Designated delivery team

[kejRN88]

Hey everyone, I was just curious what the practice was of having a designated delivery team for Labor and Delivery? On the unit I work on, when we are ready for delivery (when baby is crowning or just before) we call the "code pink team" to the delivery. We also give plenty of heads up for meconium, or forceps/vacuum deliveries. The "code pink" team consists of the nursery nurse and a respiratory therapist. They come to every lady partsl delivery and C-section. If we have premature delivery, we always let the NICU know before hand and they come as well. I am just interested to see how other facilities practice.

[klone, MSN, RN]

Trying to remember. The first place I worked, we had a light system - we would turn on the first light (they were outside the doors, up at the top) when we were in there during stage 2. We would notify the nurse who would be there for the baby that we were pushing (as well as the doc, standing by). When the baby was crowning, we would push a second light, and that would cause the light to flash (can't remember if it made a noise, this was 5+ years ago), and the baby nurse (we called her the baby catcher, even though she had nothing to do with catching the baby, just transitioning it) and doc would come in. If we needed more help, the charge nurse would come in as well. For C/S, the labor nurse would become the baby nurse, and she was also accompanied by the pediatrician on call (OR staff circulated C/S, not OB).

The second place I worked, when delivery was imminent, we would call the charge nurse, and she would come in and be the baby nurse. If we had mec or an instrumental delivery, we would call the NICU staff to come for baby. The NICU staff would also be there for C/S, as well as RT.

[RunBabyRN]

Seems like overkill. The hospitals here require NRP for all nurses. If there's a major complication in labor or there's a c-section, there will be a NICU nurse at the ready or in the room.

[seemerun]

It's hard to say without getting a feel for how the unit as a whole runs but that seems like overkill to me too. Here, whoever has been laboring with the patient stays as the mom nurse. Our team lead comes as baby is crowning to transition baby. RT and NICU only come for a bad strip, forceps/vacuum, preemie, shoulder dystocia etc.

if its a C/S, then the nurse assigned to the patient is circulator, the team lead nurse is extra hands in the OR to assist with spinal, place foley, do the scrub etc. NICU and RT are always there until 5 minute APGARS. If baby is fine they leave and baby care goes to a post-partum nurse or the team lead if post-partum is unable to attend.

[klone, MSN, RN]

Oh, and everywhere I've ever worked, "Code Pink" means infant abduction. So we don't use that term unless a baby's gone missing (never happened to me, thank goodness).

[kejRN88]

Our infant abduction is a "code Adam".

[Elvish, BSN, DNP, RN, NP]

Baby nurse at every delivery for resus/apgars/transition period. This is my job and I love it! 98% of the time I am just there to dry baby off, put a hat on, and put him skin to skin with mom until she's ready for me to weigh/assess etc. (I'm also there to make sure things like blood sugars and other labs don't get missed but that's not relevant to the context of immediate delivery.)

High-risk deliveries - mec, instruments, section, bad strip, shoulders, preterm - have a NICU team present. A NNP/MD, an RT, and a dedicated NICU nurse. Once baby is out/stable and we determine he's not going to NICU, I step back in and recover him until they turn over to mother/baby.

I'm stationed in L&D, so when the primary nurse calls out for 'doctors for delivery', that's my cue to head on in there. If it's high-risk, I call NICU as I go in. I try to have my blankets etc set up already on the warmer so I can just walk in, grab a blanket, and go to work.

[kejRN88]

I have only worked on Labor and Delivery, so I am only used to having this team. They usually stay in the room the assign the apgars, they also do the computer work to admit the baby. Once they are confident that the baby has transitioned well, they go and we take care of mom and baby until we transfer them to mother/baby. If need be, they also take the baby to the nursery. I have a job interview today with a different L&D unit in a different state. This is definitely one thing I am going to ask.

[klone, MSN, RN]

Our infant abduction is a "code Adam".

That's ours for outpatient (clinics) and children >1 year.

[NurseNora, BSN, RN]

My hospital does about 80 deliveries a month. For low risk deliveries, whoever is least busy with her patients is catcher (we all have NRP). Usually baby goes skin to skin right away and stays there until after baby is finished nursing in an hour or so. The catcher gives Apgars and gets first vital signs and then often leaves baby to mom's nurse to transition with mom. Depending on unit activity, the catcher may come back to do signs every half hour. I usually do it by myself so I dont interfere too much with what's going on with the couplet. If there is any problem, or mom doesn't want to do skin to skin the catcher stays longer. If a low Apgar is anticipated, or an instrumental delivery, or a section, we may have a nursery nurse come or an NNP, or a pediatrician (called in from home), depending on anticipated severity. A Respiratory Therapist comes to all sections. Since I've really started pushing to have baby stay in the OR for skin to skin during the rest of the case (low risk sections), whoever catches in the section has to stay the whole time. We don't always have staff for that to happen for everyone, so I've come in a couple of times for friends or patients I've "bonded"with.