Quiet time in nicu

Specialties NICU

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Specializes in midwifery, NICU.

Do your units have a quiet time to allow the babes to rest? Our unit had a policy of quiet between 1-2pm, NO visitors allowed, not even parents. This has been extended to 1-3pm, same rules apply, only mums allowed in if the babe needs a breastfeed at that time. Some mums upset at this , both with the length of time and that they arent allowed to sit in peace and quiet with their baby for two whole hours! Some mothers feel the need to spin out the breast feeds so they arent asked to leave! Also some of our mums travel some distance every day since our unit was centralised,and have no where to go during these two hours, apart from the cafeteria, (expensive on a daily basis!). I feel this is unfair to parents, our rules are pretty inflexible. we practise using a developmental care model, its very important to us, so I understand the reasons behind this extended time but I feel its too long and too rigid. Boss not sympathetic, when trying to reason with her about a mum who had travelled a fair distance and just wanted to sit with her babe during "quiet time" I was asked whos side I was on!!!!!:angryfire any variations on length and "RULES" for quiet time?

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Specializes in Maternal - Child Health.

Sounds unreasonable to require every parent and baby to conform to a unit-wide quiet time.

Why not designate a specific time for each baby and note it at his/her bedside?

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Specializes in midwifery, NICU.
Sounds unreasonable to require every parent and baby to conform to a unit-wide quiet time.

Why not designate a specific time for each baby and note it at his/her bedside?

Hi jolie, forgot to mention, quiet time also covers staff lunch times , handovers etc:rolleyes: . Some staff not exactly quiet to say the least during this time! mothers feeding have noticed this. Your idea of specific times sounds reasonable, even a room at a time, we have four rooms going sometimes. can you tell this is my GRRR for the week, I'm really wound up about it. hard to change unit policy, sometimes things are done just because "thats how we do it here !!!

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Specializes in Pediatric Pulmonology and Allergy.

That is really sick. Not letting a mother in to see her own baby because of an arbitrarily imposed "quiet time"? What the h----? For whose benefit is this quiet period supposed to be? Maybe the baby will benefit more from 2 hours of one-on-one with mommy more than 2 hours of lying lonely and uncomfortable in a bassinet?

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Specializes in midwifery, NICU.
That is really sick. Not letting a mother in to see her own baby because of an arbitrarily imposed "quiet time"? What the h----? For whose benefit is this quiet period supposed to be? Maybe the baby will benefit more from 2 hours of one-on-one with mommy more than 2 hours of lying lonely and uncomfortable in a bassinet?

thats what I'm trying to get through to them. I really want to show that other units Uk, USA etc dont do this to mums and babes. I want our mums to be the ones caring for their babies whatever time of day or night suits them. THEIR Babies, not ours in the end. I sometimes feel that I havent got enough voice to keep saying this and start fighting for change.

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Specializes in Pediatrics Only.

danissa:

Kudos to you for not just going along with this policy and for trying to do something about it.

I dont do NICU, although I had done a rotation as a student and also floated there to work a few times, but instead of quiet time- maybe Kangaroo Care time? I know that its been proven to help babies and also eases their resps and HR and calms them down, so why not make Kangaroo time the new Quiet Time? I would still consider this a quiet time since it is proven that it helps babies relax more (and someone please correct me if I am wrong about that), and its also a great time for mom and baby (or dad and baby), to do some real one on one bonding.

Now the NICU I did my rotation in only had 1 1/2 hours of of the day that they requested parents not be present, and that was when they did report. So from 6:45am-7:15am so that oncoming shifts could obtain report, and parents couldnt hear report on all infants. I dont think there should be any more "quiet time" then that, if at all.

I think you should bring up Kangaroo Care instead :) Just my opinion :)

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Specializes in midwifery, NICU.
danissa:

Kudos to you for not just going along with this policy and for trying to do something about it.

I dont do NICU, although I had done a rotation as a student and also floated there to work a few times, but instead of quiet time- maybe Kangaroo Care time? I know that its been proven to help babies and also eases their resps and HR and calms them down, so why not make Kangaroo time the new Quiet Time? I would still consider this a quiet time since it is proven that it helps babies relax more (and someone please correct me if I am wrong about that), and its also a great time for mom and baby (or dad and baby), to do some real one on one bonding.

