New Mama Baby RN

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Hello everyone! I have been "lurking" for the past year and have appreciated the abundant information found in all of your posts! I've currently finished a "new grad" program on our Mother/Baby unit and have a few questions.

Our unit is implementing couplet care. Typically we have four moms and babies. What I'm wondering is when doing couplet care, do you still have a nursery nurse? We are a community hospital and do not have a NICU at our facility.

Also, since all care is given at the bedside, does that include PKU's and bili's? New moms can be so fretful that I'm just dreading doing these procedures at the bedside. Any tips?

Thanks again everyone!

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I am still in mostly lurker/not yet a nurse status myself but I can tell you what happened when I recently had my baby in a community hospital.

My daughter roomed in with me and they did all the regular checks (blood pressure, etc) in the room and then took her out of the room and did the heel prick (and maybe did blood test for for Group B strep?). I could still hear her screaming though, LOL. I never had to watch anything that would have made me cry too.

The only time she went back to the nursery was for that and the hearing test. I hope that helps.

Courtney

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Hi I also work at a small community hosp and we are assigned to 4 or 5 couplets. We do both hearing screens and PKUS in the nursery, and baby's stay out w/ mom the whole time. We try to always have a nursery nurse at all times because we are in a high risk area and a lot of our babies need level 2 nursery care-About 50% of our patients have no or little prenatal care.

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small community hospital here also. Babes stay with moms for the majority of the time but hearing screens and PKU's are done in the nursery unless mom requests otherwise. Do you use sucrose prior to the PKU's? We do and it is wonderful! I have had lots of babes sleep through heelsticks after using sucrose.

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Hi there! small hospital LDRP here, no we don't have seperate nursery nurses. We are staffed with 2-3 RNs and we all do it all from labor through discharge. As far as roomning in goes, we do most cares in the room but do take the baby to the nursery for bath, PKU, and hearing screen.

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small community hospital here also. Babes stay with moms for the majority of the time but hearing screens and PKU's are done in the nursery unless mom requests otherwise. Do you use sucrose prior to the PKU's? We do and it is wonderful! I have had lots of babes sleep through heelsticks after using sucrose.

Sorry to show my ignorance but how do you use sucrose? We do have glucose water and if the mother has ok'd binky use then I'll put a little glucose water on the binky and it makes the procedure go much better.

I'm finding the nurses that have been there for a while are really resisting the couplet care change but from what I'm hearing from other hospitals, I think it's here to stay awhile.

Thanks to everyone for responding.

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Sorry to show my ignorance but how do you use sucrose? We do have glucose water and if the mother has ok'd binky use then I'll put a little glucose water on the binky and it makes the procedure go much better.

I'm finding the nurses that have been there for a while are really resisting the couplet care change but from what I'm hearing from other hospitals, I think it's here to stay awhile.

Thanks to everyone for responding.

We use Sweet-ease brand sucrose. It is a 24% Sucrose solution. it comes in little coffe creamer-like containers. You dip the pacifier or a gloved finger in it and let babe suck for a few minutes prior to procedure. It is supposed to release endorphins to help with pain control. Like I said, I have had many babes sleep through their heelstick for PKU. Also it is very nice in conjunction with local anesthesia for circs. After sucrose, a good percentage of babes don't scream with local administration. Can I again say how much I LOVE sucrose!

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DOes anyone know if there is any testing of the use of Sucrose in colic? We are tying to see if it could be effective in treatment in the ED.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

We do couplet care in our LDRP and the nurse caring for that couplet is generally responsible for ALL care of the newborn, as well as mom. This would include:

newborn assessments each shift.

assisting w/breastfeeding and infant care

d/c teaching as it applies to both newborn and mom care

PKU draws, hearing screening, bili testing, etc.

antiobiotic/medication administration of that newborn

nightly weight checks/footprinting

so no, we don't have a nursery nurse to do this----we do it. UNLESS there is a sick baby in the nursery, and we are very busy. THEN sometimes, that nurse in the nursery will do the labs/meds and weights for that baby.

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