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.
We used to have 20 LDRP rooms, and a separate unit of a dozen rooms for c/s pts, antepartums and pp readmits. This has changed over the last year, and we now have 15 LDR's, 6 pp rooms on that unit, and I think 18 or so rooms on a separate pp unit. Those beds get filled up with transfers first. The L&D nurses will do pp if it's slow, but the pp nurses only do that. We staff the Level II nursery, and can float to peds or pp if we are really overstaffed...it doesn't often happen. We don't have a level I nursery. We also have a group of nurses trained to work in all areas.
If all your staff do not do all areas, then yo are not a true LDRP. ALL staff have to be crosstrained to all three areas to be a real LDRP. It is a hard changeove and you haev to have a manager committed to doing it. Suggest that your manager send some staff to visit other facilities that do LDRP. It rally is a great concept.
Yes, we do occasionally have to move people out of LDRP rooms if we get busy. No, all our rooms are not dedicated to LDRP. We have regular rooms within our unit that we use for sections, observations or mothers we have to move.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by BETSRN
If all your staff do not do all areas, then yo are not a true LDRP. ALL staff have to be crosstrained to all three areas to be a real LDRP. It is a hard changeove and you haev to have a manager committed to doing it. Suggest that your manager send some staff to visit other facilities that do LDRP. It rally is a great concept.
Yes, we do occasionally have to move people out of LDRP rooms if we get busy. No, all our rooms are not dedicated to LDRP. We have regular rooms within our unit that we use for sections, observations or mothers we have to move.
I agree. Time for a CHANGE now.......if we wish to be patient-centered and NOT routine-stuck. Visit places where TRUE LDRP concepts are in place. You will see a HUGE difference. I LOVE IT!
An example of resistance to change..... last night, we weren't real busy. We had one PIHer and the M/B nurse was taking care of the PP pts back in L&D. WE had 2 pts come in and deliver through the night. I held on to mine after delivery instead of turning her over to M/B. I did take the baby in the NSY for transition though because at about an hour, Mom requested that baby go to NSY so she could sleep. (not highly unusual) When the day shift nurses came on, there was one M/B nurse for 5 couplets, so she asked that we hang onto the 2 that delivered during the night. You would have thought we told the L&D nurses coming on that we were going to chop their heads off.
I don't really think they understand the whole idea behind us cross training is to actually take care of PP pts.
Thankyou to everyone that gave advice or input! Was so surprised to see so many responses in such a short time (so was hubby when I showed him the thread). We will probably talk it over the next week or 2 at which point will address the issue with the hospital as I would hate to bring it up untill closer to full term, just in case. Having some contractions tonight *sighs and rolls her eyes* lets just hope they are 'pretend' ones right!
Will keep everyone up to date and of course more input is still appriciated either way. *hugs all*
Don't wait until you are in labor to present your birth plan to the staff. Write up your birth plan and go talk to the nurse manager of the department. Years ago before we instituted couplet care, the family was required to pay extra to have a nursery nurse in the room for the observation period.
You obviously feel very strongly about these issues so don't back down. It is your birth and your baby and you should be able to have these very reasonable requests met.
As an aside, I don't understand why everyone is freaking out about giving the baby a little water or glucose water. Breast fed babies are not going to refuse the mothers breast based on a minute of nursing a bottle of water. The best thing you can do for breast feeding is relax and enjoy it.
I breast fed three children to age 18 months and they all had a pacifier and occasionally drank from a bottle and neither of these things caused any great catastrophe.
Checking the patency of the esophagus is an old fashioned thing. That is no loger necessary. There is absolutely NO reason to introduce a bottle of water at all. put the baby to breast and be done with it. There is no literature to support having to do this. It's archaic.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Originally posted by BETSRN
Checking the patency of the esophagus is an old fashioned thing. That is no loger necessary. There is absolutely NO reason to introduce a bottle of water at all. put the baby to breast and be done with it. There is no literature to support having to do this. It's archaic.
As an aside, I don't understand why everyone is freaking out about giving the baby a little water or glucose water.
But why is it even necessary? And some babies do have a difficult latch so why confuse them with trying to differentiate between an artificial nipple and the breast? Some babies can switch back and forth easily. Other times, breastfeeding is a learning experience for Mom and baby, so why jeopardize making it an easy one?
But why is it even necessary? And some babies do have a difficult latch so why confuse them with trying to differentiate between an artificial nipple and the breast? Some babies can switch back and forth easily. Other times, breastfeeding is a learning experience for Mom and baby, so why jeopardize making it an easy one?
I didn't suggest it was "even necessary" to do it, just said it wasn't necessary to freak out about it.
Breastfeeding is always a learning experience for the baby and most of the time for the mother as well. The best thing for all parties is to relax and let it happen... the biggest obstacle to breast feeding is pressure to do it perfectly that leads to a vicious cycle of tension leading to more tension that ultimately interferes with feeding and often to desertion of breastfeeding.
We need to remember that people were breastfeeding babies long before there were ever any breastfeeding coaches, teachers or facilitators. Before you jump on me, I am not saying these services shouldn't be provided, just that the people in positions of authority shouldn't be fanatics.
I wish you the best, and hope you feel well enough to do as much care as they will allow. Please remember they do not call it Labor for nothing. BTW my niece's 34 weeks premie twins are now 4 months old. Thomas was the larger he was 4.5 pounds and got to stay with Mom, Trista weighed 3.5 pounds and could not hold her temp for 11 days, so she had to stay in NICU. Just saw them at thanksgiving and they now are called affectionately Chunky Cheese (thomas) and Trisket.
My point, see how it goes. Talk with your Doctor and tell him your wishes, wishes do come true sometimes.
I didn't suggest it was "even necessary" to do it, just said it wasn't necessary to freak out about it.
Before you jump on me, I am not saying these services shouldn't be provided, just that the people in positions of authority shouldn't be fanatics.
I'm sorry if I misunderstood your statement. I read it to mean that parents were freaking out about babies getting sugar water, but now I guess you're saying that people in authority (nurses, managers?) shouldn't be fanatical about insisting on glucose water?
And I wasn't jumping on you, simply asking a rhetorical question. Yes, women have been breastfeeding for as long as their have been breasts, but now women have to hear about how "easy" it was for so and so to bottlefeed, and how "hard" it was for so and so to breast feed. Not to mention the temptation sent home in the form of a free diaper bag with samples of formula, kwim?
Some babies can switch back and forth easily. Other times, breastfeeding is a learning experience for Mom and baby, so why jeopardize making it an easy one?
Mimi2RN, ASN, RN
1,142 Posts
We used to have 20 LDRP rooms, and a separate unit of a dozen rooms for c/s pts, antepartums and pp readmits. This has changed over the last year, and we now have 15 LDR's, 6 pp rooms on that unit, and I think 18 or so rooms on a separate pp unit. Those beds get filled up with transfers first. The L&D nurses will do pp if it's slow, but the pp nurses only do that. We staff the Level II nursery, and can float to peds or pp if we are really overstaffed...it doesn't often happen. We don't have a level I nursery. We also have a group of nurses trained to work in all areas.