Hi guys, I need some opinons. I work in a rural hospital in the newborn nursery. We don't do couplet care. Have different depts for L and D, nursery, and post partum, with different nurses for each. I have been there for about 3 years. Well, last night I had a baby, SVD, breastfeeding, fine kid, about 36 hours old. Mom wanted me to keep him the night before, she was tired and just wanted him for feeding, but last night she wanted to room in with him. So, I take him in for a few minutes assess, weigh, bath all that stuff and take him right back out. A little while later dad calls for something and talks with another nurse and happen to mention that they are rooming in. This nurse, who is a really great nurse and a friend of mine, tells them that they can't keep the baby unless someone is awake at all times and goes to bring the baby back. I get back about this time and we had a bit of an argument about this, but she says they can't keep him if they are going to be sleeping, period. Liablity issues, etc. I point out that most other hospitals do couplet care, that this family would be sleeping in their own house if they had decided to go home that day, etc. She is not moved! LOL Says they can do what they want when they get home, that while the baby is in the hospital he is our problem and it is on us if the baby dies while in the room with the parents and they can't keep him if they are going to sleep. I backed off, (she was charge and has been there 20+ years) smoothed it over with the parents (who were NOT happy about this), and just took him out for feedings. We don't have a written policy about this. I just called my NM for some clarification but I couldn't get her. What do you guys do at your hospitals? How do you feel on this subject?
Thanks,
Criss
Whoa, did a search for threads on this and just wanted to say, I don't want this to get ugly, lol!
Our unit doesn't keep a well baby nursery; all healthy babies stay with families unless it's an unusual situation and it's great. I couldn't imagine it any other way.
The 'liability' argument to keep babies apart from mom is funny to me... I'd probably feel like suing if I was told I couldn't have my own baby - it is seriously that foreign of a concept and off-putting to me. I wouldn't chose to deliver (or work) in a unit where I couldn't have my own healthy baby (and didn't, all three were rooming-in; one large city hospital and two at a small community hospital) at will and frankly I can't believe that the moms submit to that.
I respect that some of you work in places like that and maybe some of you like it or can't change it, but wow that's wild - sounds like the 1950's or something!
This is exactly how I feel! We really do things like in the 1950-1960 era, it is really driving me crazy. I am not the "new kid" anymore so I feel like it is a good time to try to make some changes. We are a large community and this is the reason we don't have more del. a year-everyone that can is going to different hospitals where they can have there wishes respected! As far as the liability issue, has anyone every had a suit that concerned the baby being in their room? Not just a tragedy as another poster said, (cause things happen in the nursery too, can't constantly watch 10-12 babies at a time), but an actual suit? Thanks for your replys to this, I feel more confident that I am not just a tree-hugging, granola type (as some of the other nurses jokingly say), but that this really is something most everyone else is doing.
Our moms have the option to have the baby room-in with them, or hang out in the nursery and come out for feedings (or we bottle feed if requested). For whatever reason, we do not super encourage rooming in, we just present both options to mom and do what she wants. I know other places really encourage it, I'm not sure why we don't so much...but most of our patients elect to send their babies to the nursery, frequently. I guess that's just our population. And in response to your other post, we don't have NRP equipment in our post partum rooms (but we do in the labor rooms and OR), but we make sure all cribs have a bulb syringe and the parents are educated on it. Fortunately our unit is small enough we can usually run the baby into the nursery pretty quickly if deep suction with some O2 is needed. Thank god I haven't seen a baby out in mom's room need anything more than that!
All I have to say is I would have dared whoever to tell me that I could not room with my kids. I don't mean any harm but I feel that is wrong. I agree with TCRNCOB61.
here in New Zealand all hospitals and units have to be baby friendly. all babies room in unless they are in nicu or sbcu, and you tend to get the third degree if you want baby in the nursery. i did put my 3, and 4 in nursery so i could get some sleep but they make it a rule that they come back to you for all feeds. it works well, but if the mum just isnt interested in her kid what can you do?
The hospital I delivered my daughter at did not have a well baby nursery. I had to keep my daughter with me at all times, even at night. The only time she left my side was when she had to get assessed. If my husband was not with me and I wanted to take a shower, I rolled her into the bathroom with me. I did not mind one bit. I wasn't so shocked and overwhelmed when I got home.
The hospital I delivered my daughter at did not have a well baby nursery. I had to keep my daughter with me at all times, even at night. The only time she left my side was when she had to get assessed. If my husband was not with me and I wanted to take a shower, I rolled her into the bathroom with me. I did not mind one bit. I wasn't so shocked and overwhelmed when I got home.
That is the argument that most parents will actually see a point to. I say all the other stuff (babies cry less, you can get to know her feeding cues, etc) and it kinda gets ignored. When I say, "This way you know what you are getting yourself into so reality won't hit so hard when you take this baby home. And you still have some backup if you have some questions or concerns or need help," that usually gets some attention. Usually at that point they will decide to keep baby in with them, at least most of the night.
