Is this a common practice? My hospital calls itself "family centered" and practices couplet care. As such it claims to support "rooming in." However there is a long standing culture of kowtowing to the patients every wish and customer satisfaction is the golden rule. In this population of well off older professional women, it is a great "dissatisfier" if we say we cannot watch your baby because we have no nursery nurse. We are not allowed to do this- this comes from above our manager who has been trying to change things since she got here.
I have found myself with a bassinett at the nurses station, the other nurse admitting a patient, the CA on her lunch break (as she has a right to do) the secretary answering the phone and door ( and not allowed to watch babies- due to policy/ no NRP) and myself trying to figure out how to answer 3 call lights -
Me;
Dragging the bassinet down the hall and opening the door: "can I help you"
" yes, I was wondering if you could give my baby a bath"
( explained about newborn skin care, not bathing daily etc)
Next room: needed pain medicine so I drag the bassinet to the pyxis etc
And so on.
It's torture and cannot be a safe practice. What can I do?
All this with 4-5 couplets. Usually five with 6-7 counting admissions and discharges.
What recourse do we have when the staffing recommendations of our professional organizations hold little weight and the joint commission which claims to want patient safety turns a blind eye to the biggest problem of all, staffing practices???
I just wanted to add that besides exhaustion, there is the fact that we give some of these patients powerful narcotics. Give a couple of Percocets to a really worn-out mom and how vigilant do you think she will be. She could be the most devoted mom in the world, but she may not be able to keep her eyes open for long.
If I'm giving mom Percs or she is using her PCA frequently, I really hope she has someone else in the room with her. If she's alone, I'll strongly recommend that she let me take baby to the nursery. I'm happy to bring the kid out on demand, but then I know when baby starts feeding and I can keep a closer watch to make sure everything is okay.
When I gave birth 15 and 13 years ago, I was not ALLOWED to keep the baby with me overnight even though I wanted to -- "against policy." I had my next 4 births at home.
IMO rigidity in either direction is not a good idea -- no enforced separation, but no enforced rooming in either. The policy has to be flexible enough to meet the varying needs of mothers and their babies. Not everyone is able or wants to care for their baby within hours of birth. The argument that "nobody will be there to help you at home" is hogwash. First of all, if so then discharge them right away -- don't keep them in the hospital at all. Also, don't we encourage mothers to arrange for the help they need at home? I don't fault anyone for assuming that help is available for them in the hospital.
We are a small hospital with no nursery. I'll admit I have had sympathy for multips who are tired and could do with a nap before heading home; however, I don't feel responsible to babysit if there is not enough staff. I will mind the baby for a short period but if I need to attend to another pt, the baby will have to return to mom. When I admit a pt, I always tell the moms they should have someone with them always in case we get busy. Once I had a mom fall on her way to the bathroom, hemorrhage and lose consciousness. Thank goodness she had her mom with her.
Although this could go a few different ways...I will jump in with this thought. If your facility touts "family centered care" or provides couplet care without nursery, it would be prudent that your customer/patient base KNOWS this, and can prepare accordingly. If they believe you have the capability, of course you will be dragging babies around in their bassinettes. It is a dissatisfyer initially, but if that is the model you are working with, then work with it. You cannot have patients believe you have a service you do not. Your managment is just wrong there. We went from having a nursery to mom/baby couple care and we did have a few bumps, but we rely heavily on the support person (hahahaha). There are times that we do end up with a baby or two at the desk, but for the most part we room in. Having a baby is hard work and so is taking care of them. How many times have you had a mom come in umpteen times for labor checks and demanding you get the baby out, and the moment it arrives into the world, they want it in the nursery????
Your management is going about this the wrong way, sorry.
i think i have never heard anything more ridiculous. you and your coworkers need to get together and report this insanity to your congressional representatives, the police, your infection control coordinator, and pres. obama. i am only half joking. report your lunatic bosses and their lunatic practices to regulators, licensing boards, anyone you can think of.
We are a small hospital with no nursery. I'll admit I have had sympathy for multips who are tired and could do with a nap before heading home; however, I don't feel responsible to babysit if there is not enough staff. I will mind the baby for a short period but if I need to attend to another pt, the baby will have to return to mom. When I admit a pt, I always tell the moms they should have someone with them always in case we get busy. Once I had a mom fall on her way to the bathroom, hemorrhage and lose consciousness. Thank goodness she had her mom with her.
Insane. First off, why are they first being told at admission that they will need a helper? And what if they have no one? Should they hire someone?
Terrifying how calm you sound about the mom who fell. Not faulting you, it just made my blood run cold to read it and to guess she'd have died or been left disabled from blood loss if her helper had not been there.
