cherokeesummer

Nope I don't call that lazy at all. That is normal. We can't blanket it all and say any mom who sends her baby to the nursery is lazy, its a specific type of person I think of, the ones who don't want to particpate in care at all, i.e. feeding, changing, etc. Now if we could staff for a person in the nursery it would be even better. I offer to my moms to keep the baby if they even so much as think/blink or act like they could use it. If they ask, I say sure and ask how they want the baby fed, etc. If I need to do a lab or anything I will ask, do you want me to keep the baby for a couple hours so you can rest? Etc. This way I'm not pushing but they don't feel bad for asking b/c I've presented them with it. Sometimes you just gotta rest!

We must work in the same place LOL! Just kidding but it sounds so familiar!

Ditto, we do this too - ood is very important b/c like you said, in the begining babies may go a long time without waking to eat and we need to make sure its being done. I've had moms really not want to have baby to nursery but they were so to the point of exhaustion and crying that I suggested just a three hour break, that way they can rest and they still don't feel bad b/c its not all night. OOD is a good option.

Yes. I'd say probably half send their babies to the nursery on any given night. It is rare to have less than 5-10 babies overnight. Generally our charge nurse cares for them or we take turns. Also our admitting nursery nurse will if she is not getting new babies in. We can't staff to keep a nurse in the nursery so we just have to rotate. I don't mind giving moms a break so I'm ok with it sometimes but what does bother me are the ones who never want their baby in the room and they are not resting, they are up on the phone all night long. Or the ones who send the baby to the nursery and the baby is screaming but they refuse a paci or a feed, only wanting breastfeeding (which I think is fine) but I think that when the baby is screaming it needs to be comforted and if you don't want to hold it, comfort it, feed it or pacify it, then it bothers me. I will hold the baby as long as I can but I think that breastfeeding on demand is important and I will take a baby back that just ate if I can't console it any other way. I just explain to mom that baby is having a hard time being consoled even after holding/rocking/etc. and may need to nurse or do skin to skin. Again I'm all for giving mom a break but I can't bear to hear/see the baby so upset and moms not wanting to take part in the care.

I also have no magic words and I know each loss is different and the experience is different. When we had our loss I was not in the field so it was different. I could not bear to be around pregnant people for a long time, even family and friends. It was a very emotional time for me. What I can say is this, I've read your posts and I know how caring and loving of a nurse you are. That being said, take some time to care and love yourself. Take some additional days off just to give yourself some time. Also know that some situations may be harder to deal with than they were before (pts with poor or no pnc, patients who are indifferent, etc.) and know that you can grieve for as long as you need. Love and hugs!

PS and I do not give formula unless mom asks me to. I have gone in a room in the middle of the night to make sure its what they wanted if they sent the baby to the nursery for the night but have been otherwise breastfeeding. I will ask if its an out on demand infant (feeding in the room when hungry) or if we are to feed in the nursery and many moms choose to feed formula at night.

We support it at our facility BUT often are over worked and understaffed and do not have the time we would like to devote to it. BUT when someone asks me to help latch a baby I do it, even if it takes time that I don't have at that moment I do it b/c its important and even if it is someone who really doesn't want to do it but is feeling pressured. I've had a patient ask nurses to tell her spouse she was unable to nurse b/c of a breast surgery b/c she didn't want to nurse and didn't want to just tell him that. Frustrating. It is frustrating when I tell ppl over and over again that colostrum is small in quantity and huge in quality and that its important to try to latch if they want to breastfeed and then they give up immediately b/c the baby is crying. I try to explain that it does take work, dedication and its a personal choice, i will support them either way. On the flip side I get frustrated when I have a baby that has a HUGE decrease in weight and increase in bilirubin and the parents will not budge on giving a supplement and only try to nurse the baby when its awake and only for a few mins. I suggest at that point finger feeding/syringe feeding pumped milk and formula. I want to support moms but at the same time, I want their babies to be able to go home with them so I try to get them to breastfeed successfully and offer alternatives to supplementation that do not involve a bottle. If they want a bottle I will give it to them without lecture and I explain that it is still possible to switch from breast to bottle, it may take more work but it can be done. I was one who tried, could not get it right, my son had a bottle from the start b/c of hypoglycemia and when I tried to latch I couldn't and I gave up too quick and didn't seek help. I pumped and gave that to him for a bit. I still feel bad about that 4 years later and try to help my patients so they can work harder at it if they want to. I wish I had worked harder at it but I know that he is happy and healthy and thats what counts. But no I do not think that HCP are against breastfeeding, but there are those who will be hardcore one way or the other as well.

