patient teaching...or lack of

[Sarahstudent]

Yesterday I went on an obstetrical experience as a second year student. The RN whom I was paired with was helping the new mom to breast feed...well I shouldn't say "helping" rather "doing" the breast feeding for this first time mom. She would not let the mother hold the baby, rather, the RN held the baby to the mothers breast and with the other hand grabbed the mothers breast and shoved it in the babe's mouth....no explanation at all...no teaching... just doing. What a loss of a good teaching experience and bonding moment for this new family unit. I would have been so offended if I was that mother. She was not even given the chance to try to do it herself initially. How frustrating!

[moia]

YUp, it happened to me before I was a nurse and it was one of the motivating factors to become a nurse.

As a student you were in a bad spot there but if it happens again I would ask to speak to the nurse privately and ask her for her rationale. She may have a very valid explanation and her experience may have taught her a certain order in breastfeeding. I would listen and I would comment to her that it may be important that the new mother has a chance to hear the rationale and decide if she agrees with it.

This can be a delicate conversation and I would only try it if you feeel that this nurse would be able to hear it. Some nurses have a real attitude about seniority and refuse to hear anything new from a junior.

If you can't affect the situation then tell yourself that you will never do that as a nurse. Make a promise to yourself that you will never forget that everything you do as a nurse requires permission from the patient. The patient is the key to everything, they pay your mortgage and car payments and they send your kids to summer camp.

The least you can give back to them is an explanation for what you are doing to them.

[canoehead, BSN, RN]

I've watched new moms trying to put the baby to the breast, they are unable, or too hesitant, and the baby roots well, then starts crying and doesn't get that initial association of rooting and sucking results in satisfaction. So the first time I put the baby on and get that good latch. Then, when Mom switches breasts she tries. Of course the whole time the baby is nursing on the first breast we are chatting about what to watch for/how to be successful. I like Mom and baby to have that first experience go well, so they know they can both do it, and then practice with positioning and latching on during the rest of the admission.

If Mom says she can't get the baby to latch I always like to try "my way" to see if the baby will be successful with an experienced technique, then I know who to work with most. If the baby latches, then mum needs help, and if the baby won't latch or suck with my best effort I can reassure mom, and do sucking exercises. Of course I explain my reasoning to mom and get her consent, and then we work together on whatever the issue is.

[laurasc]

So the first time I put the baby on and get that good latch. Then, when Mom switches breasts she tries. Of course the whole time the baby is nursing on the first breast we are chatting about what to watch for/how to be successful.

I wish there were more nurses like you around! The first time I nursed my second son he wouldn't latch (they fed him formula in the nursery before bringing him to me....but that's another gripe) and the nurse not only manhandled my son but my breast as well. Hurt me and made him cry. I ended up telling her to take a flying leap and leave us alone.

I now work in a family practice office and prior to that a paediatrician's office...I'm amazed at how little the new moms know.

Sarah, you have a golden opportunity to really make a difference. Take the time to teach.