America should be ashamed of herself, the way we've let health care slip in our once-great land.
We struggle with this too. We are supposed to promote 'couplet care' and family bonding, etc...which is great in theory. We're supposed to help mom take care of her baby and help her keep her baby in the room with her so she can feel confident taking him home knowing what she's doing.
I am fine with that, but we also have 4-5 couplets a piece and doing that with five couplets - 10 patients - is impossible. It is doable with 3-4 couplets but I still run my legs off. I don't mind the running, but it's not really fair to my patients who should be able to expect a reasonable amount of help from their nurse. Throw in one couplet with breastfeeding issues or a sick mom or baby, and everyone else gets a raw deal. The only way I see around this is to staff for a max of 3-4 couplets per nurse.
We do have a wellbaby nursery staffed with 2 RNs, which is used for new admit babies, moms who want to sleep, AND long-term non-critical convalescent care (45-bed unit). Most of our moms keep their babies with them...but on any given night that's hard to predict. Some nights only 4-5 babies will be in there and other nights it's 20. And I am not about to tell a mom who's hit the wall at 0200 and hasn't slept for 3 days that she 'must keep her baby'. Or a mom that's on baby #4 that she needs to learn how to take care of her baby; pretty sure she's got that part down and needs a bit of sleep before going home to three more. I have no problem with people sending their babies to the nursery and I have no problem with helping moms keep their babies with them - I am crosstrained for mother-baby and nursery - but the breastfeeding-friendly police at my place seem to think there can be no happy medium. It gets wearing.
the breastfeeding-friendly police at my place seem to think there can be no happy medium. It gets wearing.
I'm fortunate in that the lactation folks at the hospital where I work are pretty reasonable. Our staffing is decent most times. And we do offer the nursery option on noc shift.
I get really tired of the "baby-friendly" philosophy that takes only the baby into consideration and can be downright mom-un friendly. The big picture looks at everyone's needs and aims for flexibility and balance.
Yopur employer is nuts. All involved are at an enormous liability if this doesn't stop. Don't risk your license for these lunatics. This is curstomer service run amok not to mention dishonest and harmful.They need to either get a nursery in place or tell the patients the truth right from the start. I am fully in favor of having a nursery in place for the moms who need some rest, drugged up, etc.
I would stop lying and I would stop taking the baby ASAP. It's a liability for you and a risk to the baby. Everyone is lucky a tragedy hasn't already taken place. Call Risk Management TODAY. They will right this ship immediately.
Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
I'm just curious. Does your hospital do tours for the moms who will be delivering there, OP? What do they tell them then about this issue? I would imagine as a new mom getting ready to deliver, that they have to ask about sending the baby to the nursery. Are they flat out lied to?
After I gave birth to my son, i remember being so exhausted that I could not even keep my eyes open when my nurse brought my son in the room to be fed the first time. She took him to the nursery because I could not stay awake for the life of me! Its kind of scary to think what could have happened if he was left in bed with me
Which is exactly why it's the hospital, not the staff, the pushes the couplet care.
Yes, I am calm now as I reflect on it so I can learn from it; however, at the time I was ****ing my pants! We only have 2 nurses on the floor (only 1 left on the floor if the other nurse goes on a transfer-as we are a level 1) and so if we are having one OR MORE deliveries, then any post partum moms, newborns, walk-ins, NST's, etc. will be dealt with as a triage scenario: by priority. Part of our preadmission is that moms have someone with them for at least the first night as we may be busy with other patients.
I agree, it is totally ridiculous that many times, patients have to rely on their family/friends but it is a reality with today's difficult economy. We are currently keeping track of any overtime and the number of hours we have someone else come to the floor to help us when we are crazy busy so we can appeal to get a 3rd nurse on the floor at all times but as I said, it is a difficult economic time. If someone comes in alone, then we I will do everything I can for her as I do for all my patients but I can only do what I can do.
I wish sometimes the public was more aware of what nurses really do on a daily basis so they would realize how invaluable nurses are.
rn/writer, RN
9 Articles; 4,168 Posts
I just wanted to add that besides exhaustion, there is the fact that we give some of these patients powerful narcotics. Give a couple of Percocets to a really worn-out mom and how vigilant do you think she will be. She could be the most devoted mom in the world, but she may not be able to keep her eyes open for long.
If I'm giving mom Percs or she is using her PCA frequently, I really hope she has someone else in the room with her. If she's alone, I'll strongly recommend that she let me take baby to the nursery. I'm happy to bring the kid out on demand, but then I know when baby starts feeding and I can keep a closer watch to make sure everything is okay.