Baby Advocate @delivery-nursery nurse or L&D nurse???

[MomX2andNurse]

Our hospital uses nursery nurses to be baby advocates at delivery ( not L&D nurses) . We dont do LDRP's, so we are trying to figure out a smooth way to get the baby to couplet care (report, etc). Please share what you do at your hospital. Thanks!!

[RNandRRT]

Where I used to work, the nursery nurse and respiratory therapist would accept the baby right after the cord was cut. after the 5 minute apgar, the baby was presented to mommy if everything was normal. c-sections were NNP, nursery nurse and respiratory therapist.

[LDRNMOMMY, BSN, RN]

A fellow L&D nurse and Air Force or Army Med tech who are NRP trained are there for baby. NICU (RN and NNP or neonatologist) will be there if meconium, vacuum, forceps, or at the discretion of the nurse or provider. If all is well we put baby on mom (unless she wants the baby to go to the warmer). APGARS are assigned while infant is skin to skin. After the 5 minute APGAR baby stays with mom. Weight is obtained within 30 min because we need to obtain dexis on babies that are LGA or SGA by 30 min and then again at 3 hrs of life. Eyes and thighs are given within the first hr, a full assessment is completed. After the initial transition period the baby becomes the responsibility of the L&D nurse who is taking care of mom. Babies stay with us until transfer to MBU which is anywhere from 1.5-4+ hrs.

If chorio and the baby doesn't appear in distress the baby is allowed with mom and dad for 30 minutes, then must transition in the NICU. Babies under 2500 gm regardless of gestational age must transition in the NICU as well, the same 30 minute rule applies.

Babies are mostly transitioned while they are with us in L&D. Usually the only things left for the MBU staff are the open crib temps after the bath.

[Mandy RN]

This topic is of interest to me too. We actually seperate everything. Nursery nurse, special care nurse, labor nurse, postpartum nurse. If our census is low we may do couplette care. We do not do assessments in the room. If mom is bf then she may keep infant to nurse if the infant is stable. I appreciate some of the way we do it, but some of it I do not. A friend of mine who works on same unit different hospital, says that they have transition nurses who do the in between L&D to postpartum/nursery. I want to hear other ideas as well.

[Elvish, BSN, DNP, RN, NP]

Immediately after delivery (first hour) L&D keeps an eye on the baby (2nd L&D nurse assigns apgars). If baby develops problems, L&D brings him to the nursery to watch. Otherwise she watches and does vitals q30min on the baby. At about an hour, baby goes to the nursery for first bath, shot/drops. If Mom requests, nursery can go do bath etc. in the room but we're not staffed to do that for every delivery.

Once baby is warm after his first bath, he goes out to mom and then becomes responsibility of the couplet nurse. It works pretty well most of the time. It's a shared responsibility to ask about/report any special issues - ex., if baby needs blood sugars, is a little spitty, etc.