Infant admission at bedside

losbozos · Jan 7, 2013

At my current job, that's the only way we do it. And that's the only way I've done it for about the past 20-25 years. In fact, it takes less nurses to do so. We only have 2 nurses on duty no matter what's happening. I am at a rural access hospital but we still get the same pts the big hosp do. Last job was a much bigger hosp & we still admitted babe w/ mom. Just have your paperwork, meds together & just do it! Most of the babies I admit are done on mom's chest & breastfeeding. There is no need to remove the baby unless there is a problem. And unless baby is really bad sick, it stays in mom's room. we just don't have the staff to dedicate to a nsy. Good luck! Hope it goes well.

s.maire.2126 · Jan 7, 2013

Thanks for the feedback. I agree...we should just go for it! Can I ask are you a L&D or PP RN?

Elvish, BSN, DNP, RN, NP · Jan 7, 2013

Big hospital here. L&D brings babe over in mom's arms. Admit nurse comes to room to ID baby and assess, do vit k and drops, measure, etc. Once initial assessment is done, mother/baby RN takes over care of the couplet. Our nursery is only for sick babies or to keep baby if mom is ill. Our couplet ratio is usually 1:3-4. We used to admit babies in nursery but we really do like this way better....took some adjustment but was worth it.

Fyreflie · Jan 7, 2013

We do our band checks bedside in post partum and Mom follows along on her bands to verify. Babies are technically admitted (to a bed in the computer) at birth from L&D and bands are double signed by RNs there as well. I'm not quite sure how else that could happen--unless you mean admission assessments? I do those skin to skin :)

losbozos · Jan 9, 2013

We do everything, here! I've even mopped floors on a bad night. :-)

Mermaidblues · Jan 9, 2013

We call it "transition nurse". If L&D nurse only has one pt, she usually does it herself. We keep a baby cart stocked that gets brought to the LD room near delivery time that has everything but meds in it for the NB. after the delivery,once we have wt,time of birth, etc, the info is given to the secretary who admits the baby, then meds can be pulled from the Pyxis. Baby stays with Mom unless there is a low apgar score, or some other reason not to. We have a level II nurse who an attend deliveries if a complication is anticipated. Nursery has the chart made by secretary. Only thing babies go to the NSY for is hearing screen or illness. It does take preplanning and cooperation with other areas like pharmacy, admissions and Peds to work out all the kinks, but it can be done. The benefits for mom/baby and continuity of care speak for themselves.

allene24 · Jan 10, 2013

At my hospital, once the baby is born-the L&D nurse drys/stimulates, applies armbands, takes the weight, and helps mom initiate breastfeeding if wanted!!. We immediately call Nursery and within the hour, a nursery RN will come over and administer vitamin k and eye gel right there in the room. Each L&D room has a built-in warmer and basic resuscitation equipment. After the mom recovers for an hour in L&D she can choose "family place" or "nesting place." family place- the mom has a separate nurse from the baby, and the baby can go to and from the nursery as much as the mom wants. nesting place is where the baby must stay in the room with the mother, and the two have the same nurse. family place and nesting place are different units with different staffs of nurses. It works pretty well!

direis09 · Feb 16, 2013

Interesting, what is the size of your "family" and "nesting" unit? Guessing that you must have a large facility to be able to offer two different postpartum units.

klone, MSN, RN · Feb 16, 2013

We have "admit" nurses staffed (usually two) just handle baby admissions. All admits are done at bedside by the admit nurse and she keeps the baby until the mother is recovered and they're both handed off to the couplet nurse. The only time a brand newborn goes into the nursery for anything is if there is TTN or something that requires close watching. Then, the baby either goes back out to the mom, or down to the NICU.

**LibraSunCNM, BSN, MSN, CNM** · Feb 16, 2013

Basically same as above, although our L&D nurses do the Vit K and eye ointment and initial weights. We have one "admit" nurse per shift from the Mother/Baby unit who goes either to L&D to assess the babies bedside or does it once they come upstairs to M/B at the bedside. The exceptions would be on night shift, if the admission wasn't done in L&D, and the patient is now admitted to a semi-private postpartum room, they won't do the admission bedside and "wake" the neighbor up (like they're generally sleeping!). OR for c-sections, we will often avoid admitting bedside in the recovery room, which is very cold, and get the admission done quickly in the nursery while the mom is being transferred from stretcher to her new bed on postpartum, so that by the time she's settled the baby is ready to come out and warm up skin-to-skin again. But certainly any patient who didn't want even that brief separation would be accommodated. My only complaint is that most shifts, one admit nurse isn't enough!

RNnicu42 · Feb 16, 2013

I work at a large teaching hospital and we have a dedicated baby nurse in L/D. Most of us are trained as perinatal nurses so we rotate between L/D nurse, PP nurse, and baby nurse. We are trying to be a baby friendly hospital so we encourage rooming in together 24/7. Our LDR's all have warmers and resus equipment. The baby nurse attends the delivery and is responsible for stimulating, suctioning, warming, weighing, assessment, meds and banding. This is all done in the mom's room with as much as possible done while the baby is skin to skin with mom. Having a dedicated baby nurse works out really well for us and allows the L/D nurse to focus on caring for mom's instead of both mom/baby in the immedicate recovery period.