Due to being high risk (had my 2nd child preterm) and for insurance reasons my choice of hospital has been limited to one. They have an incrediably good NICU and I have no quelms about delivering my baby there except one...they have a policy of removing the child to the nursery for observation about 1 hour after birth for an hour or two.
When I heard this I approched the childbirth instructor at one of my classes as the class is taught by a L&D nurse from the hospital I will be delivering at about the possiblity of the 'observation' being done in room as was done with my oldest and would of been done if second was full term (both born at different hospitals). She stated they would not allow this as they examined the baby during it's first bath (no I could not give the first bath) and put the baby under a warmer and even if I stated no artificial nipples they did give a very small amount of gloucose water to make sure everything inside was flowing smoothly! I kindly thanked her for the information and went on my way. Wasn't about to blow my top as I realize she isn't in charge of policy and answered my questions honestly.
Now a few weeks later I find myself seething more and more over what probably is a minor issue but feel it over rides my choice to have my child stay with me the entire time. I can't help but wonder after 2 children why I am not 'allowed' to bath my own child, where they 'have' to give gloucose water...as I don't see that working through 'all the piping' in one or 2 hours ...and i had no problems nursing my children or where a warmer is any warmer then my little one snuggled up to my own skin.
My first child I had with me the entire time and my 2nd did go to nicu for 2 days with no breathing assistance needed and I even gave her little tiny body the first bath.
Basically my question is barring any complications (believe me if there were any questions about her well being I would diffinately let them take my child) can I refuse to let them do this and insist the baby stay the same room as me? I hate to be a bad patient and totally understand this isn't the nurses fault but administrative policy. If I state I will absolutely not let them take the baby out of the room can they still do it? I am totally willing to let the nurses assist/observe my feeding, bathing, caring for my child. Just feel it should be Mom and Dad's choice if a baby goes to a nursery if it's doing well... am I wrong for thinking/considering these things?
sorry for the long post and any spelling errors. Any advice and thoughts on this matter is truely appriciated.
As soon as the baby is born, tell them they will not be taking it to the nursery and if they want to look at it, the nursery nurse can come to your room and do it. It *IS* your baby - and you CAN call security (LOL) if they insist. Afterall, you have every right to refuse ANY treatment or procedure and yes that includes process!!!
Treatment or other actions against your will can be considered assault and/or battery in some states. As long as the baby is not premature, grunting, retracting or having other complications, there is no reason to remove the baby to the nursery other than that the nursery nurse doesn't have to come to you. Just stick to your guns. The facility I work in is much the same way and I know some mothers will protest and get what they want, but not without some friction.
And the feeding of sugar water is just plain old garbage - again - if they do it without your consent or against your express wishes, it may be grounds for assault or battery.
Its a shame that in the year 2003 we have to act like we are back in the 50's!
Some of your requests are for standard care on many units. The problem to me is that the hospital does not do couplet care, and is not equipped or staffed to do so. How to get around it?
If you want the newborn assessment, meds, weight, etc. done in your room, it gets a little more complicated. It takes a nurse out of the nursery, who probably has other work to do, to monitor your baby. That is setting a precedent. Equipment would have to be taken to your room
Gee, I just mentioned this and several people thought it was abnormal. Anyway, that's another thread.
We will try to accomodate parents who request bedside transition if staffing allows. I would suggest including bedside transition in your birth plan, talking with the nurse manager ahead of time about it, and asking the L&D nurse to remind the NSY that you would like bedside transition when you come in for delivery. If the NSY has some warning before delivery, they may be able to free up a nurse to come out to your room.
Did you say you were planning on BF? Obviously, if you nurse the baby right after delivery, the rationale for giving the glucose water is negated.
I agree with pretty much everyone, you have every right to refuse baby to go the nursery. Refuse the bath, refuse the meds until later, it doesn't hurt to give them later. They can't force you to do anything you don't want, but expect conflict. I agree about talking to clinical care coordinators/managers, and attempting to make accomadations ahead of time.
I would also suggest writing a letter and encouraging anyone else you know to write a letter complaining of the current policy, if enough people complain maybe they will come out of the dark ages!
Remember it takes work to promote change, dont be afraid to rock the boat a little bit and stand up for what you want!
You seem intelligent and you make some good points.
I think she said she was talking about normal delivery, and that she knew if would be a different story if not.
Would it help to talk to the doctor? I always hear that the doc can write orders in your record to be followed?
Doctors' orders that contradict hospital policy DO NOT have to be followed (and will not be followed by nurses who want to keep their jobs), so that offers no guarantees.
As a NICU nurse, I see nothing wrong with the aforementioned requests, (and I have heard some pretty off the wall ones!) but then again where I work, there is no normal nb/transition/observation nursery, only intensive care - so once moms have the babies, they keep them unless baby needs NICU care.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by Mimi2RN
I think that she doesn't want the baby to leave her room at all. The meds wouldn't be bad, but pushing a scale around and sending a nursery nurse to her room to monitor the baby may be a little more complicated.
not where I work.....the scales are on wheels for a reason and we DO wheel em in for initial (birth) and nightly weights etc. It's not a hassle from where I sit.
These requests are MORE THAN REASONABLE for a HEALTHY birth. I would re-emphasize how important it is to you that the baby NOT leave your side for any reason other than medical necessity. You have that right, so ask for it. I wish you a joyous, safe, and healthy outcome for you and your baby. OH before I forget. about baths:
I just got off of a BUSY shift where I delayed bathing baby for 5 hours at mom's request. (it would have been much easier to do it immediately, but I complied with the family's desires). Further, the baby never left the room as the only babies in our nursery are SPECIAL care ones, not healthy ones.
