NRP, nursery nurses & attending c sections

[FemmeRN]

Hi,

I work on a mother/baby unit (about 45 postpartum beds; about 4500 deliveries/yr), we do couplet care and have a well-baby nursery that basically does admissions, and watches a few babies while mom naps/showers, etc. The nursery is staffed by some of the couplet care nurses who have had extra training/orientation to the nursery. We have about 10 or 15 staff nurses who have trained for this, and they just sort of rotate daily who's in the nursery and who is on the floor.

In the last year, our practices have changed so that a nursery nurse (instead of a NICU nurse) is attending all scheduled repeat c sections. A respiratory therapist from the NICU team attends as well.

At our hospital, mother/baby nurses (including these well-baby nursery staff) take only the first 4 lessons of NRP. We don't receive training in the use of any of the drugs etc, the way the NICU nurses do. There is a "code" button we are able to press in the OR, if we need a NICU nurse to come do whatever it is that's in NRP lessons 5-8....

My questions are:

1. To what extent are mother/baby or well baby nursery nurses trained in NRP at your institution?

2. Is this safe/would you feel comfortable/are there any AWHONN guidelines about who needs to be in the OR to receive a scheduled c/s baby?

I haven't been trained yet to go to the c sections, but frankly, the thought of this makes me uncomfortable. The RT can't push the meds, and the circulating nurse from L&D is NRP certified, but she's not technically responsible for the baby.

I'd really appreciate any thoughts you all have on this. I don't know if I'm being needlessly panicky, or unrealistic about the realities of risk in healthcare, and decisions that are made based on staffing/money, etc. But, I know that most if not all of the nurses who are being asked to do this feel uncomfortable about the situation.

Thanks,

[klone, MSN, RN]

I guess I don't understand what you mean by "first 4 lessons of NRP". I think NRP certification is pretty universal and standard, and has to include med administration (although, it seems like every time they revise their standards, fewer and fewer meds are part of the protocol). So they're either NRP certified or they're not, and everyone who is NRP certified receives the same class/training.

At our facility, EVERYONE who cares for the baby has to be NRP certified. L&D nurse, who ever is going back to be baby nurse for the C/S, nursery admission nurse, and couplet nurse.

[serenity1]

Same at my place. All of us have to be NRP certified--post partum, nursery, and l&d.

[ocmama]

When I recently took the NRP there were 9 sections. I was taught all 9, but told that what I was learning at the end was beyond my scope of practice i.e. administering epi.

[bluangel215]

I am on a Women Services floor and we also only went through the first four sections. The NICU/well baby nurses went through all of the sections.

[tablefor9, RN]

Everybody goes through *all* of it. So, we can all go to any delivery. If you are going to any delivery, you should be qualified to handle whatever comes. Anything else is just bad ju-ju.

[brownbook]

femmrn, I understand how this would make you uncomfortable. Just reading it raises my anxiety. I don't know your hospital policy, I don't exactly understand your first 4 lessons of NRP? I do know anxiety and nervousness in new situations are normal feelings. Just in general realize a good nurse/doctor/RT always feels a little anxiety. It keeps you on your toes. Face your fears and anxiety and you will grow emotionally and professionally. As I type this I think "oh yeah, I HATE that anxious feeling I get when having to do something new!" Somehow I muddle through it, we all do.

[FemmeRN]

Thank you all for your replies! :)

Klone...What I meant was the M/B and well baby nursery nurses at my hospital are only taught and tested on the material in chapters 1-4 of the NRP book. The L&D and NICU nurses complete the full course of information. It sounds like bluangel215's institution does the same thing. I just figured this was a common practice, until I started reading these replies. Sorry for the confusion!

brownbook...Thanks for the words of encouragement, they are much appreciated. I know exactly what you are saying, and definitely feel anxious in new situations. I'm just trying to discern if the nervousness I'm feeling is just the normal "new situation jitters", or if it's one of those gut feelings that this is a bad situation, and we're just asking for the "bad ju-ju" tablefor9 is talking about!

Thanks again! This site is such a great resource!