Well baby nurseries - page 3

I'm a little hesitant to ask this, given the thread on asking questions in another forum ;) , but I'm a paediatric nursing student in the UK, and whilst I get a maternity placement and a NICU... Read More

  1. by   mother/babyRN
    I find that most of the people who elect to send the babies back to the nursery overnight are the multips, and especially the bottle moms....
  2. by   fergus51
    I don't know why this is considered a good idea. Our women from healthy vag births often go home by the next day, or they are gone on day 2. That means they get a maximum of 2 nights to learn to care for their babies without us. We just don't have the time to waste (let alone the nurses to staff a well baby nursery). The main reason I don't like well baby nurseries (we had one at my last hospital) was for the breastfeeding moms. We would always have women who wanted to sleep for 8 or 9 hours, but forbid us from feeding the baby while she was asleep. I had a hard time explaining to some of them that the tiny bit of colostrum they got at the first feed (which is usually not a really good feed anyways) will probably not hold them that long (and 8 or 9 hours always becomes 10+).

    If a woman is exhausted we encourage the father or support person to stay and provide them with a bed. Otherwise they sleep when baby sleeps and most get a good 4+ hours right after birth. I have only had one woman get really upset about us being unable to babysit, but like I said, this isn't a hotel and I can't give services that we don't have to provide.
    Last edit by fergus51 on Jan 23, '03
  3. by   SmilingBluEyes
    If we were staffed better for well baby care in a nursery, I would have no problem with it. I would offer it EVERY night. ON slow nights, I do make the offer. Unfortunately, in small hospitals, this is more often NOT the case. We have several couplets and also labor and GYN to split among 3 or 4 nurses. We have no CNA. WE do have a CST but she is NOT allowed to "take care of babies" as it's out of her scope. This can get hairy. Which take precedence? Pain medication and turning, coughing and deep breathing for your surgical cases, working w/an active labor patient, or the healthy baby sitting in the nursery (or at the desk while we do paperwork)?

    Also, what do they do when they go home? Do you think these people who spent all day watching daytime trash tv and cartoons, rather than resting, will change their habits? Their exhaustion will continue at home. Even so, Exhaustion is part and parcel of having a baby; the lucky ones have family to help them. I did not, yet I managed. Those who give birth at home or in birth centers manage to assume care of their newborns immediately. Why do we expect any different in a healthy birth situation in the hospital? (not talking about sick mom's here). Should we when we tout labor and birth as a HEALTHY and NORMAL natural process????? They need to be taught early-on to assume care of their babies and where I work they rarely stay longer than 24 hours. Even when we nurses feel it's against our better judgement and ask dr's to keep them longer, it often does not happen. Chances are they will go home exhausted, yet having spent little time learning how to cope w/a crying or frustrated newborn. Then the calls pour in cause they know very little about what to in the simplest situations....they are understandably scared. That said.....

    We usually do our best to accomodate people. We juggle the crying babies among us and answer each other's call lights to keep everyone happy. But as we get busier and busier, I see this going away. Security is too big an issue. Having just one baby out means a nurse has to STAY in the nursery or at the desk w/that baby, no matter what. This gets tough to do with a mixed bag of patients on the floor. I see this concept working better when you are an ALL pp or mother-baby floor. But when yours is like mine, LDRP AND GYN, it is VERY tricky. Just one needy patient or active labor throws us all into a tailspin when a baby is out. But we DO try.

