Gravity Feeds

Specialties NICU

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Specializes in NICU.

I was just curious about how you all do gravity feeds. We usually tape ours to the inside or outside of the isolette. But if the baby is in a giraffe isolette, we use the "arm" so if the top is acidentally opened, it won't rip the ng tube out. But, at a staff meeting this week, our NM told us that we really should be holding all of our gravity feeds and not hanging them. I think it would be very difficult to stand there holding the feeding for 30 minutes while it goes in, especially when you are busy with three or four babies in your assignment. Anyway, I was just curious if any other units stand by their babies to hold the gravity feed while it goes in?

Thanks for your input.

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Specializes in PICU, ICU, Transplant, Trauma, Surgical.

We usually do our feedings via syringe pump. I do every once in a while do feedings via gravity. If the parents are there I will ask them to hold it, while holding the baby of course. Otherwise if babe is in a crib, I tape the syringe to the IV pole, bassinet I will tape to whatever stable thing I find, giraffe I will tape to the IV pole on the giraffe. We thankfully have done away with all of our old school isolettes.

Hope this helps :)

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Specializes in NICU.

We definitely hang them, either from a light attached to the Giraffe or from an empty IV pole set up next to whatever bed we are using. We use a rubber band to hang them. We don't hold them...I agree that would be time-consuming!

We only use syringe pumps if the order is for the feeding to run over a certain amount of time, due to increased residuals, or if the feeding is continuous.

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Specializes in NICU.

If it's a small amount of feed we hang it (usually with rubber bands from the "arm" in the isolette) if it's a larger feeding we put it on a syringe pump BUT I know of another NICU in my area that requires the nurses to stand there and hold it while the entire feeding goes in...I don't know how they have time for that

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I feel like that could be so time-consuming and tedious for the nurses when the babies are getting larger feeds and you have 3-4 patients to tend to. We also use tape or the arm in the isolette. The syringe pumps are only used if the feeds are over a set amount of time.

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Specializes in NICU, adult med-tele.

I hang them using whatever looks handy, but I always stay right there to babysit.

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Specializes in NICU.
I was just curious about how you all do gravity feeds. We usually tape ours to the inside or outside of the isolette. But if the baby is in a giraffe isolette, we use the "arm" so if the top is acidentally opened, it won't rip the ng tube out. But, at a staff meeting this week, our NM told us that we really should be holding all of our gravity feeds and not hanging them. I think it would be very difficult to stand there holding the feeding for 30 minutes while it goes in, especially when you are busy with three or four babies in your assignment. Anyway, I was just curious if any other units stand by their babies to hold the gravity feed while it goes in?

Thanks for your input.

Seems to me that each baby deserves our time and attention. You would stay with a baby if you had to po feed him, why should it be different if you have to gavage feed? You can help keep the pacifier in his mouth during the feed,or you could talk to him,the list goes on and on. How many times have you walked away from the isolette with a feeding hanging only to come back and find it dumped all over the baby because his little arms have become tangled in his feeding tube and pulled it down? In my unit, 99% of the nurses hang their feeds...gives them more time to chit-chat or whatever. I was taught, that you are at work to work, not socialize at every opportunity you get. Your assignment is your responsibility for 12 hours or whatever. I guess I am on a soap-box....but :banghead: I guess the younger generation has a different work ethic than I was brought up in

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Specializes in Neonatal ICU (Cardiothoracic).
Seems to me that each baby deserves our time and attention. You would stay with a baby if you had to po feed him, why should it be different if you have to gavage feed? I was taught, that you are at work to work, not socialize at every opportunity you get. Your assignment is your responsibility for 12 hours or whatever. I guess I am on a soap-box....but :banghead: I guess the younger generation has a different work ethic than I was brought up in

In the unit I work in, the acuity level of my patients does not allow me to remain physically at my patient's bedside as the feed goes in.

Younger generation person here with a great work ethic.

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Specializes in NICU.

lol wait until you have about 25 years under your belt and look back....

I agree about the acuity levels, I guess you can't feed everyone at the same time, but I don't know...maybe a time management thing? I work in a fairly large regional unit and see so many nurses with time on their hands. I hang out at my assignment's bedsides during my shift and try really hard to hold the feeds, to give that baby some 1:1 time when mom isn't there. I have no spare time, which is ok, because that is why I am there. oh well...I give up

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Specializes in NICU.

I take a little offense to the generalization you made that the younger generation has a different work ethic than you do. I am of the younger generation, and my work ethic is just fine, thank you very much. However, I still don't stand at the bedside to watch a gavage feed go in. There are other things that my time can be much better used for, and I agree that the acuity level of my patients does not often allow me to spend time standing by the bedside for the length of the feeding.

Perhaps on a public bulletin board you could avoid having the preconceived notions you have based on your work situation cloud what you think of your peers on the bulletin board.

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Specializes in Neonatal nursing (paediatric trained).

Even if we hang our feeds, we're not allowed to leave the baby unattended. I regularly have 4-6 babies to look after with a variety of hourly, two hourly, three hourly and four hourly NG feeds (not always one of each but you get the idea) and sometimes a bottle feeder or two thrown in the mix. I never, ever, ever leave a NG feed hanging and walk away. It's a risk, and I wouldn't do it even if our unit allowed it. Even a 50ml feed doesn't take that long.There's recently been a thread on this subforum about babies falling of scales. If we know how well these guys can wiggle around and therefore wouldn't leave them unattended during weighing and wouldn't leave incubator doors open and walk away, how can it be justified with a feed?

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Specializes in NICU.
Even if we hang our feeds, we're not allowed to leave the baby unattended. I regularly have 4-6 babies to look after with a variety of hourly, two hourly, three hourly and four hourly NG feeds (not always one of each but you get the idea) and sometimes a bottle feeder or two thrown in the mix. I never, ever, ever leave a NG feed hanging and walk away. It's a risk, and I wouldn't do it even if our unit allowed it. Even a 50ml feed doesn't take that long.

We always used to hold our feeds, but now we find that a feeding that's 27 cal formula takes a long time to flow in. Now they are hung or given via pump. It worries me to see the nurse not at the bedside, but if it takes 45 minutes, there isn't enough time.

Is it normal to give you 4-6 babies in your assignment? I live in California, and with the ratio, our max on the stepdown is four babies. I still think that is too many!

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