NICU lighting

prmenrs, RN · Jul 10, 2002

Hi, Dawn--We have a Developmental committee that was in charge of this--at certain ages you're supposed to partially, than fully uncover the incubator. We also have an "arts and crafts" unit of Volunteer Services that made us lots of covers. People on the Development Cmte take the covers home between pts. and washes them, along with the cuddling rolls and small swaddling cloths we use on the babies.

It's not just light that the kid is protected against, but sound. We're used to it by now, but it was tough getting used at first. Kids who are chronic offenders re: a's and b's might get one front flap lifted so we can see if they're refluxing before going into the bubble, but otherwise, covered wagons all around.

Jolie, BSN · Jul 10, 2002

I agree, cover 'em up, for protection from light, as well as sound. These poor babes were not meant to be exposed to light and noise until birth at 37 weeks or better!

NICU_Nurse, BSN, RN · Jul 10, 2002

This is so sad, and it only goes to further my point that perhaps my under-funded hospital is missing out on precious opportunities to properly care for it's patients, but our unit has standard (bright) fluorescent lighting, and NO ISOLETTE COVERS of any kind. I was told that years ago, they had them...where did they go? Must have quit with all our CNA's!!! rofl We use swaddling blankets when necessary and drape them over the isolette or top of the cribs when the babies need down time, and we can turn down some lights, which helps. We do our work in the dark as much as possible on our unit, which isn't as often as we probably should. When you have five nurses and one light switch, majority rules. The draping blankets issue is a real one, because the swaddling blankets we have are thin and white, letting plenty of light through and are a pain to fix so that we can keep an eye on the baby but still shield their eyes. We have signs to post over cribs, stating 'Minimal stimulation! I'm growing!' but they do no good- NOBODY respects them. Our unit can get VERY noisy, lots of laughter, discussion, etc. It's getting very frustrating to me, to be honest, and I'm beginning to feel as if I should move on. Is it selfish to want to work in a place that has actual working equipment? Actual scales and warm running water and isolette covers and with people who are QUIET around chronic de-satters? Semi-clean floors and developmental items and clean linens? I felt idealistic when I came here seven months ago; I thought, wow, if ever a place needed good staff, it is this one. However, in retrospect, I feel horribly naive. How can you care for these babies properly with all of these strikes lined up against you before you start?? Are you telling me that all of you have all of these things? Is it only my hospital? I don't know what to think...! We were told to encourage breastfeeding and kangarooing. Okay. Given no info, had to look everything up and teach myself. Out of fourteen babies on our unit now, only ONE is being breastfed and kangarooed. Thirteen babies are getting none of it. That's pathetic, I think!! Sorry, I seem, as usual, to have gotten off track. ;>)

NicuGal, MSN, RN · Jul 10, 2002

We encourage the parents to bring in comforters or quilts from home, or heavy blankets to cover the isolette :) We had isolette covers, but they usually got thrown off because we had to move them everytime to do the baby and they were bulky and hard to work with. We have central lighting that is usually off and have dimmer switches on the overheads. We also have lighting over the counters so we can see. During the day we try to simulate day, unless you have a really, really sick kid. We put our older kids on the side that has outside window, so that they do get the day/night thing going for them. Little ones we nestle and nest and keep covered as much as possible...if we need in there a lot we try to at least put a washcloth over their eyes.

dawngloves, BSN, RN · Jul 10, 2002

Story on cycled lighting in NICU

http://www.wggb.com/health/prematurebabies.htm

live4today, RN · Jul 10, 2002

Dawngloves...that article suggest day/night lighting to help the preemies get use to their bodie's circadian rhythm. Interesting since I believe likewise. When I worked in Newborn Nursery...standard lighting was used ATC...military hospital...no changes were made at night for the little fussers. :)

prmenrs, RN · Jul 10, 2002

Kristi and Dawn: all it takes is ONE COMMITTED individual to start a change. Just don't even think it will happen as fast as you might want.

Go to a fabric store, and look thru the remnants for calico to make ~ 22" squares. Just hem them, and you've got a swaddling cloth. If you have those "pt. belonging" bags, put it where people can put it when it gets slimed. Moms can be asked to take them home and wash them--they are often very happy to do something for the baby besides visit. (Ask them to use unscented detergent and fabric softener. What smells great to her is OVERWHELMING and obnoxious in a closed incubater.)

Also, in your spare time, [i know, don't slap me) check out garage sales and thrift shops for baby comfortors, blankets, quilts to go over incubators. The fabric store may have some inexpensive pre-printed quilt fabric that just needs some seem binding around the edge, and some elastic loops to keep it in place.

Grandmothers love to be given stuff like this to do. Brownie troops can make the swaddling cloths as a community service project.

The very least is the receiving blankets. I don't know what kind of incubators you've got. but for our round OHMEDA "bubbles", I would drape 2 diagonal fashion over the ends, then put a couple more over the top. Use lots of masking tape!!

You can roll a blanket and curl it around the baby to help him nest. Swaddling and nesting helps them maximize their own coping mechanisms.

Do you have a volunteer department? Ask for their help to make stuff.

Lastly, if the place you're working at is so entrenched and unsupportive of the BABIES, consider your options. In any case, be sure to use this project (if you decide to take it on) for your evaluation.

If I can be of any help, PM/e-mail me.

nell · Jul 10, 2002

Sorry, couldn't vote: none of the options were quite right.

Our main lights go out automatically at 8-9pm and we have lighting over each bed with it's own controls. The desk just outside the patient bays stays lit all of the time, so there's always some light. The unit has HUGE windows all along one side, but we can close the blinds most of the way - still very light during the day.

We have isolette covers that are quilted and dark on one side that we use for the little/sensitive preemies, and then when they are older, we usually just cover the isolettes with baby blankets.

We are supposed to consider developmental needs, but what is done is highly individualized - nurse's preference. Sometimes we have nurses on different shifts caring for the same set of babies that un-do what the previous nurse has done, so it's on again, off again... :roll

KRVRN, BSN, RN · Jul 11, 2002

We have volunteers that sew isolette covers and snugglies. Some also knit small afghans, hats and booties. We have a stackable washer/dryer in our unit for washing these, which we keep separate from the hospital laundry.

We have a big unit with several light switches, and by the middle of the night all switches are usually off. We have lighting over our counter areas that make a nice soft/dim light when the overheads are off. We keep all isolettes covered unless the baby is under bili lights. We frequently put bili masks on our micropreemies' eyes if they are on a warmer.

And just as a side question-- does anyone make some type of little ear protectors?

prmenrs, RN · Jul 11, 2002

Hey, KRV, where ya been??

dawngloves, BSN, RN · Jul 11, 2002

I was thinking the same thing about ear protectors! Or unit is thinking of doing cycled light, but are concerned about the noise level that the covers eliminates.

NICU lighting

What does your unit do?