Now the NICU I did my rotation in only had 1 1/2 hours of of the day that they requested parents not be present, and that was when they did report. So from 6:45am-7:15am so that oncoming shifts could obtain report, and parents couldnt hear report on all infants. I dont think there should be any more "quiet time" then that, if at all.

I think you should bring up Kangaroo Care instead :) Just my opinion :)

:idea: Thanks, will bear this in mind, great idea actually!

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Specializes in NICU.
That is really sick. Not letting a mother in to see her own baby because of an arbitrarily imposed "quiet time"? What the h----? For whose benefit is this quiet period supposed to be? Maybe the baby will benefit more from 2 hours of one-on-one with mommy more than 2 hours of lying lonely and uncomfortable in a bassinet?

There is an actual reason for this quiet time. It's not to be cruel or to make some silly rule so parents can't visit. It's because sick NICU babies tend to be very overstimulated. NICUs are very loud sometimes with all the alarms, machines, talking, intercoms, etc. Some of the sickest babies we have are on open radiant warmer beds and they are very sensitive to noise. Now, night shift is often pretty quiet, but day shift can be crazy in a NICU. The noise doesn't stop. So I can understand having some quiet time on day shift to give these babies a chance to really rest and regroup. We have some babies on our unit that scream practically all day long, but are angels on night shift. It's not the lighting - because sometimes we have to keep the lights pretty bright at night - it's the quiet of the night that calms them.

I do not, on the other hand, agree that parents should have to leave for quiet time. As long as they respect the unit rules for keeping the unit quiet for that hour or two, they should be allowed to stay. True, if the family is there almost all day long and are keeping the baby from resting properly, then yes there should be some limits on how much they stimulate the baby. But that is a nursing decision, not a unit-wide kind of a thing. But if the family is there, being quiet, and letting the baby rest (whether it's in the bed or quietly being held), then why not let them visit during that time?

The only time parents are not able to visit on our unit is a 2-hour block in the morning when the docs do rounds in the middle of the open unit and talk about every single baby. It's strictly for confidentiality reasons, and most parents are very understanding about that. They don't want other parents hearing every little detail about their baby, either.

I really wish our unit would get some of those light boxes or light bears that flash when it gets too loud. It's so annoying when there are people (visitors AND staff) that talk really really loud, and you want to tell them to keep it down but don't want to seem like a nag. If there was a light flashing, it would be pretty obvious without anyone having to point it out that the noise level has become unacceptable!

Speaking of noise, though...

Is anyone else having issues with these newer, stricter sat ranges? Like when we have to keep a baby between 85-90% and the alarms just ring off all shift because it's hard to keep them right in that exact range. We keep saying that their vision will be better, but their hearing a lot worse!

:rolleyes:

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Specializes in Pediatric Pulmonology and Allergy.

That's a good point, Gompers, but if overstimulation is a problem, shouldn't they be working on overall noise reduction, rather than creating a tiny island of quiet in a sea of noise? How much is the one hour of quiet time going to help if nothing is done to keep noise down to reasonable levels all the rest of the time? In any case, the parents should be informed of the policy and asked to respect the quiet time, rather than barred from visiting.

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Gompers, your point is valid, if you can prove that the parents are the source of overstimulation, which I know on my unit they are not.

Our parents,(and only the parents) can visit 24/7. Other can come during regular visiting hours.

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Specializes in NICU, CVICU.

I agree, our unit gets ridiculously busy during the day and the noise level is up and the lights are on...the little guys get over stimulated.

Our unit is open 20 hours a day. We close from 6-8am for shift change and 6-8pm for shift change. Unfortunately, this is not a quiet time either because reports at the bedsides, everybody trying to get as much done as possible before parents are allowed back in, etc.

We have an official policy for quiet time from 12-2 on each shift, but in the year I've been here, I've never even heard anyone mention it, much less follow it.

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Specializes in NICU.

Didn't anyone read my post? :( I said that I don't agree that parents shouldn't be allowed in during quiet time. I think it is fine as long as they, too, are quiet. I also basically said that if there is a situation where the family is there all day long and the baby is obviously overstimulated, that it should be an individual nursing decision to take some time out, not a unit-wide policy. And if you guys are referring to that comment - I'm talking common sense stuff. Like those parents who insist on waking uptheir sleeping babies when they've finally fallen asleep for the first time in many hours, or insist on tickling a baby that desats to the 40's with tactile stimulation. Stuff like that.

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