Mother-Infant Coupling - page 6

I just became the assistant manager of a women's health care department. We just had consultants come in who have decided that our whole department needs to be changed around. We are a 200-bed... Read More

  1. by   mandykatrn
    Quote from vwgirl
    I forgot to mention that our facility does NOT encourage fathers/support people staying past 9 pm. I am more flexible than a lot of nurses; if the patient does not have a roommate and we are not busy I will let family members stay if the mom wants them to. Other nurses get on the intercom and kick everyone out at 9pm, no excuses! I don't think does anyone any good, but hey, I've only been there 4 years and she's been there 25, so what do I know anyway?
    OMG - what hospital is this? At least please identify the state you're located in, because I don't want to chance getting near that hospital with a ten-foot pole, and I'm betting many others wouldn't either!
  2. by   mandykatrn
    Quote from austinsmom
    OMG - what hospital is this? At least please identify the state you're located in, because I don't want to chance getting near that hospital with a ten-foot pole, and I'm betting many others wouldn't either!
    Sorry, just saw your reply about the rooms being semi-private. But still, this hospital sure sounds less than desirable to deliver at. JMHO
  3. by   mitchsmom
    Are yall Pittsburghers talking about Magee Women's?
    I delivered my first baby there in 1997 and he stayed with me the whole time except for an initial "observation" time and then when he went for PKU - otherwise he was with me the whole time. (My next two were delivered in a small town Florida hospital with LDRP's and no mandatory "observation" times, etc. These days I would not chose a hospital if they had mandatory times to keep the (healthy) baby away from me.)

    Also, I got curious about birthing centers in Pittsburgh and I found a link to one here, attended by 4 CNM's!:
    http://www.midwifecenter.org/

    Also for those of you who keep the babies in the nursery and send them back when they need breastfeeding, how does your nursery determine they when need to feed? Since crying is a late indicator of hunger, and you may have several babies keeping you busy, do you just do certain time intervals or ??? I guess part of what I'm getting at is that babies usually show subtle signs of being ready to nurse that don't always happen on a schedule, and it just seems like it would be easier for mom to cue in on these than a busy nursery. Plus, I think I've repeatedly seen it quoted that breastfeeding moms actually ended up with more rest when rooming in anyway. She and baby get "in sync" more quickly this way, and are likewise further "out of sync" with the nursery option (and thereby the whole process keeps them up longer, getting less rest afterall). An example of this scenario is described on p. 50 of Dr. Jack Newman's Ultimate Breastfeeding Book of Answers, but is too long to write out here!

    I think it's a sticky situation about doing things that mom might not like. I mean, patients probably don't like to ambulate after surgery but it's best... seems like there are some things that are similar in L&D??

    For those of you who think more things should be done evidence-based, how do you not go insane from the frustration? I just went as a labor coach for my best friend the other day, and have just been really frustrated ever since. It makes me wonder how I will deal with it on a day to day basis (although I guess I'll have a little more control with my own patients than I did as labor coach. As labor coach I kept mostly quiet as I did not want to step on anyone's toes... also a difficult balancing act between self, patient, and staff - I just pretty much let her and staff do what they wanted and I just helped her out around the room, etc.)
  4. by   karenmcd
    One consultant...too many. A mother baby unit only works if it is strictly adhered to. Staff and families need to be aware of what is acceptable. I work in a well nursery and level 2 nursery. We go between each depending on our assignment. The unit is "supposed to be" a mother baby unit but mothers constantly send babies to the nursery at night. One question for you....how can you accept one baby and not another's??? In reality no baby can be turned down at the nursery door. What ends up happening is that even though you call it mother baby it doesn't happen that way. I wish you could get a different consultant but I bet no matter what information you present you will be forced into this. I strongly reject the idea of only one RN. That is not acceptable because as you stated you will still be responsible for the stabilization of infants prior to transport.....what if there are 2 requiring transport???? Even the best trained L&D nurse will not be much help in this area. If you do it....in writing a plan must be in place with specific information on which circumstances allows a baby to go to the nursery and who watches over the babies when the one and only RN needs to eat, go to the bathroom or has to handle a sick baby. Keeping in mind that unlicensed assistive personel no matter how good they are...can never equal an RN.
  5. by   colleen10
    Mitchsmom,