    Now, if there is a SCN baby in the nursery, in a way that makes it easy. We wheel the newborns in there w/that nurse to keep an eye on them......but then that is one nurse we DO not have for the floor. TRICKY and tough at times. I am not sure what the answer is. They sure ain't gonna give us another body for well-nursery care, whether it's perceived that is a paid service or not......that I promise ya. Maybe survey results that reflect their displeasure will help, I don't know.
    Last edit by SmilingBluEyes on Jan 23, '03
  4. by   mother/babyRN
    I think everyone has several good points here. But, I also have to add that in all the years I have been a nurse, we rarely ran into bonding difficulties if people chose to rest during the night while inpatients instead of rooming in. They were well rested and more able to comprehend teaching as well.....I have a problem with people who don't want to see their babies. I couldn't wait to have mine with me......But does that make either choice perfect? Hmm...Guess we will never change some people and hopefully will educate most.....
  5. by   NellieNurse
    How do you all staff for mother-baby care? How do you know when the moms want their babies to go to the nursery? Sho watches them, etc.?
  6. by   mother/babyRN
    I think on the night shift, as I am, it is a bit different....Our babies are out to the rooms during days and evenings, and for the majority of people, during the night also...Patients are our clients. In my book, if you decide not to room in despite being made aware of all the benefits to you and your infant, you are the client and we essentially, work for you...I am not paid enough to boss people around, and this is NOT meant to be a lecture. It is, however, the way I do and will continue to feel, whatEVER the staff situation...Ours is a level one nursery, which does not in any way shape or form, confine it to well baby...That can change in a milisecond.....
  7. by   SmilingBluEyes
    Originally posted by NellieNurse
    How do you all staff for mother-baby care? How do you know when the moms want their babies to go to the nursery? Sho watches them, etc.?
    Please read my posts if you are interested in how it works at the two small hospitals in which I work. I won't bore you by repeating it all. If you want a quick answer, we are NOT staffed to do this, period. We juggle at best. Or simply have to decline if it's too crazy.
    Last edit by SmilingBluEyes on Jan 24, '03
  8. by   SmilingBluEyes
    Originally posted by mother/babyRN
    I think on the night shift, as I am, it is a bit different....Our babies are out to the rooms during days and evenings, and for the majority of people, during the night also...Patients are our clients. In my book, if you decide not to room in despite being made aware of all the benefits to you and your infant, you are the client and we essentially, work for you...I am not paid enough to boss people around, and this is NOT meant to be a lecture. It is, however, the way I do and will continue to feel, whatEVER the staff situation...Ours is a level one nursery, which does not in any way shape or form, confine it to well baby...That can change in a milisecond.....
    See I just don't buy into the patient being client concept at all. I RESPECT them as PEOPLE, but they are not my CLIENTS. It is what is getting us between a rock and hard place, with management and our patient/family population. But that is me. I will do what I can to help, but my priorities are set by the census and associated acuity, not by my "client's preferences". If I can't take a baby out because the floor is too busy, I have to inform them. If you choose not to room in, you should look into a larger hospital that can accomodate this. Or one who does not do LDRP concept the way we do. Cause that is how they staff us....not to open a nursery for well babies. We even explain all this in our welcome letter that they sign and we keep on file. Really gone are the days when babies were lined up like soldiers in the nursery most the day and all night. I think this is a good move, really. And, Like Fergus said, it is NOT a hotel and I cannot offer services I cannot provide and I am not a chamber maid. I am a nurse, one who does a diverse set of duties on any given night. Changing hats frequently while I am at it.
    Last edit by SmilingBluEyes on Jan 24, '03
  9. by   fergus51
    Thank you Deb! I hate the notion that we are paid to do what the clients want, whatever that may be. I was actually berrated by one woman when I didn't have the time to wheel her out for a smoke (this was when we were so busy we actually went on diversion and we were putting PP patients in the hallways cause laboring patients were spilling over into the PP beds!!!!). I am there to do what needs to be done for my patient's health. Period.
  10. by   OBNURSEHEATHER
    Originally posted by Tycoben
    Would anyone be kind enough to explain to me the basics of the function and role of a well baby nursery?
    I find it interesting how the theme of the thread has turned from what the original poster asked, and into a well baby nursery vs. no well baby nursery debate. Of course everyone likes the way they do it, and everyone has an opinion.

    If your hospital does not have a well baby nursery and you have to push babes out to their moms when it gets busy, great. It's what you have to do. And if your hospital does have a WBN staffed with anywhere from 2-5 nurses and can function in that capacity, great.

    But let's not turn this into a name-calling and snobbery session, simply because of hospital policy.

    Sincerely,

    The Chamber Maid
  11. by   SmilingBluEyes
    We weren't heather. But thanks for your input.
  12. by   fergus51
    Not meant that way Heather. Just meant as an "I can not provide all the niceties that some hospitals can provide, but I do what is safe for my patients. Doesn't make me a poor service industry worker".
  13. by   SmilingBluEyes
    I guess for some of us, now and again, a hot-button issue is hit. I would HONESTLY LOVE TO PROVIDE well-nursery services to ALL MOMS EVERY time they ask for them. I DO feel for them when they are tired and need a break. It is not possible. The powers- that- be decided that staffing for this was NOT necessary since LDRP and "rooming-in" became the norm. Right or wrong, this is how it is esp on floors where we are combined like where I work. If it is perceived I am being snotty or stuck-up, I am sorry. Not meant that way at all.

    I guess I am tired of being expected to be an astute nurse on top of ALL my patients needs, PLUS be the person who empties a hundred pounds of waste and trash when I come on (these rooms are scary, hate to see their homes), clean up abject messes, change linens (we have no CNA), etc. AND yes, babysit for those who smoke or need sleep. I wish I could be all things. I can't. Nursing duties have to take precedence. That is all I was saying. If it sounds rude, I apologize to anyone on this thread who took it that way. It's just frustration speaking, trust me.

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