Caring for infants when mom is unable and no newborn nursery exists

[mthuckleberry]

With the growing trend toward couplet care and the elimination of a well baby nursery in many facilities, our hospital is trying to solve the issue of having no place to take care of normal newborns when mom is unable to watch and care for her infant because she has had a c section , is sleep deprived, or is spending time in the jacuzzi and there are no family members available to help out.

While our NICU used to watch babies when moms needed to rest or were unable, it has grown and is now too busy to be able to do this. And since we are not a large city hospital (population of approx 20,000 surrounded by more rural communities), our census and available nursing staff fluctuates greatly. We have at times brought babies out to the nursing station to be "watched" by whatever staff are available, but have found that this is not always ideal. And of course, sometimes there is simply no one freed up to sit with an infant.

So.... we are wondering how other facilities have solved this problem?? Do you have a separate place to take infants and a plan for staffing on a changing needs basis.

~~thanks~~

[d2k2ross]

I don't work on our Mother Baby unit all the time but we don't have a well baby nursery. It seems to me that when baby is away from mom for any reason, the RN takes responsibility for that baby. That usually means that the baby will hang out with the RN while he/she charts, etc. If the RN has to go to a patient room, a CNA will take over "babysitting". Granted, it doesn't seem to happen that much but this works well! If this "babysitting" takes place on your unit more frequently, you would probably need additional staff.

[retiredlady]

Our hospital had a small one room nursery for that purpose with a Rn in attendance. It worked very well. The babies were brought to her and sent back by the mother/baby nurse. Some of the doctors also wanted to examine the babies in there because the lights were better and also all the circumcisions were done there.

[LifelongDream]

Our floor operated the same way retiredlady. There is one nurse that is strictly a nursery nurse. She sits with babies, performs hearing tests, PKU's, and retrieves babies for the doctors. She also recieves new babies and does the assessment in L&D. Then the baby/mother (couplet) are cared for by a floor nurse after the inital assessment. Hope this helps!

[rn/writer, RN]

On our postpartum unit, we practice couplet care but still have a nursery that is staffed the entire shift by a trained PCA who can feed and change the kiddos and call for help if there are problems. Nurses are often in and out of the nursery as well.

Couplet care is great and should be promoted, but many moms (and dads) appreciate some respite, especially if they are going home to other kids. The section moms can feel pretty bedraggled that first night and so can a vag mom who labored for a couple of days or who experienced a postpartum hemorrhage.

The so-called "baby friendly" units that make no provision for such situations seem downright "mom unfriendly" to me.

There ought to be a balance.

At any rate, we have found our PCAs to be capable and skilled. I don't know what we'd do without them. Maybe this could be a solution for your unit.

[copperkali]

I don't work on our Mother Baby unit all the time but we don't have a well baby nursery. It seems to me that when baby is away from mom for any reason, the RN takes responsibility for that baby. That usually means that the baby will hang out with the RN while he/she charts, etc. If the RN has to go to a patient room, a CNA will take over "babysitting". Granted, it doesn't seem to happen that much but this works well! If this "babysitting" takes place on your unit more frequently, you would probably need additional staff.

We do this too. Lots of times we don't have a CNA so the unit secretary (if we have one) will sit with the babe for a few minutes. Sometimes it's nice to have to "babysit" because you can't really leave the baby so you have to chart I often will volunteer to watch the kid so I can catch up on my charting.