    I had an opportunity to tour and meet with one of the CNM at the Mid Wife Center. It was an incredible experience to see their facility and talk to them about their birthing ideaology and patient care. It was such a positive experience. Wish in Pittsburgh that we had more birth options such as their facility but it seems that more CNM are being pushed out. They created their own center because their CNM practice at AGH was discontinued d/t increased prices, etc. Glad they fought the good fight to create their center.
  6. by   mitchsmom
    Quote from colleen10
    Mitchsmom,

    I had an opportunity to tour and meet with one of the CNM at the Mid Wife Center. It was an incredible experience to see their facility and talk to them about their birthing ideaology and patient care. It was such a positive experience. Wish in Pittsburgh that we had more birth options such as their facility but it seems that more CNM are being pushed out. They created their own center because their CNM practice at AGH was discontinued d/t increased prices, etc. Glad they fought the good fight to create their center.
    Yes, I hope they have a thriving practice and can stay in business! Do they deliver at the center and at the hospital or just at the center?
  7. by   colleen10
    They deliver at both the mid wife center and at the hospital. However, the mid wife center does not offer epidurals because there is no anastesh. on site.

    They have three birthing rooms that you can see on their website. It's a very "homey" feel. There is a kitchen down the hall from the birthing rooms so that family and friends can stay at the center while mom is laboring and have a place to meet and eat or cook food if they want.

    They have a couple exam rooms and do all kinds of woman care. They also have a classroom/learning center in the basement for education.

    They haven't done too many births at the center yet because they have been having problems getting accepted by insurance companies. Not because they are risky or anything but because when they were in the process of organizing the center they didn't realize how long it would take for insurance to accept them.
  8. by   tinnekke
    Quote from vwgirl
    ....are a nice concept, but only work with healthy infants and mothers that are willing to actually care for their babies, this includes during the night! When staffing is short on my unit, management likes to say, "Well, send the babies out to the mothers, let them take care of them." Needless to say, the mothers are NOT pleased when they are told, "I need you to keep for your baby for a while so I can treat this new baby/baby in respiratory distress/baby with an unstable blood sugar/baby who can't figure out how to eat/baby who need blood cultures drawn, etc." The moms expect to be able to drop their babies off at the nursery at 7pm and pick them up at 7am. And then management wonders why our "customer service" scores are dropping? (Like anyone really gives a ***** anyway.) Good luck, is all I can say.
    I feel your pain and also feel astonishment at those "convenience moms". I gave birth back in 2001, and the hospital where I had my son had all the rooms set up for couplets. They also have a class III NICU in its own area of the maternity floor. (Basically NICU is in a quiet area between L&D and Mother/Baby so that they don't have to be taken off the floor, just down the hall.) The NICU has its own area for moms so that they can stay in the hospital with their infants instead of having to leave to make room for healthy couplets. The Mother/Baby unit should rightly be called the family unit since they not only condone fathers staying the night, they outright encourage it. The Mother/Baby unit nursery is mostly for observation and doing infant care like baths and assessments, but moms are told to bring their infants down if they need a little time to themselves. I gave birth on a very busy weekend, (I labored in one of the OB examining rooms most of the night.) but you wouldn't have known it if you walked by the nursery. Other than a few under the warmers after a bath, there were no infants in the nursery. They were all in with their parents. Just about everyone there rooms in. Even I got to, and my son ended up being a c-section. I don't see why both the NICU and the observational nursery concepts couldn't be made to harmonize, especially if pregnant moms were given support during pregnancy to realize how good it is for them and their infants to room in after delivery. I loved it. It also gave my husband and I a perfect chance to get acquainted with our son's rhythms while we were in a place that was supportive and allowed us the opportunity to get rest if we needed it. (We never did, but it was nice knowing it was an option.) By the time we went home, we were already in synch with his sleep/wake schedule, and the sounds of his different cries were already firmly set in both our minds. I don't want to have any more childrem, but I do remember his earliest infancy very fondly. It was an incredible experience.

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