Rooming-in Vs. Nursery Care - Page 2

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  1. Sep 2, '05 by
    I agree 100% Deb.
    That is just what I was talking about.
    I do find I have little patience for the mom by her 15/16 smoke break halfway through the shift. But, I do have pity on the mom who was a 3 day induction actively laboring for 18 hours and pushed for 2. I think she is alloted a little rest before resuming mommy duty.
    See the difference?
  2. Sep 2, '05 by
    Wow!! all that in 2 days or less!
    Just kidding, that was very well written and thought provoking. You should print it up and hand it out in the delivery room
  3. Sep 2, '05 by
    Quote from dawngloves
    Your baby was on an O2 monitor in your room??! :uhoh21: Not cool.
    Why, we do that on occasion. If you have very involved parents, and a baby that is not critical, it's fine for the parents to watch, as long as the nurses are around if need be. In my opinion, the parents are far more likely to really watch (sometimes too closely) the numbers on the Sat monitor than nurses are.

    Sometimes, nurses tend to try and rxclude parents from the baby's care. Sometimes, we have to step back and rememebr that the baby belongs to the parents: not to us and they certainly have a right to be involved in the baby's care.
  4. Sep 2, '05 by
    Quote from babynursewannab
    My situation was a bit different than most. I live away from most of my family (across the country) and my husband had to stay with our other child. My mother-in-law couldn't come and stay. I was completely alone with the exception of occasional visits for those days. I also have an autoimmune disorder that, as most do, rears its ugly head with stress.

    Don't automatically assume they returned the baby for feeding. I was supplementing. She was a great latch and would feed well from me, but we had other GI issues with her so we were doing both. The nurses knew they could have given her something. I know all about bonding and breastfeeding and all the rest. This was my third child and I had already had years of experience in L&D. No one needed to teach me or my underlying maternal self to bond. The baby and I had already shown we were fine in that area.

    I simply needed one night of sleep to recoup from the problems I had at delivery and the exhaustion from the heavier than normal bleeding...methergine was given twice....my counts weren't quite low enough to warrant a transfusion. Nevermind the stress from worrying about the baby.

    All of this is simply one example of why strict rooming in may not be best in EVERY case. I wasn't saying rooming in is bad. Heck, I wanted her there, but I simply wanted a short reprieve. One night wouldn't have killed the baby...or the nurses. The best part of the whole story is one year later, I was finishing my BSN and did my preceptorship on that very same unit. I was told by a group of nurses chatting: " Lots of moms ask for us to take the baby but they just need to learn to deal. We're not going to be there when they go home." Very similar to a previous post. This is cold. I work in a CVICU now and imagine if I had one of my open-heart patients laying in tears, throwing up from exhaustion, bleeding more than expected, outright asking for help after FOUR days and nights and I told them they just had to stick it out on their own...I won't be there when you go home! This is the recovery period, I came to the hospital in case I needed help. I could have homebirthed, but didn't (thank goodness). How about instead of just lumping every patient into one way of treatment, we ASSESS the patient and treat them like they had individual needs.
    There is a huge differnce between a cardiac patient and a new nursing mother. Let's compare apples with apples. Encouraging a breastfeeding mother to sleep through and have the baby fed in the nursery is undermining that mother/baby couplet. As a nurse (but here as a lactation consultant) I have to say that you, as that L&D or PP nurse will not be the one trying to undo what has been done in the hospital when the mom is having difficulties that may never have needed to happen.
    Last edit by BETSRN on Sep 2, '05
  5. Guide
    Sep 2, '05 by
    It's important to assess each situation carefully. Is the mom asking for a temporary reprieve so she can catch her breath and care for her child better? Or is she asking for babysitting service so she can yak on the phone and show off the new doll clothes to visitors?

    I really think moms need to be given a lot more information on breastfeeding, rooming-in, the couplet rhythms that are meant to develop naturally, etc. LONG before delivery. They need time to be exposed to these ideas and absorb them when they're not under duress. Maybe lactation counselors should see them in their fifth or sixth month. I know, I know, insurance companies would have a cow (pardon the pun), but if more moms had the vision of how things are supposed to be, maybe it wouldn't be such scary and loaded topic.

    Women who have never seen successful breastfeeding and who don't have staunch advocates and examples are often just lost, no matter how highly motivated they are. Natural mothering becomes a litmus test for personal worth instead of a blessing. You can endure a lot to achieve a goal if you can picture the rewards awaiting you and if you have some confidence in your ability to get there. Without those things, doubt and discouragement take on greater power. Some moms quit just to get out of the minefield.

