Do you have a nursery at your facility?

Specialties Ob/Gyn

Published

For moms to take babies for the night if they are tired? I just find this such a foreign concept. Our hospital has a 24 hr rooming in policy and where I work on low risk there is no nursery and even on the high risk side there is a nursery but it is not staffed so it is still 24hr rooming in. The only time that nursery is even used is if the mom is critically ill, then they will staff it, other then that it is you and your baby 24/7 until discharge.

So what does your facility have?

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The hospital where I had clinicals had a "procedure room" where things like PKU were done. At night babies could go in there. It is right near the nurse's station so there was someone around.

While I can sympathize with wanting to get some rest and sending baby away, I did it myself with my own and I think it was detrimental to breastfeeding. I know the nurses/aides at this hospital were quick to give a breastfed baby a bottle when it was in the procedure room.

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I was very thankful for the option to have someone look after my sons for a couple of hours here and there while I was in the hospital. New moms need rest! I know some people have very strong opinions about this, but no mom should feel guilty for getting some shut-eye after childbirth. Breastfeeding went well (still is) for both of them.

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Specializes in Community, OB, Nursery.

We have a nursery, and a prominent one at that. It is a round glass enclosure in the middle of the unit, like a fishbowl. So there you are, on display I am on the couplet care task force, to bring 24hr rooming in to our unit and it is a challenge. About half to 2/3 of our moms keep their babies with them all the time anyway.

Most of the challenge is not with the patients; once we explain the couplet care philosophy, most moms are ok with rooming in. The ones that aren't are either a) princesses who say they're going to breastfeed because it sounds good but don't want to put themselves out to do it, nor change a diaper for fear of messing up their manicure; or b) moms with multiple social issues, drug abuse etc., in which case it's sometimes in baby's best interest not to be with mom.

The big challenge is getting admin and the docs on board with it. I'm interested in hearing how other people make this work in their facilities.

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24-hour rooming in sounds good in theory, but lots of new moms initially lack confidence in caring for their newborns and it is incredibly daunting and intimidating. They often feel lonely and scared... and exhausted! My husband could not stay with me every night and I couldn't walk by myself, much less carry my baby around. I had a nurse take him for a few hours each night because I knew he was in good hands and I needed to relax and sleep... and believe me, it had nothing to do with manicures or drug abuse!

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Specializes in Community, OB, Nursery.

Let me clarify: I do charge in our NBN pretty frequently and I don't have a problem with moms bringing babies in for the night or for a few hours or whatever. If they need rest, I understand, as I was there once myself. :) And there is a huge difference between an uncomplicated vag delivery vs. a fresh c/section or a 4th degree lac or a ruptured perineal hematoma, so if mom is sick, babe is welcome.

But at our particular facility, the princess factor or social issues tend to be behind many of our babes' stay in the NBN.

I am not criticizing anyone who brings their baby to the nursery for rest. Sorry if it came across that way.

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I find the rooming in works really well. I realize new moms need their rest and that is why our visiting hours are limited. There's nothing more exhausting then giving birth and then an hour later having to entertain 20 visitors.

We go in and help mom with things she needs to learn like diapering, bathing, feeding but it is our job to give them the confidence to do so. We do demos and let them repeat it back and that gives them the confidence to know they can do it.

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I would have liked all of that help with my new babies, but I was in a huge hospital with busy nurses who couldn't devote time to demos, etc. In retrospect, I should have gone to a smaller hospital known for its more individual attention.

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We're not a small hospital by any means, we do 5500+ deliveries a year and are just as short staffed as the rest of the country. It is not hard to give them a quick diaper demo and then they must do them. We do not have the time to change each diaper so they have to become a quick study. We have LC's for feeding problems because you could spend all day in one room trying to get a baby to feed. Bottle feeding babies are even easier. We do the baby bath in the room after birth so mom can watch as we do it.

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We technically have a room we call a nursery - we bath and weigh the babies there and do the circs.

However, we do not have the staff to keep a baby in the nursery for longer than it takes to bath a baby or do a PKU.

All our babies room in.

steph

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We have a nursery for sick babies. We are not staffed to keep healthy babies 24/7 for convenience. But if we are able, we will do all we can to give moms a break when they need a few hours' rest at night. But we are rooming-in facility and the expectation is the infants spend the majority, if not all, their time with their parents. And breast babies are to go to mom when it's time to eat. You would be surprised how many request we not bother them all night, but also not supplement their babies either. Can't have your cake and eat it, too! Babies eat q1-3 hours 24/7. The sooner these moms get this, the better for all.

Also like above, if a mom is sick or had a traumatic, long labor or delivery, we do all we can to make special provisions for baby care for her, especially if she has no support person present with her.

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We do about 200 births a month.

We have a "holding" nursery, open from 11pm - 7am. Usually used by bottle feeding moms. Some breastfeeding moms use it, we bring junior out when he's hungry (his schedule, not ours). Kid eats, returns to nursery...

Then mom can sleep without fear of baby being in room.

It's also convenient for mom's who you know were in labor the night before, which means they are sooooo tired, probably haven't had any rest for 24 hours. (which increases their pain, irritability...)

Of course, we do make sure that all parents know how to take care of, feed, change diapers before going home.

It works out well for us staff too. We can keep a better eye on babies without disturbing parents. We do make rounds on babies q2hours if they're in moms room. But there have been instances (choking, gagging) that if baby had been with mom (sleeping) the consequences could have been different. In the nursery, the baby was seen immediately, and taken care of.

Personally, I like having the night nursery. I know it makes my job easier.

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