I don't think it's safe to room-in with the baby...with insurance companies kicking mothers out 48 hours after the birth...mothers are exhausted, on pain killers, etc. They aren't going to be as alert right after a birth as they will in 3 or 4 days.
Someone posted somewhere on these boards where a new mother was nursing her baby and the RN came back 20 minutes later to find the baby dead and under the mother's breast...the mother fell asleep...probably NOT REALIZING how exhausted she was.
All the waivers in the world...won't bring a dead baby back.
In th hospital where i had my baby in April,i stayed with my baby all thru the 2 days i was there except the time the nurses took him for pku test.The nurses never helped me with any of my son's care.i don't even know if they have nursey or not.It was ok by me cos i dont even know if i could take not being with my son for a second.
I don't think it's safe to room-in with the baby...with insurance companies kicking mothers out 48 hours after the birth...mothers are exhausted, on pain killers, etc. They aren't going to be as alert right after a birth as they will in 3 or 4 days.
Someone posted somewhere on these boards where a new mother was nursing her baby and the RN came back 20 minutes later to find the baby dead and under the mother's breast...the mother fell asleep...probably NOT REALIZING how exhausted she was.
All the waivers in the world...won't bring a dead baby back.
Hopefully that doesn't happen very often! I think the mom and the nurse can decide together how safe it is, and as much as mom may want her baby every second, if she is exhausted and/or needing a lot of pain meds, she will be able to reconize that and agree that its not a safe situation at the time. In a perfect situation someone else can be there (dad, or another relative) and help mom so baby can stay with her all the time.
At our hospital parents rarely room-in...the other night we had 20 out of 23 babies in the nursery. I'm not sure why our population chooses not to room in so frequently, its a little odd at times actually. I had a mom crying about sending her baby to the nursery, but no matter how many times I said "why don't you keep him with you?" she insisted he go to the nursery. I do wonder what will happen when they go home...this baby in particular spent at least 11 hours in the nursery every day they were in the hospital, he would be there nearly the entire shift. So we knew how to make him happy, but I'm not sure the parents did! And I think they were bonding well...they just wanted him in the nursery every night, all night, from about 8pm on. Odd.
I don't think it's safe to room-in with the baby...with insurance companies kicking mothers out 48 hours after the birth...mothers are exhausted, on pain killers, etc. They aren't going to be as alert right after a birth as they will in 3 or 4 days.
Someone posted somewhere on these boards where a new mother was nursing her baby and the RN came back 20 minutes later to find the baby dead and under the mother's breast...the mother fell asleep...probably NOT REALIZING how exhausted she was.
All the waivers in the world...won't bring a dead baby back.
If this is your opinion, that's ok, but what is going to happen when people take the baby home? They are going to sleep with their babies. Maybe not in the same bed, but perhaps in the same room. Rooming-in. Incidents like the one you mentioned make headlines because they are so very rare. I am not trying to be crass about that family's loss -- the death of any baby is devastating. But the evidence is not there that rooming-in is unsafe.
Things can and do happen in the nursery, too. Of course, if something is going on with mom and/or baby, that can be worked around.
If this is your opinion, that's ok, but what is going to happen when people take the baby home? They are going to sleep with their babies. Maybe not in the same bed, but perhaps in the same room. Rooming-in. Incidents like the one you mentioned make headlines because they are so very rare. I am not trying to be crass about that family's loss -- the death of any baby is devastating. But the evidence is not there that rooming-in is unsafe.
Things can and do happen in the nursery, too. Of course, if something is going on with mom and/or baby, that can be worked around.
I'm sorry, I probably didn't word myself well.
I was only talking about the initial period after birth..b/c so many mothers only stay in for 48 hours or less...Let's say a mother was in for 5 days due to a C-section...by Day 3, she is going to feel alot more alert...in pain, but mentally more alert than she would, let's say, on Day 1, when she is probably on so many meds she didn't know which way was up. By the time women get home with their babies, they are much more alert than they were in the hospital.
I also agree with Arwen that a good nurse would also monitor the situation well.
To me, being sleep deprived, tired from giving birth, and tired from being on medication...is three different levels of "tired".
When babies stay with mom all night, how often are you required to document on baby? We are supposed to check that security device is intact every two hours. We are not required to document color or respiratory effort which I think is more important than documenting the security device. When applied properly, it would be almost impossible to come off. How often do you document on rooming in babies? Thanks!
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crissrn27, RN
904 Posts
This is exactly how I feel! We really do things like in the 1950-1960 era, it is really driving me crazy. I am not the "new kid" anymore so I feel like it is a good time to try to make some changes. We are a large community and this is the reason we don't have more del. a year-everyone that can is going to different hospitals where they can have there wishes respected! As far as the liability issue, has anyone every had a suit that concerned the baby being in their room? Not just a tragedy as another poster said, (cause things happen in the nursery too, can't constantly watch 10-12 babies at a time), but an actual suit? Thanks for your replys to this, I feel more confident that I am not just a tree-hugging, granola type (as some of the other nurses jokingly say), but that this really is something most everyone else is doing.