    I think LCs get a bad rap as high-pressure guilt-mongers because they have to compress a job that could well fill several months with education and inspiration into a few short minutes spent with a mom who is, by nature of the referral, already having problems.

    Here's an idealistic wish. Wouldn't it be wonderful if there were natural parenting classes the same way there are natural childbirth classes? After all, L&D is over in a flash compared to the rest of the baby's life.

    Honestly, by the time we get them in PP, it's almost too late.

    Miranda
  6. Sep 2, '05 by
    1st child - breastfed, roomed in. Didn't dare ask a nurse to take the baby to the nursery for fear I'd be labeled a "bad mother".

    2nd child - 23 mos. later, same hospital - breast fed, roomed in on first night (born at 2100). Second night - nurse checks in 2300 after feeding and asks if I want to send the baby to the nursery until his next feeding. I'm now in love with this woman!!! Yes, yes, yes! I knew that this would be my last few hours of un-interrupted sleep before heading home the next day to a two-year-old and a newborn. Baby returned 3 hours later for a feed, and stayed with me until I was DC'd the next day.
  7. Sep 2, '05 by
    Quote from SmilingBluEyes
    Rooming-in is for HEALTHY couplets only.

    If a mom or baby is compromised, staffing must provide for special care for the patient w/those needs.

    Babies on monitors do NOT belong in room w/mom. If a baby is that compromised that he/she is on a monitor, then that is a "special care" case, requiring close watch by nursery personnel.

    Conversely, if a mom is sick (Magnesium therapy comes to mind, among other things) then she needs special care too----she may not be capable of caring for her baby for a number of reasons. If this is the case, then again, staffing needs to allow for special care of that mom, e.g. someone to watch over the infant's needs/care while mom is sick.

    Rooming-in really IS the way to go, for all the advantages listed. But like I said, it is NOT for a compromised couplet. I would not want to work in a place where medical needs of a patient are not considered in the rooming-in process.

    Also of note: my sympathties for moms does NOT extend to the case of a breastfeeding mom who wants to "sleep all night and have her infant in the nursery" but DO NOT DARE FEED HIM ANYTHING. I have seen this more times than I care to mention. And I will tell them, if you are breastfeeding, baby will come back for eating, period. This is how it will be at home, so you need to be accustomed to this pattern. You will lose a lot of sleep. That is how it is, when you have a newborn. If you are dead-set on a "full night's rest" in the hospital I will do what I can to give you your sleep, but the baby WILL Be eating in your absence, which may compromise your breastfeeding relationship at a critical time, when you need to be learning each other's cues in the earliest days.

    Most get it, others are still clueless and I wonder what their lives will be like when they go home and there is no nurse to "deal" for them.

    Excellent post, Deb!
  8. Sep 2, '05 by
    This is one reason why I encourage limiting visitors during the day so mom can rest. Most hospitals I worked at in Canada did not have well baby nurseries at all. I'll let that sink in for a moment.... NO WELL BABY NURSERIES.... It's a foreign concept to many nurses. Healthy moms and babes stayed together the vast majority of the time. Moms were encouraged to limit entertaining visitors during the day so that they could sleep when the baby slept. Babies sleep about 70% of the time so that makes for a lot of opportunities for moms to rest if they aren't being disturbed every 20 minutes by visitors/staff. They had private rooms so a significant other could stay with them and help. Occasionally a mom would need the baby to be out so she could have a shower or go for a smoke and no SO in the room. That wasn't a problem in general and I can only remember one woman complaining that we wouldn't take the infant out to a nursery for the night. The vast majority of women want their babies with them in the room.
  9. Sep 2, '05 by
    I previously worked at a hospital that was just at the start of the "Baby Friendly Initiative", and the whole concept with me and the other RN's went over like a lead balloon. I ended up quitting before they formally started. I am currently working at a hospital that is very diligently working towards Baby Friendly status, and I must say, as an RN, it is no where near as bad as I thought it would be.

    Now, as the bad mother who bottle fed her babies, I sent all of mine into the nursery at night. Would I do it again now? I don't know. I found when I did try to keep them with me, and I did try, I wasn't able to sleep well. It didn't help that when I delivered my 3rd, there was a woman arrested at a local hospital for impersonating a healthcare worker with the intentions of abducting a baby.

    I love Miranda's idea about the natural parenting classes. I have often thought a realistic postpartum class should be part of the Childbirth Education classes.
  10. Sep 2, '05 by
    Bottle feeding does not make a bad mother.