You have the right to refuse interventions (or request things) as LONG as you are INFORMED and UNDERSTAND the circumstances and the conditions are healthy Yes, there are times when hospital routines are for the convenience of the STAFF, not patients. Some places are so busy, there almost is no choice. Fortunately, where I work we are a bit more user-friendly and NOT that busy we can'taccomodate reasonable special requests. Its YOUR birth, not mine!:kiss
Doctors' orders that contradict hospital policy DO NOT have to be followed (and will not be followed by nurses who want to keep their jobs), so that offers no guarantees.
And, no matter how many policies your hospital has none of them have to be followed by the patient.
Yes all care for a healthy baby can be done at the bedside, however it was mentioned that the meds could wait. First off why wait too long as the L & D nurse can give them right threre in the room and also, you might want to check with the state laws. I live in NY state and it is NYS law (I believe becase of the reccommendations by the american academey of pediatrics--or waht ever it is called) that all babies get the Vit K and Erythromycin by one hour of age. We have had "Bradley" patients who are very particular in how the process "should" go. They want oral vit K and want to wait several hours. We don't have oral Vit K available and have to tell them state law tells us we have to give both by one hour of age. So you might want to check for the state you live in. The Vit K within minutes I find actually helps the baby cry more strongly which helps in clearing the lungs better, just my opinion. Not all babies need that extra stimulation to cry well, but some do and it makes a difference. Sounds mean but that strong cry at the start of life if good for their lungs.
Good luck and I agree with all here in---STICKING WITH YOUR PLAN and letting them know ahead of time to allow for staffing adjustments is a good idea.
I totally agree with everyone who says the baby doesn't have to leave your room. Even our c/s babies usually go out to pp on the gurney with mom.
Having two grandbabies deliver in a place that only has nursery nurses to do the babies gives me a slightly different view of the care. Go look at the patient rooms, labor and pp. Check into the nursery situation-is it right beside L&D, or round the corner and down the hall on the way to pp. Next to the NICU or not? It's hard to discuss a situation, if you don't know the lay of the land. Then talk to the PCM or whoever, at least they'll know you when you do deliver!
This is all a moot point if you have the baby early, but long time L&D nurses sometimes don't want anything to do with babies after they deliver-never mind giving baby meds etc. We've had couplet care with the L&D nurses doing the newborn for over 10 years. It was a big change to everyone, including the nursery nurses who just did babies, with one attending every delivery.
BTW, I have no desire to do pp couplet care, give me the babies every time!
We had the changeover thing too about 14 years ago when we went to LDRP. It was tough at first, but even the oldtimers who stayed on had to learn all three areas (LDRP) and now would not do anything different. LDRP is far more cost effective and much more family centered. There isn;t one of us who regrets getting crosstrained and I ahve to say, the patients love it. The best part for me (as a nurse) is that I am never bored by doing only one type of nursing all the time. Labor one day, nursery the next, maybe then charge and then another labor or maybe PP's. It's great! :chuckle :roll
Although you may not be able to change things in time for your own delivery, I would also consider contacting your insurance company with your concerns about the policies of this hospital. When I was pregnant with my first, I found the list of area OB's to be completely unacceptable. (Working in OB made me very aware of who was good and who was not.) I called the patient services department and let them know that where was not a single OB on the list that I would consider using. I was allowed to choose a non-participating OB, and receive full benefits.
Perhaps if the insurance company knows how family-unfriendly this hospital is, they will put pressure on the hospital to change its policies, or seek other institutions for their patients to use.
We had the changeover thing too about 14 years ago when we went to LDRP. It was tough at first, but even the oldtimers who stayed on had to learn all three areas (LDRP) and now would not do anything different. LDRP is far more cost effective and much more family centered.
We just switched to LDRP's, sort of. The pt stays in the same room for delivery, recovery, and pp. But, the care is still split between L&D, M/B, and NSY RNs. The NSY and L&D are all crosstraining now for M/B, but no one has mentioned cross training to NSY. There has been talk of eventually incooperating bedside transition for all deliveries. But it's been a struggle just to get this far. I'm hoping it all works out soon. :)
Just a question for those that are doing LDRP and couplet care, are all your rooms dedicated to LDRP? We have 25 rooms total, with only 12 of them used for L&D. It's a very long unit and would be a sprint to get to the other end of the hall if someone was in labor. Anyway, we use 12 for labor rooms, 3 have Jacuzzi tubs. We have to keep 3 open for potential pts. So if a pt delivers in a tub room, or if we already have 5-6 pp pts, the new deliveries are moved out to the other end.
The strange thing is, everyone is being cross trained to M/B, but nobody wants to be cross trained to L&D.
:chuckle 
:roll
gauge14iv, MSN, APRN, NP
1,622 Posts
As soon as the baby is born, tell them they will not be taking it to the nursery and if they want to look at it, the nursery nurse can come to your room and do it. It *IS* your baby - and you CAN call security (LOL) if they insist. Afterall, you have every right to refuse ANY treatment or procedure and yes that includes process!!!
Treatment or other actions against your will can be considered assault and/or battery in some states. As long as the baby is not premature, grunting, retracting or having other complications, there is no reason to remove the baby to the nursery other than that the nursery nurse doesn't have to come to you. Just stick to your guns. The facility I work in is much the same way and I know some mothers will protest and get what they want, but not without some friction.
And the feeding of sugar water is just plain old garbage - again - if they do it without your consent or against your express wishes, it may be grounds for assault or battery.
Its a shame that in the year 2003 we have to act like we are back in the 50's!