I work at a level III NICU in Sioux Falls, SD. We are currently in the process of developing our Relationship Based Care that involves primary nursing. It has been a work in progress and we have met a lot of resistance. Even so we are moving forward because it is the best thing for our babies and their families. As for our structure, we have a voluntary sign up sheet for each infant with 5-6 slots underneath their name where RN's can sign up to be part of their primary "team". We decided not to do just 1 primary nurse because we work 12hr shifts and there wouldn't be a primary assigned for 4 days out of the week. Even though our primary is on a voluntary basis, each nurse must be assigned to at least 1 infant but no more than 3. We have been trialing this for a few weeks now and it seems to work out well for us. We will be going live in about 1 month and every infant will have a primary!