How do you encourage rooming in???

SmilingBluEyes · Oct 19, 2003

sounds like a social service/worker issue to me. i would report this so she can help. she is obviously NOT ready to deal with a baby at home. your instincts are correct.

tntrn, ASN, RN · Oct 19, 2003

All of our babies room in because our nursery admits sick babes or premies only! Period. There is no nursery, just our Special Care Nursery. If you have a newborn nursery for well babies, it's implied that the mom has a choice, in my opinion. Maybe she needs to also rethink whether or not she really wants to breast feed. It's not for everyone. And social service consult for her also.

Dixen81 · Oct 19, 2003

Makes me think of all of the people who want so desperately to have a child and can't, but then someone like this girl has one and doesn't seem to really want it. How sad. My heart breaks for that baby.

fergus51 · Oct 19, 2003

If the option is there, it will be used. I haven't worked in a hospital that allows well babies to go out to the nursery at night. Policy is, you had the baby, you look after the baby,

palesarah · Oct 19, 2003

we don't have a well-baby nursery, but we are usually staffed well enough to allow exhausted parents the option of having us take the babies out to the nurses' station for a few hours in between feedings. Since we have a locked unit, either a nurse or an aide is always at the desk. However if it's too hectic a night to ensure the safety/security and well-being of the babies up front, back to mom's room they go!

I agree with Deb & tntrn that a situation such as the one you described with the teen primip requires a social services consult. Scary.

NurseyNursey · Oct 19, 2003

We only have nursery available at night 11-7. This is to allow the new moms a chance to rest. They are always informed that it is only as staffing permits and if we get busy the infant will be returned to their care.

Breastfeeders are informed that if their infant is inconsolable and it has been more than an hour since being fed the babe will be returned to them.

No real complaints yet.

Definitely social services consult with that young lady.

NICU_Nurse, BSN, RN · Oct 20, 2003

Yep, call in Social Services. Teem moms are an automatic referral for us anyway.

Call in your Lactation Consultant.

Tell mom in no uncertain terms that this baby has caloric needs and WILL be fed- either she's waking up to feed him properly (and tell her that you may be required to stay in the room with her to ensure that the baby is fed, if you are allowed to do this) OR you're feeding the baby.

Tell her the baby will need to be fed a minimum of such and such so often (q3 or 4 or whatever your policy is), and if she's not going to do it, you will have to. If your policy needs to be updated, expanded, or rewritten, begin working on this so you won't have to deal with this again while not having hospital-approved channels to back you up.

I would include wording in the policy, as well as in a patient education pamphlet (that you hand to every single mom) that says something along the lines of, "Your baby, while you are a patient here on our unit, will remain in your room at all times unless he/she is needed by the nurse or doctor to perform a procedure or be assessed. The nursery is not used to house infants; the nursery is only available for medical reasons, or for temporarily holding infants whose mothers are on certain medications or otherwise unable to care for their own babies. This will be left at the discretion of the doctors and nurses. We want to provide you with ample opportunity to bond with your new baby."

To her "He is fine..." comment, I would have nicely said, "No, he is not fine, he is hungry. That is what babies do when they are hungry. He is telling you that he has not had enough to eat, and as his mother, it is your responsibility to feed him."

I'm still voting for mandatory birth control with a test required to conceive. Anyone with me on that one?

Dave ARNP · Oct 20, 2003

I'm still voting for mandatory birth control with a test required to conceive. Anyone with me on that one?

I have you my vote, everyone in my families vote... and the entire nsg staff at my hospitals vote. (Not the docs... that might mean less $$$)

Dave

rntg · Oct 20, 2003

Wow, it seems everyone is really jumping to conclusions here. Granted I had my kids ions before rooming in was the norm, and a 3 day stay was a given, but I don't think moms' needs have changed that much over time. I sent all three of my kids back to the nursery at night, to get some much needed sleep, sleep I wasn't going to get when I got home. I nursed all three of them and oh my goodness, even told the nurses to bottle feed them at night. All nursed quite well when we got home, and I was glad to get a little rest. I don't think it was a reflection of my future parenting skills, and did not hurt my mother-infant bonding. What happened to the maternity nursing theory take care of the moms in the hosptial so they can take care of their babies at home. Instead we are sending moms home quicker, and making them care for every aspect of their baby's care while they are there, they might as well skip the hospital altogether and bring back home birthing. Rooming in, in my opinion, was brought about hospital administration that wants to cut staffing numbers, not for the well being of the mom or baby. :rolleyes:

fergus51 · Oct 20, 2003

rntg, you were willing to feed them. That's the difference. Research has shown the benefits of rooming in, and it is exactly because moms go home so soon that it is a necessity for first time moms in particular. A lot of them come in without knowing how to breastfeed, or care for their babies in general. I can't afford to waste a whole night by sending baby to a nursery.

rntg · Oct 20, 2003

Your right, I was willing to feed them, but I also was selfish in the fact that I wanted my sleep. I do remember, especially after my second child, I was physically not ready to care for him. I felt like c---, I couldn't pee, I hurt like crazy, couldn't sit. I wanted to be taken care of. I am still not a proponent of total rooming in, probably never will be, but I am old school, I guess. I did care for my babies during the day, but at night, at least the first two, sleep was more important, especially with the 2nd and 3rd, when you know what exhaustion is waiting for you at home. Maybe a social service consult was in order for your particular patient, but I hope you take it on a case by case basis.