Do you guys have an evacuation plan in place for newborns and what is it? I am working on updating (hopefully) or at least clarifying our policy/plan and was looking to see what other options are out there. Thanks in advance!

We have the same issues and for the same reasons. It sucks for both sides that sometimes the other side doesn't get what the other needs, but yes we have the same problems and same underlying causes.

I should add that I am a type I diabetic since age 12. My diabetes was in great shape during pregnancy, HA1C was 5.9 (best it had ever been) the entire pregnancy but as I got further along my pump infusion had to be increased quite a bit, the doctor said to expect that and we adjusted as necessary. He was born at 39 weeks exactly, via c-section. He also needed some o2 to get going and then spent the first 24 hours in the NICU with a drip due to low glucose. I don't think we'll have any more children but if we do have another one, it would be nice to have a little smaller one. :)

My son was 11.4 lol, I had a c-section. We expected him to be bigger anyway but not that big. LOL! He is now a 4 year old that is 44 inches tall and 80 lbs. My hubby is a big guy tho, so we figure he gets some of it from him lol. I've had a patient that had an 11.7 baby lady partslly with no tears and no epidural!

100% all the way agree with this!

Yeah I was thinking about that too. I really have no problem with those who want to be bald and can see that men would appreciate it and like it or even prefer it. The only thing I have issue with is a man telling a woman she must do it. LOL, I just don't like being told what to do lol!!!!!!!!! :) I can not imagine the pain of waxing but hey its probably more effective than the old razor deal! :)

LOL yeah! I asked my hubby about it once, lmao and he was not for it LOL, but hey I'd support him even if he wanted to color it rainbow colors lmao! But I'd still have to laugh a smidgen! :):)

LOl I love this thread, cuz I've seen all kinds of things at work LOL. I must say, my husband cares not either way - hair or no hair. There is no "reward" he does what he does b/c he loves me :) He also fixes things and eats a lot of steak lmao! And my thought is if you want the woman to be bald then the guy parts need to be bald too. Which in itself sounds like it would be pretty funny looking lol. :)

I wanted to add too, one of the biggest issues is getting them on board, even repeat sections can give me a hard time about getting up b/c they are not wanting any pain and I manage the pain before hand but also try to remind them that it is surgery and that pain may be involved but will be worse if they stay in bed. Also it is clear liquids til ambulation most of the time, so my patients tend to be more agreeable to trying to ambulate if they can eat. (I do sometimes give crackers tho if they have good bowel sounds). I had a section with my son, delivered at 1152am and was in the nicu via wheelchair by 5pm.

Our protocol/orders say 2 hours post op, I however don't usually have a patient with legs at that point if they still have a pain pump. So generally speaking I come in at 7pm and will get them up anywhere between 9pm and 5am, depending on when they delivered. I prefer to get them up after several hours to rest/get feeling back, etc. I will try them out just to the bedside chair first if its still kinda early.

Previously we did as it was always a selected order by anesthesia who controls the pain meds in c-section cases. However then they started to not give it to known breastfeeding moms. Generally it was 30mg IV (sometimes 15mg) q6 hours x 10 doses and then switch to prn 800mg motrin after the 10 doses. But it really depended on the anesthesiologist that was on as to whether it was given or not. It works well so I wish more would give it. And if my patient is having problems and its not ordered I do call to ask for it.

