Primary Nursing vs Transisitional Care Core Team

[ncnicunurse]

I am wondering if anyone is having problems with the primary nurses of the

transisitional infant wanting to take over in the transisitional care nursery.

We have a core team of nurses that work there, and it was decided a year ago that the primary nurse would bring the parents to meet us in transitional care. Now all of a sudden the primary wants to come to transitional, which most of them hate and we having a hell of a time.

How do you handle your step down vs your intensive care nursery patients and their primary nurses.:argue:

[SteveNNP, MSN, NP]

Our stepdown is on another floor, but is staffed by the same nurses as the rest of the unit. We tend to follow primaries when they go to stepdown. How exactly are they "taking over?" Perhaps the primary nurse is just reacting to a new group of RNs taking care of "his/her" patient?

[ncnicunurse]

Thanks for your reply. When they come to transitional the first thing out of their mouth is "i am only here to take care of my primary". Doesn't matter that the core team has been doing all the teaching, interacting, etc. Or they are mad to be here, they through their backpacks, pace up and down the floor, unprofessional in front of parents, or complaining "all day long". So we are having a big meeting this week and try to resolve some issues.

[Sweeper933]

We take care of our primary babies until the day they go home. We do have a "step-down" like part of our unit, where a lot of our chronics will go (along with other kids who are close to going home), but it's all considered one big unit. We follow our chronics back to that area until they go home. I couldn't imagine taking care of a baby for months, and then not being able to "finish the job" by helping them and their family get home.

[RainDreamer, BSN, RN]

Our unit and step-down are all staffed by the same nurses .... although there are some nurses that only like working in the unit (although they do have to do their time in the step-down) and there are some that only like the step-down.

I think the primary nurse should be able to follow the baby all the way to discharge. They have taken care of that baby/family from the start ..... why not follow throughout the step-down stay too?

A lot of our nurses will follow the baby all the way to discharge, but some nurses only like working in the unit primarily and won't follow them after they move to step-down because they don't want to be stuck in step-down for weeks/months.