Baby nursery

SmilingBluEyes · Aug 26, 2005

HI THERE! welcome to the forum! I am not specifically a "nursery" nurse, but I will try to help........

Some people do work in the nursery, mostly "level 2" or NICU--Where babies are "sick" or need to learn to feed and have time to grow, or have intensive needs (extremely premature, sick, etc).

The day can vary; where I work most nursery nurses work 12 hour shifts 2-3days/week. It can vary what you do by the place you work, and level of intensive care you provide.

You may spend a lot of time in the Level 2, feeding/tending IV's, giving medications, helping new parents bond/feed new babies. You may also be doing light therapy for jaundice cases. You will interact daily (or more often) with the pediatricians, keeping them up to date on baby's condition, receiving news orders....etc.

You may be drawing labs for blood counts, cultures, other tests, etc.

Your "toughest patients" may be the family members, not the newborns, however. Particularly in the NICU environment. So many strong emotions at play.....

A new baby being in the hospital is VERY TOUGH on a new family----you will spend a LOT of time teaching, reassuring, and working w/family members. Some will be very hard to work with---they will test you sorely......

You will spend weeks doing this in the NICU, as many babies may stay there for weeks and months. You will get to know the families well---you will know the babies even better. Sadly, tragically, Some, you won't be able to save. You will grieve and cry with the families in the dying process and intense sense of loss you all will share. You will have to steel yourself to be strong, but you will know it is ok to cry and hug the families, as the loss will be real and very hard on you, too....Your heart will break in some cases.....

But there can be an upside. Many other babies do "graduate" and get to go home!!!!! And you will notice a bittersweet, tugging at your heart feeling when the day comes the babies go home w/family. Because, in a way, they became almost "yours" for the time they were with you, when you cared for them. They were your "extended family" for a while there------you knew their cries and their cues and saw to them when family were either too tired or unable to.

Make no mistake, you will touch and change lives. Your heart will ache at some of the sad situations some kids will go home to, so much dysfunction exists these kids are born into--------you will lose sleep at night for some of them. Others, you will feel so glad they have loving moms/dad and families to go home to.

Just one thank you, one hug, one tearful expression of sincere gratitude will keep you going, just when you feel it's time to quit because you have given all you can...and you become tired.......

But you will make a difference in countless lives. Understand that. These people will remember you for the rest of their lives. And their babies will have you to thank for having a hand in helping them thrive while they were with you.....

There is no "average" day in the NICU/Level 2 nursery-------because there is no "average" patient, and you won't be an "average" nurse, either.

Hope this helps.

misschelei · Aug 26, 2005

If you are working in nursery for healthy newborns you will get height, weight , and length before the baby goes on a warmer with a temp probe.

The rest will vary depending on the type of unit. Some of this may even be done in L&D. But in general you will:

get a set of vitals

do serial glucose checks on certain babies per unit protocol

and act accordingly

vitamin K shot and abx eyedrops

perform and document specialized assessments based on state law

plot baby's measurements on a growth chart

reclamp umbilical cord if too long

be prepared to do a septic workup if the doc thinks its appropriate

this means start iv, give abx, get blood cultures and other labs, urine culture (good luck) assist with a lumbar puncture

if all is well:

perform first bath

wrap baby up and take out to mom.

Do teaching with mom about safety and make sure she has had all her questions answered

after 48 hours perform PKU

Before discharge: Hearing test, Hep B immunization, circ, picture, birth certificate and all other tedious unit specific paperwork

if the baby become jaundiced you will have to do heel sticks for bilirubin levels and you may need to place the baby under bili lights.

The newborn nursery can be a scary place to work cuz its almost like med surg for babies. Alot of times critical problems are missed because the baby is deemed "healthy". Assesssment skills are crucial in the nursery. And it can get very busy with very little notice. You have to be ready to juggle some babies. And the families will be beating down the door to meet thier new little one.

Hope this helps.

SmilingBluEyes · Aug 26, 2005

All the above is done by all of us---we are an LDRP (labor/delivery-recovery/postpartum) unit. So we do mom and baby (couplet care)....much broader scope. The list above is EXCELLENT----particularly for healthy newborn care......

but...

If you plan only caring for newborns (and not moms), plan on working with sick babies more---more and more places are doing away w/"well baby" nurseries now.

RNsweetie · Nov 10, 2005

You are right smiling, our hosp has officaly done away with the normal newborn nursery but unofficaly we still have it....

our other hosp policy states that fresh cs can not have babe in room with her unless feending or another person in room with her....

well our visiting hours policy states that in semi private rooms support people and fathers are only allowed to visit from 830 am to 10 pm so as a result we have the night where we have no nursery but we can't have babes in rooms... so short of having babes behind the desk---- we have a nursery!

Erin

mstigerlily · Nov 10, 2005

We have a well baby nursery as do several other hospitals in our area, staffed 24/7 with a nursery nurse. She gets paid the same as any other RN depending on how long she's worked there, etc.

She can take 8 patients max. First priority: Csection babies come to her for assessment (vag deliveries are assessed by L&D nurse in L&D). She does the initial assessment, bath, temp stabilization, vit K shot, erythomycin on all csection deliveries. Then when baby is stable and mom is moved to our floor, baby joins mom.

Second priority: Babies also go to the nursery for phototherapy or for observation if they are spitty, high RR, any other problem not worthy of transfer to LII but needing to be observed. Next priority is caring for babies whose moms are "resting" and need a break.

She will do q4 vitals, feedings, diaper changes, hearing tests, weights on all babies in there IF SHE HAS TIME and depending on the nurse. Otherwise it is the primary nurse (for the mom/baby couplet) who needs to come in and do those things. Any other tests done PRN - blood sugar, hep B injection, prepare babies for lab draws (lab comes up to do CBCs, PKUs, etc). For the day shift nursery nurse, esp in the am between 7-9 that is when the peds come in to do the circumcisions and she must set up whichever babies who are getting circed (sometimes several lined up in a row), assist the MD and clean up afterwards.

Does anyone work in the baby nursery? If so, what is your day like and what are the pros and cons of being in a baby nusery? How long are your shifts? Also, how much are you paid hourly? Thanks for putting up with me....lol and my questions.

studentnurserachel · Nov 11, 2005

The hospital where I do my clinicals has a well-baby nursery attached to a level-2 NICU. Babies born there spend a great deal of time in the nursery. There is generally 1 LPN (the only place in the hospital that still has LPNs working) and 1 CNA assigned to do the basics for all the babies and an RN from the NICU comes over to do an assessment once a shift. This is the only hospital in the area that still has a well-baby nursery, and I noticed that the general attitude about it by the families was bad because hospital policy states that they are not allowed to keep the baby in the room with them while they are asleep, at least 1 parent must be awake. This is polar opposite to the hospital where I had my son and was not allowed to give him over to any staff at any time (taking shower, in bathroom, sleeping, etc), even assessments performed in-room. I could not tell you what the RN's job was because we did not observe NICU and her total time in well-baby nursery was maybe 45 minutes just doing a basic newborn assessment. The LPN and CNA spent most of the day rocking babies, feeding babies, bathing babies, and that was about it. I love newborns and I was bored after 2 days. I personally could never work a well-baby nursery, however, at most places, I don't even think it's an option for RNs, I think if you're going to be working on babies outside of an LDRP/PP setting, it's most likely going to be sick babies.