How can I educate fellow nurses?

[beachmom]

I need suggestions please!

Our hospital has encouraged skin to skin after birth for many years, and after lady partsl births this is happening. After C/S births, IT'S NOT.

Our manager is all for us doing skin to skin in the OR, breastfeeding and keeping baby with mom all though the OR, PACU and back to her room. (If baby is stable and staffing allows.) The OB's, OR staff and PACU staff are all OK with this.

The problem is, most nurses are still bringing baby to mom for a few minutes after the C/S then taking baby to the nursery to do the weight, meds etc. Some will then get the baby to mom in PACU. Others will keep the baby in the nursery while they do their paperwork and not get baby to mom until she is back to her room. Grrr.

It is much easier on the nurse to bring the baby to the nursery. And it's an ingrained habit.

We've had many forced changes by management lately, I think encouraging a change in practice would come better from a coworker (me) than from management. I'm on practice council, and this is one of our goals.

I put a flyer on the bulletin board, but I need something more effective. I'm thinking a slideshow or video at the unit meeting, maybe? Do you know a good video?

Any suggestions for me would be greatly appreciated. :)

[APRN., DNP, RN, APRN, NP]

My suggestion would be to find your early adopters (nurses who are pro-skin to skin), and start a journal club with them.

Try and make one of your first topics be skin to skin, and critically appraise about 3 to 5 good solid peer review articles on the subject.

Disseminate the data, and promote the awareness of the data with your early adopters and other nurses on the unit. You'll never get 100%, but you should see much better results.

Have the docs and management on board as well. Produce the evidence. It's out there.

See if your facility can run for "baby friendly" status. That may get even more momentum running.

[RunBabyRN]

The PP nailed most of it. The only other thing I was thinking is making it easier to catch up on paperwork in the PACU if at all possible. It might be an easier way to try to get those resistant nurses on board.

Taking steps toward Baby Friendly status would be HUGE if you can get it implemented!

[SoldierNurse22, BSN, RN]

I appreciate your enthusiasm to encourage better care for your patients.

However, at best, all you can do is encourage change. When it comes to enforcing and really strongly promoting a policy, that's the job of management.

With that said, be careful how you come across. Ingrained habits are hard to break, and yes, it will be a significant amount of work for your L&D nurses in PACU if babies stay with mom. If it's coming from you personally (even if it's just your name on the email), be prepared for backlash, whether outright our passive-aggressive.

Personally, I'd leave the crackdown to the management. They're paid to be the bad guys, and paid more than us to boot. Don't take the fall for them.

[NurseNora, BSN, RN]

Be a good example and do it yourself. Mention how much more easily the baby went to the breast than with this oman's first section when they were separated. Tell patients your facility is just starting this and ask them to write to your director if they liked it, make sure your Director shares this positive reinforcement with all staff. Be sure you show new staff members how to get charting done while doing STS with their patients. It's easier to teach new people how to do it than to get oldsters to change, but with time, it will become the standard for everyone.

[cayenne06, MSN, CNM]

It's all about culture change. I would meet with the unit manager and discuss how to implement this as standard protocol. Figure out what changes need to be made to make it as easy as humanly possibly for nurses to do this, and then hold staff education sessions to make sure everyone knows why S2S is important, and to help you address any concerns from the staff.

Little things, like changing the protocol to explicitly state that weights and measures should be done no sooner than one hour of life and after the initial feed, can help relieve the pressure that all of us bedside nurses feel to get our huge list of tasks done asap.

Things that make S2S difficult in the OR- it's cold, you have an open abdomen to be cautious about, mom has monitors stuck to her chest and might be nauseous, and baby is more likely to be a bit tachypnic which might make it harder for nurses to feel comfortable monitoring on mom's chest. These issues can be addressed. The biggest barrier is just that people have been doing it one way for their entire career, and change is hard. You have to make it easy, and you have to get the staff on board with the underlying principle, otherwise it is an uphill battle.