read this - I'll NEVER say we're short staffed if you ensure that we are always adequately staffed.

  • May 25 '10

    Pro vaccine isn't the issue I'm talking about. I'm talking about common sense vaccinations. The question to ask is not "can this save 30 babies lives per year?", but rather "can this kill more than 30 mothers per year?" or "how many infections will this hide and potentially increase health care costs, cause lost uteruses, etc?".

    Informed consent is not legal under narcotics. That's just the way it is, and in a lawsuit it looks bad. Doing it as they walk out the door might protect you there, but it sets them up even further for an infection when they get home and have infection symptoms and don't them treated right away.

    The question should be "has this been studied throroughly and thought out or is a reaction?" That's not good science, not good nurse, not evidence based practice.

    I do care about babies getting sick. But I care about sick mom's, moms who might lose a uterus (which we did have one this past year) and moms who might die.

    I think we're in uncharted territory, not practicing evidence based nursing practice, but rather going on a reaction of what might happen case scenario, which is fear based. We don't even have consents signed in our area hospitals, which further ups the risks. I would hope that nursing would be improving by now in these areas, but we're still reacting,instead of being ahead of the game.

    In another few years when the numbers come out and we see the harmed mothers and the effects, we might rethink this policy, just like we do every 5-10 years, too late for them, and shame on us for poor science and poor research (and picking and choosing recommendations in this case instead of either enforcing all of them or none of them).

    This is one area I illustrate to my students how we left common sense at the door and all lined up without thinking it through. I want my students to think, to practice evidence-based nursing, to question, and especially to not react with fear, but with reason.

  • May 25 '10

    My problem with this new recommendations is that hospitals tend to pick and choose, if we are going to follow the recommendations and make a "campaign", then do so to the fullest.

    This means that
    -ALL health workers need to be up to date with the Tdap and MMR, otherwise, you and your facility could be exposing babies.
    -ALL family members should be up to date. Is your facility giving out information stressing the importance to other family members? If our goal is to really make a dent and prevent it, why do it half way? Why not make up some handouts and show the importance for all family members. That's the recommendation, not just new moms.

    And as an FYI, the current statistic is 30 deaths in the neonatal period PER statistically, giving the shot is not going to make a huge difference if you look at how many babies are born, how many die from other causes.

    If you look at how many women get infections, if you look at the fact we are somewhere like 18th on mortality in mothers, then anything that could potentially hide an infection (such as fever, chills, pain, etc) is a huge risk factor that should be eliminated.

    Sometimes I think we do things to make ourselves feel better, but we don't really take the time to look at all the evidence and really stop to look at it from a common sense approach. We'd save more than 30 lives a year doing so many other common sense things, and if we're doing to do the vaccination promotion, then just giving the moms the shots without following the FULL RECOMMENDATIONS is really just fooling ourselves and giving ourselves a pat on the back. If the health care workers are walking around not up to date and we aren't pushing the other family members who are in the home, then we aren't making a difference. We're just making mom's uncomfortable and possibly could see more than 30 moms get sick or die over a year's time from masked infection (we've already had 2 in our facility, so I'm sure the numbers will be there over the whole country).

    And giving a mom the VIS while she's recovering from birth, on narcotics, hasn't slept, and often giving it to her right as we're prepping the shot is a joke as far as informed consent. Informed consent should never be given when mom is under the influence of narcotics. We do it all the time in ob, especially with such short stays. These are moms who have been given huge packets of information, bombarded with all kinds of educational materials, and we hand them some information about vaccines, and then give them the shot a few minutes later, and think we gave them informed consent. I find that we should at least be embarassed by that and at worst should be thinking about malpractice if there's a reaction and mom can't even remember it and you find out she just had percocet 2 hours ago.

  • May 25 '10

    All of our area hospitals offer it, and the patient doesn't have to sign a consent, but they really should.

    Personally, I am not in favor of the idea. First of all, fever is a known side effect and pretty common. I think it's dangerous to have that in the postpartum phase, it confuses the infection issue.

    Secondly, the woman already feels like crap, then we give her tetanus, now her muscles ache and she feels like she has the flu and feels just miserable. Why do that to someone? Why not give it at her 6 week checkup? That would give her time to get used to being a mom, get breastfeeding established and then give the immunization.

    I understand the community health issue, but I think in our overzealous attempt to get these vaccines, we are causing more problems and suffering. Just not a fan.

  • Apr 16 '10

    Quote from Hushdawg
    Wow... I'm shocked at this statement.

    A school nurse should be able to do anything a staff nurse at a hospital or clinic is able to do.

    A school nurse can tell the difference between a kid with a cracked rib and a kid that just got the "wind knocked out of them" while playing.

    A school nurse can asses and evaluate a long list of health issues that can arise at a location where kids are spending 30% of their lives between the ages of 5 and 18!

    So if 1/3 of your kid's life is unimportant then fine, cut the school nurse... better yet send them to my old school district where they are not present and desperately needed!

    You're right, a school nurse SHOULD be able to do anything a nurse at a hospital can do. BUT, around here, there is none of that going on. The nurse here never "assesses" anyone. If anything is wrong, they call mommy or daddy. That way, they can get right back to their socialization.

    If there are students who are diabetic or have other maintenance needs, the teacher is charged with taking care of it. NOT the nurse.

  • Apr 16 '10

    Quote from SuperSara
    I can't speak to all school districts, but in mine, school nurses are useless. At the school where my kids attend, the school nurse spends the majority of her time hanging out with the social worker and SRO. None of them are ever at the school but you can almost always find them at the local Mexican restaurant.

    I used to work at the school and if a student ever needed to see the nurse, they were out of luck because she was no where to be found.

    So, at my kids' school, the school nurse is a waste of taxpayer dollars.
    Exactly... what does the school nurse really do? Hand out meds, take a kids temp, and put bandaids on kids knee? That's all I've ever seen them do.

    Honestly, if there is an emergency, call EMS since they can probably do more since they have a lot more equipment.

  • Apr 16 '10

    I can't speak to all school districts, but in mine, school nurses are useless. At the school where my kids attend, the school nurse spends the majority of her time hanging out with the social worker and SRO. None of them are ever at the school but you can almost always find them at the local Mexican restaurant.

    I used to work at the school and if a student ever needed to see the nurse, they were out of luck because she was no where to be found.

    So, at my kids' school, the school nurse is a waste of taxpayer dollars.