Newborn Nursery!

[MIA-RN1]

Today I was in the NBN from 7a - 3:30pm. Oh my goodness. I have never worked so hard in my life and have never been so frustrated with myself before! I am used to doing things right more often than not and I just can NOT get the hang of the newborn bath and general holding of the newborn. I got how to prop them up sitting, supporting under their chin and under the arm, but add in soap and water, not to mention wearing gloves, and I am a mess.

I tried bathing laying on a Chux in a bassinett, which was great til I got to the hair. THen I tried a football hold in one hand and using the other to pour warm water over head to rinse. Slippery and I was scared I would drop her into the sink.

I know, I know...practice.

I *was* the first one to notice jaundice in a little one today, and I did a TON of TPR's, so I did some stuff right. And I learned (mostly) how to generate charts etc. But I really really wish that I'd done better with the bathing. We are really supposed to do them in the room w/ the parents as a teaching/learning experience and I absolutely dread that.

ANyway, just a vent I guess.

[Gompers, BSN, RN]

What is Vapotherm?

Vapotherm is a type of respiratory support used in NICU. It looks like a regular nasal cannula, but it's attached to a machine that provides high pressure, high humidified airflow at 37 degrees celcius. You can blend in oxygen up to 100% Fi02 or you can leave it on room air. It works to inflate the lungs kind of like CPAP but it's much more comfortable for the babies. It doesn't have to be occlusive on the nose/face like CPAP either, and the nasal prongs are normal cannula length. When you listen to their chests, it sounds just like they're on CPAP but they're not. It's wonderful!!!

Problem was that there was a run on infections with the Vapotherm system. Something about bacteria in the filter and not having all disposable parts. They're working out the "bugs" now, so to speak, and hopefully it'll be back on the market soon. The units have been recalled at this point.

We're using the Fisher Paykel version right now. It works about the same but doesn't have an alarm on it like Vapotherm did, so you can't tell if it's not functioning well until your baby decompensates. Otherwise it's working pretty well.

Sorry for the hijack!

[MIKelly]

I've worked in hospitals that had them in L&D, and they offer a great comfort to moms, but I can't imagine how they can be sufficiently disinfected between patients.

I think you answered your own concern, the tubs would be cleaned with disinfectant inbetween room occupants. If you think the labor tubs in the hospital are full of cooties, what about the beds, toilets, floors, etc?

[mandana]

If it helps at all, I have two children and it's always been tough for me to bathe them until they can "help" by holding their little heads up. There really isn't an easy way to do it, as far as I can tell. The Newborn nursery was definitely a challenge for me in clinicals, so don't let that one part get to you, oK?

Amanda

[htrn]

We have to weigh and bathe babies every noc. My routine is:

1. put recieving blanket on scale and zero

2. put naked baby on blanket and weigh

3. Put diaper back on kiddo (or you get a bath of another sort )

4. swaddle baby like a burrito and while holding in football hold, wash and towel dry hair then REPLACE HAT - wet head + naked wet baby = cold stress

5. lay baby on folded blanket (for cushioning and to dry with) on counter next to sink or in bassinette.

6. wash face without damp cloth, no soap

7. soap up face cloth and quickly wash the rest of the baby with special attention to neck, underarms and bottom (last, of course).

8. with new cloth, rinse soap off and place baby on new, dry towel or blanket and dry.

9. lotion, lotion, lotion

10. diaper, cord care and clothes.

I go through alot of linen and still make a mess but it gets done. Don't worry, you'll come up with your own routine.

[CEG]

Gompers raises an interesting point that I hadn't heard before, and would love to read some research on.

I've given newborns tub baths in the hospital setting, but only in their own basin, never a sink. That does sound gross! Just like the Jacuzzi tubs used in labor-unless it is my own, there is no way I would get into one! I've worked in hospitals that had them in L&D, and they offer a great comfort to moms, but I can't imagine how they can be sufficiently disinfected between patients.

Aaaack! When I had my last baby, my CNM wanted to get me the "good" room with the jacuzzi tub. The housekeeper was finishing up cleaning the tub. I watched her scrub and scrub and put in disinfectant and run water and scrub and...... STEP INSIDE THE TUB IN HER SHOES TO TURN OFF THE WATER!! YIKES!!! THE HOUSEKEEPER!! Definitely not a clean tub. We gave it a couple more hot rinses before I got in... I figured in the long run my feet probably have the same germs her did, but seriously.

[Jolie, BSN]

I think you answered your own concern, the tubs would be cleaned with disinfectant inbetween room occupants. If you think the labor tubs in the hospital are full of cooties, what about the beds, toilets, floors, etc?

But I don't sit IN the toilet, or on the floor!

I also have observed housekeeping cleaning the Jacuzzi tubs, and I can't imagine that their routine is sufficient. They swab out the tubs, but I've never seen them fill the water high enough to flush out the jets. Seems like a great place for microbes to hide. I've never known of an infection related to the use of tubs in labor or PP, so I'll be the first to admit that I'm a little paranoid and germ phobic!

For example, we moved into our home last year. It has a Jacuzzi that I've never used, and probably never will. The house was 2 years old when we bought it, and all I can think of is the previous owners in the tub, and wondering what germs they left behind. I know, it's nuts!

[nursecher]

I am so jealous of those of you who get to bath babies everyday at work. Seriously, you get paid to do that? I can't wait!

[KRVRN, BSN, RN]

I am so jealous of those of you who get to bath babies everyday at work. Seriously, you get paid to do that? I can't wait!

Oh, Honey, that's not all we do, sometimes we cuddle too!

[BirthingBabies]

I am now orienting in the Newborn Nursery and I have to say, getting used to the whole bathing thing was a trip and a half, however, I feel very comfortable with it now. I bathe the baby under the warmer face first, then chest and arms, then back and legs, and then bottom. Then I swaddle them up good and use the football hold under the sink to wash their hair. It works for me wonderful! They all love the hair washing thing under the water... must feel like the womb!

:)