Wow that is scary! We do not have ldrp, we have ld and then a seperate mother/baby unit. On post partum we do not have any ancillary staff so we are required to do everything for the patients (vitals, trays, discharge teaching, bed linens, etc. etc.) and we start the shift generally with 4 couplets (8 patients) or a mix of couplets and gyn surgical patients. There are times when we've had no choice and been up to 6 or rare occasions 7 couplets. But that is a rarity. Generally 5 couplets, or a combination of couplets/gyns to equal about 10 patients that we do everything for is the norm. (not saying I agree with it but its what generally occurs). I can't imagine having to divide up with laboring patients as well, that is just so intense, I can only imagine how stressed you would be.

Ditto pretty much everything Elvish said here, except we don't care for antepartum patients generally. We do moms/babies and gyn surgical patients. :):) We usually start with 4 couplets and end up with 5, sometimes more depending on how busy it is. There are rare times when we have way more but that is not the usual. Generally speaking we have 10 patients (5 couplets or any mix to equal that like 4 couplets, a gyn and a mom whos baby is in the nicu, etc.). My shift generally runs about the same as below also (I'm a night shifter as well).

Wow compared to some of the responses here our unit provides a lot more meds, sometimes I wonder if that is the problem with our patients not wanting to get up. CS come over with epidural in place and keep it 1-2 days there have been rare ppl who had it on day 3. I encourage removal as soon as they can tolerate it b/c I really don't see how it helps them a lot, some ppl yes but most of them seem to be ready to be done with it sooner rather than later. CS also have toradol q 6 for about 2 days. They can have percocet in between for breakthrough pain. lady partsl deliveries can have motrin 800 or percocet or both. I try to start out slow, if my patient is complaining of cramping (lady partsl) I try a motrin and then if that doesn't help or if they ask for somethign stronger I will try one percocet (we are allowed to do 1 or 2 q 4 hours prn). But I strongly encourage ambulation, especially for cs patients, they really need to get that gas out. Personal experience, having had a cs as well as a few other surgeries, pca pain management is not good for me, I do better with po meds. I think toradol is good iv though for many pains and I think if I have another child and its a cs delivery I will try to find an alternate route, or have the epi pulled asap. I just don't find the benefit in it and always did better with other methods of pain management. And walking as soon as I could was always helpful! I am just shocked sometimes at how much time post partum patients spend in bed, I think it really helps to be moving and doing things even if its just within one's room.

Thank you for sharing this! I'm always interested in learning about VBAC issues not only b/c of work but because I have wavered on whether I would attempt a vbac if I were to have another child.

Elvish I'm with you, I would be totally shocked if all my patients came over tucked into bed and already showered LOL! No way, most of the time they are still partially numb, or at least a little shellshocked and we are expected to do all of their care, orientation, plus recovery (once we get them we recover them with vs and fudal checks q30 mins x 4 ad q 1hour x 2, then q 4 hrs x 24 hrs and the q shift unless there are problems), plus our other couplets (average for us is 5 most days) and do other work (vital signs, i's ad o's, pass meal trays, change linens, empty foleys on surgery patients, assist with circumcisions, etc.).

Where I work our LD nurses keep moms for one hour after delivery time i.e. if baby is born at 1800, mom usually comes over to MB at 1900, sometimes later but usually not, and they come numb or not, most of the time. That is for vag deliveries. C/S are 2 hours post delivery time but its been earlier on occasion. The baby comes to us fairly quickly, ideally they are to keep them an hour but that doesn't happen all of the time, just depends on the baby/mommy/etc. We do couplet care, we usually start with 4, but more often 5 couplets and on occasion go higher, I've had up to 7 couplets. Also during dayshift you may be getting couplets while discharging others, so by the end of your your shift you may have had a looot of couplets LOL. There have been times when I've started with 5, sent 3 home and got 2-3 more, so by the end of the day I had 7-8, not fun when it comes to charting LOL!

as a side note with the baby away from mom issues, 70% of our patients are telling us to keep the baby in the nursery, not the other way around. We have tried to encourage rooming in and bonding but for whatever reasons a large majority of our patient population are not in to it, but we keep trying! :)