puddles11

Also, I am sorry.. as a side not if you guys are willing to... can you put the name of the hospital that you work at? (those that left replies also)... I am running into legitimacy problems on my end when presenting information to others thanks!

I want to thank everyone for their input, and if there are any more ideas please keep them coming!! These comments are being kicked around in our meetings and hopefully will lead to policy change..... Thanks!!

So, we do give the mothers the option to delay the bath . Some do it some dont and according to our nurse manager, once that baby is on the floor it is the floor nurse responsibilty. And their big motto around here is that delaying baby care that is routine such as prints, measurements, etc is not to be held over for next shift... bath only but like I said the floor nurse who has that couplet then has to bathe the baby. (We are trying to advocate for CNA's to be able to bathe the babies... so we will see) Yesterday we tried having an admit nurse who did all the baby admits (or at least the first set of vitals, measurements and assessment ) then hand off to the floor nurse, however that RN had 6 admissions in her first 8 hrs of her shift and it was very overwhelming to do admissions sometimes back to back and even at the same time.. it was not safe for the baby. And as far as the mother being a transfer, I agree and we don't do the whole full admission but when the nurses starting saying we are admitting to patients at the same exact time and it becomes a safety issue among others things, the nurse manager said no.. the mother is a transfer .. so that was just a point of how the language is being used to push for this new model. As far as charting, I personally think it is insane the way they do it here. We have 12 hour shift (altho we do have some that are 8 hours) and we have to chart 2 times on every mother and 2 times on every baby. once at 7 and once at 3. And with the addition of all the charting invovled with a newly admitted baby it adds more onto the floor nurse (also we are responsibl for blood work that all babies need at 25 hours of life (PKU). sorry, i am not disputing your suggestions, just trying to let everyone see what craziness we are working with! The way we had it before (which I don't even rememeber if I mentioned in the last post) was 3 nurses in the nursery. Once was charge, one took care of circs, and drug withdrawal babies, and also did every other admission while the other nurse did admissions and took care of the withdrawal babies when their primary nurse was in an admission. Then on the floor we each had 6 couplets (if we had a full house which is pretty much the norm, once one left, another arrived) They want us to have 4 couplets which is what it is according to guidelines and put 3 nurses on each side of the floor, and by pulling the nursery nurses they want to accompolish that. However most of the staff wants 4 couplets, and the nurses in the nursery as it was to continue to admit the babies, and they just won't do it. During the day they say they don't want any nurses in the nursery at all (except for the nurse taking care of the withdrawal babies.. which we ALWAYS have) . its just an awful situation , and people that have been here for years are seriously looking to transfer to other departments, and its a shame. Maybe there just is NO easy way to do it?

Hi everyone!! I need some advice, some ideas, some help, and some thoughts!!! I work in a high volume hospital as it pertains to people giving birth. (Nearly 4000 a year) We have an L&D unit with their own nurses, NICU with their own, and then the postpartum unit where we are trained to care for babies and mothers. Initially when I Started years ago the babies were brought to the nursery and admitted there, and the mothers were admitted on the floor then the babies brought to the mothers when they were all finished. Now of course we have been doing admissions in the room so we are a non separation hospital. Fine, we made it through that transition tho it was difficult..change always is,. So there would be three nurses assigned to the nursery (they would do admissions on the babies in the room, circs, take care of the withdrawal babies once moms were discharged and assess any babies that were in the nursery overnight before bringing them to moms room in the morning). On the floor we each have 6 couplets. When an admission came to the room one nursery nurse would come out to the room for the baby and the floor RN would admit the mom then the baby nurse would give report to the floor rn who then assumed care for the couplet. This has been working very well for us ... Heres the problem... according to guidelines we should only have 4 couplets each. So to combat this, our nurse manager has decided that there will only be 1 nurse in the nursery (withdrawal babies circs, etc) along with the charge nurse (who is COUNTED in the numbers but does not do actual care of any pt... maybe an occasionial circ) then have 3 nurses on each side (we have a south and north side and then each with 12 rooms and then on the floor below we have the south side with 12 rooms to hold NICU moms... which of course always ends up holding couplets as well). ANYWAY .... they want to have 3 nurses on each side with 4 couplets at the most. However, when you have 3 couplets and an admission comes you are now responsible to admit the baby AND the mother at the same time. We have been piloting it for a couple of weeks and everyone is unhappy and it has been an awful time to come into work everyday. The issue is the baby. the mom admission is really quick comparatively.. The baby is what takes time.. say about an hour and a half from start to finish... bath , measurements, assessment footprints..etc. And THEN if the baby need d sticks, or is not essentially a 'well' newborn but not unwell enough to goto NICU, then that more time. So everyone is unhappy... we feel it is unsafe, and that our other patients are being ignored, and with hourly rounding.. its impossible.. (ALSO , it happens very frequently that there will be 2 admissions brought at the same time if not more .. so a lot of the times 2 of the 3 floor nurses are in rooms and leaving the 1 nurse to care for the others on the floor, and we are NOT allowed to ask L&D to hold onto anyone for any amount of time). We have been discussing and searching high and low to try to come to some kind of compromise that will make the flow smoother, and above all else safer. any suggestions? What is everyone else doing? And if this is how everyone IS doing it... are we just being babies because its just another change that we don't like?? (Personally I feel that my license is at risk because I have to admit 2 patients at the same exact time while I have 3 other couplets under my care) .. and BTW, they are calling mom's transfers...not admissions because they are technically 'admitted' to L&D and just being transferred to us.,.. but she is still a full admit for us... so? THANK YOU FOR ANY SUGGESTIONS!!!!!!!!!!! J