My facility is in the process of changing the way babies are handled at delivery and I need your help to find other facilities that do it this way!
A little about my facility... We are a 775 bed hospital in NJ, right outside of NYC. We have about 6,500 deliveries a year, with 50 postpartum beds. The postpartum nurses do couplet care with typically 10-12 nurses for the unit on the floor. We also have two charge nurses and two nursery nurses in the main nurseries to admit babies, assist with circumcisions, handle lab orders and phototherapy babies, as well as feedings for any babies not in the rooms with the mothers and more.
Currently, the L&D nurses are the ones being the Baby Nurse at delivery and in charge of the initial resuscitation and assigning APGAR's. They assist with the skin-to-skin and breastfeeding immediately following. About one to two hours after birth, the L&D nurse will bring the newborn to the nursery for the postpartum nurse to officially admit the baby. We will do the weight, measurements, admission medications, vitals, head-to-toe assessment, bath, and any monitoring that needs to occur. Typically the mother comes up to the postpartum floor shortly after and as soon as the baby is done, we will send the baby out to the mom. Separation time is typically one to two hours.
Right now we are in the process of changing all of that! They would like for a postpartum nurse to attend the delivery and be the Baby Nurse. She would do the initial resuscitation, assign the APGAR's, and then do the whole admission process (except the bath, which will occur later during their stay), in the L&D recovery room. Babies that need closer observation, such as respiratory distress babies, as well as all c-section babies, will still go to the main nursery after delivery for admission. The "goal" or "purpose" of this new change is to keep the mother and baby together. However, there is a lot of push back from the postpartum nurses about not wanting to be the Baby Nurse.
We have been given the opportunity to find a hospital that does it the same way or similar as described above, so that we may do a site visit to better understand the process. I am looking for that hospital!
The key changes are:
-Postpartum nurses being the Baby Nurse and doing the initial resuscitation and APGAR's
-Admitting the baby in L&D
-Once mom is stable and ready for transfer to postpartum, mom and baby would travel together, never being separated
-Decreasing the staff in the main nursery (ours would go from four RN's to two RN's)
I'd like to hear how your hospital handles babies at delivery! I'd love to find a hospital that does it the same way as above so that we could possibly do a site visit!
