Mother/Baby rooming in

Specialties Ob/Gyn

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I would like info/thoughts on mother baby rooming in. My hospital is to start this. The patients don't appear to want this. They want to sleep. Many have been up for 24-36hrs by the time that first night gets here. Also the NOC Rn's are very nervous. What happens if you have s "silent choker" in the mom's room and she is sleeping and nobody see's that the infant is blue. They are not even putting infant O2 setup in all the rooms they say we are "jumping the gun" and that it is not (the awful words) "COST EFFECTIVE" whoa the poor rn who walks in to do her rounds and that mom is sleeping and the baby is not breathing. Will a lawsuit and the tragic loss then make it cost effective? We are not a small hospital we are a moderate hospital by Chicago. The big guys in the suits say this has been benchmarked and that other hopital do it with no problem. The Rn's who know rn's in other hospital say it is not working. Stories of baby cribs at the nursing station are not unusual.. They have remodeled and have made our new nursery smaller (Holding 10 cribs when all other equipment is in there) We quite often have 25-30 infants in there now. We move to our new home in about 1-2 weeks. Any thoughts, ideas or suggestions would be appreciated. THANKS

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karngs, The hospital I work at built a brand new several million dollar L&D unit. It is beautiful and a wonderful place for my to deliver (look wise). But, the hospital now has the rooming in policy for moms and babies. While a few like this idea, most moms want sleep. So, now moms choices are taken away. Forget sleep, the hospital wants to save money. Especially at the fact my hospital is in the hole and cannot even afford to hire new staff for all the new rooms or replace staff that has left due to unsafe policies. So, now nurses are even more over worked and stressed. And this puts moms and babies in danger!! As well as all our nursing licenses. The hospital's answer to the unsafe policies is, there is a policy to protect you in case something happens. I don't buy it and can no longer be a part of it. I am sad to say, I am leaving the life of OB/GYN to go to home care. And, they wonder why there is a nursing shortage. I can say I will not be having a children at my hospital until things change. Like there unsafe policies that put babies in danger!!

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Our small hospital has done Mother/baby or Rooming In for at least a year now. I worked NeoICU and we watched the well nursery, also.

I guess it is working...no dead babies yet. But I can see so many things going wrong. Aspiration (esp with c-section babies and ones that regurg a lot) Abducted babies, etc.

There is so much I could go into. One thing that you can tell the Moms...They have rights...they CAN have their babies in the nursery. We as a hospital cannot take away patient rights even if those above us say the babies will stay in the rooms. If I were in there, I would actually have the baby sleep with me...in my bed. I wouldn't want her in the nurses station (which DOES happen a lot) or in a nursery that isn't staffed to take care of the babies because they are SUPPOSED to be with their mothers, or in a crib where I can't tell what is happening (because I am exhausted)or who may come take her. Give the best care you can. I can't see how hospitals will avoid a lawsuit if something happens to these babies, God forbid.

Lets put the patients first.

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Your situation is not unlike many other units that are having to combine services.

You do not state how the staff has been prepared for the changes. Has cross-training occur? Will the nurses be responsible for both Mom and Baby? or will you keep nursery staff that will be responsible for the babies?

You say you're to start in 1-2 weeks. I can only hope that your administration has given staff the ample time to get ready for the changes. If this has not been done its a great injustice to both staff and patients.

We have gone through several adjustments since going to babies staying with Moms. Even once you go to it there will be changes that need to be made to make it work for you. As for the patients we found that if they are made aware of the change ahead of time - prenatal classes, while in L&D, it helps. We were very surprised to see that most did not protest the change as it gives them more time to learn how to care for their babies and to ask questions while the baby is right there. It also gives them the opportunity to talk with the pediatrician who comes to see the babies in their rooms.

Wish you luck with your transition.

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I have worked in two hospitals where rooming in was encouraged and worked fairly well. One was a small (800 births per year) unit set up on the LDRP concept and there it worked very well. The other was a large (3500 births per year) unit where we had LDR with sperate post-partum unit, all semi-private rooms. The semi-private rooms seemed to be the biggest problem, some mothers sent their infants ot the nursery becasue they were afraid of keeping their roomate awake. The majority of the infants did spend at least part of the night with thier mothers. I think it is important to remeber why keeping mothers and babies together is so important. I did home follow-up for a while and I would see parents who hardly knew anything about their baby and mothers with almost no milk production at post delivery day 4 or 5. I could tell who had a lot of time with their baby and who did not. We are also moving to a new facility in June and we have a lot of the same concerns raised about 'choking babies' and staffing. There may be other practices that we need to look at, for example is overly aggressive suctioning at delivery casuing increased secretions thus more choking or when and how we do assessments and weights on infants. Training is very, very important. We have a staff and physician group working together and our physicians have been very supportive. I wish you the best!

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Hi all...

I'm not an OB RN (I work in geriatrics, the other end of the spectrum smile.gif) but am having baby#3 on Dec. 3. All our hospitals here have a rooming in policy with the OPTION for the nurses to keep baby overnight for exhausted mommies. I kept my first son from the first, and I tell ya, he would have been better off with the nurses!! (emergency section after 40 hours of induced labour -- was I a mess!!) Anyway, my second son stayed in the nursery the first night, and they would bring him to me to feed only (even though I was bottle feeding). That was great. HOWEVER...I know LOTS of moms that were very satisfied with rooming in from hour #1 until discharge. There have not been ANY reported baby deaths in as long as I can remember, and the nurses DO check on baby and mom hourly, at least. Of course, if there is any indication that babe needs more monitoring, they are taken to the nursery.

Money is a BIG factor in all this, but so far has worked out really well. The "transition" was made about ten years ago when I was a student, and a lot of nurses were opposed to the idea, for a number of reasons, but have found that the new policies enable them to observe the mom with baby, and do a lot of hands-on patient teaching as situations arise with baby fussing, feeding, bathing, etc. It was VERY difficult to change years of policy and procedure, but (as I said) seems to work well, if you keep an open mind -- and open eyes!!

All the best...

Heather, RN

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