Pts paying for night nursery care??

Purple_Scrubs, BSN, RN · May 11, 2012

Lots of good thoughts, thank y'all for indulging me on this topic. I think if I were ever to give birth I would require the baby to stay in my room, but I also have a great husband who is comfortable with babies and who could do the majority of the care if I was needing to recoup. I can see for single moms, or new terrified dads, or anyone without a strong support system, some nursery time would be beneficial. I tend to agree with iyqyqr and PetsToPeople that it is very likely in the baby's best interest to stay close to mom, but this is based on my training on attachment received as a foster parent, which puts an entirely different spin on things.

cindyk123 · May 11, 2012

I am also a NICU nurse that floats to newborn and mother/baby. We have respite care for the mothers and I have encouraged some who were exhausted to get some rest while they had the opportunity. Once home they are on there own without that option. To that said, our babies don't cry for hours in the nursery if they are fussy and can't be calmed down or need to eat they are taken back to the mom to feed and then brought back to the nursery. Sometimes new parents just need a couple of hours of sleep where they know their baby is safe and taken care of.

While I had 3 kids and kept them all with me as much as possible, I certainly don't judge others for wnting to rest. And yes there are some parents that we strongly encourage to keep their babies because of bonding issues or because they need that extra time to learn to care for their munchkin.

I don't agree that they should have to pay for this service. And babies stays are covered by health insurance as their are patients as soon as they are born and until a doctor writes that discharge in their chart.

Jolie, BSN · May 11, 2012

Newborn infants are most definitely patients of the hospital. They are issued hospital ID bands, charts, undergo medical and nursing assessments, receive medications (Vit. K and eye prophylaxis unless the parents opt out), and this care is billed to third party payors or self-pay parents. To argue that they are not inpatients "eligible" for nursing care is absurd.

Now, if a hospital wishes to extract additional money out of parents for the "luxury" of respite "babysitting" while the mother (the father is not a patient) rests and prepares for homecoming with her newborn infant, then they should at least be consistent and charge all other hospitlized patients for similar "custodial" care that does not qualify as skilled nursing. This would include assistance with feeding, bathing, clothing changes, toileting and basic safety and security.

Otherwise, they need to expect a mass exodus of expectant parents to neighboring hospitals that are willing to provide basic services to their maternity patients (mother AND infant) without nickel and diming them to death.

futurehomebirthcnm · May 13, 2012

They're probably trying to do away with the nursery for mother-baby initiative. Some hospitals are doing away with nurseries altogether.

And they _should_--a newborn baby should be within arm's reach of their mother or their father or at least somebody for the first couple of days. In a nursery, there's no guarantee an infant will be soothed. That baby has known nothing but the warm, comfortable embrace of his mother's body and her sounds and scents, and now he's out in the world where he's hungry, where it's not always the perfect temperature, where no one is holding him--can you imagine!

Rooming-in helps a mother learn her babies cues, helps breastfeeding (if she's chosen to do so), helps bonding, helps that infant feel secure. Why are you upset at this and not happy they're trying to facilitate it?

Esme12, ASN, BSN, RN · May 13, 2012

They're probably trying to do away with the nursery for mother-baby initiative. Some hospitals are doing away with nurseries altogether.
And they _should_--a newborn baby should be within arm's reach of their mother or their father or at least somebody for the first couple of days. In a nursery, there's no guarantee an infant will be soothed. That baby has known nothing but the warm, comfortable embrace of his mother's body and her sounds and scents, and now he's out in the world where he's hungry, where it's not always the perfect temperature, where no one is holding him--can you imagine!
Rooming-in helps a mother learn her babies cues, helps breastfeeding (if she's chosen to do so), helps bonding, helps that infant feel secure. Why are you upset at this and not happy they're trying to facilitate it?

This particular facility in the beginning of the post, is building a nursery where one does not exist right now with the intention of charging to use it.

VICEDRN, BSN, RN · May 13, 2012

If it reduces the costs of my care for the me and my baby, then I am all for it. I shouldn't have to pay for services I am not using in a consumer driven healthcare delivery system, right?

This mother of 3 who has long labors has no sympathy for the mothers who "want rest". The baby will provide you with none after your discharge and I suggest you get used to the idea now (unless of course you are paying someone to watch your kid) but this is why I work ER and not mother/baby.

Mother/baby takes the patience of a saint from what I saw in nursing school. lol

NicuGal, MSN, RN · May 14, 2012

Most places have not only a postpartum fee but a nursery fee,so would this be on top of that? We charge separate fees for that, just like if the baby comes to NICU. We always have one nurse in the nursery, even if there isn't one in there.

melmarie23, MSN, RN · May 14, 2012

I'm a NICU nurse who periodically has to take her turn floating to our hospital's newborn nursery. Our post-partum wing is new with large rooms and a couch that converts to a bed and a recliner so grandma, dad or both can room in with mom to assist her and help care for the baby, so mom can rest and recover from childbirth. But where is the baby? Not in the room with his mom where he can smell her and hear her voice and nurse on demand or bottle feed. No, the baby, who has also experienced the stress of the delivery, even if it is a normal one, and now finds himself in a totally new world, the baby has joined many others in the nursery and he is screaming his head off, protesting his separation from his mom . . . the mom who needs to rest and recoupe. Mom and dad aren't told that with this separation and crying his cortisol level may jump to 7 times the normal amount. This in turn can slow down his gut, the crying makes him gassy, so he may puke and he gets fatigued from hearing other babies cry and crying himself. Then, after 4 hours of crying and fitful sleep, if any, the clock finally indicates he can be taken back to mom to nurse or bottle feed. Back in her arms he may eat some, but then promptly falls asleep, as he is soothed by her heartbeat and smell and voice; only to awaken a short time later back in the nursery where the tragic cycle repeats itself. The last night I floated there were 32 mother/ baby couplets and by 0430 we had 22 babies in the nursery! At any given time 7-9 were crying and we did not have the staff to soothe them all.
When I would take babies out to moms to be fed, dad would be snoring and of no assistance to either mom or baby, so why was he there? If charging moms for nursery care will keep nurseries empty and babies IN THE ROOM where they need to be for their sakes, then I totally support it, except in cases where mom has had a very traumatic delivery or baby needs watching, or mom is drugged and truly has no family or friend to stay the 2 nights to help her. If babies had a voice, I know where they'd ask to be and it isn't the newborn nursery; charge or no charge. Why are we not advocating for them since they have the least coping skills to draw from?

Well said! seriously, I cannot gold clap loud enough over here.:yelclap:

Jolie, BSN · May 14, 2012

I'm a NICU nurse who periodically has to take her turn floating to our hospital's newborn nursery. Our post-partum wing is new with large rooms and a couch that converts to a bed and a recliner so grandma, dad or both can room in with mom to assist her and help care for the baby, so mom can rest and recover from childbirth. But where is the baby? Not in the room with his mom where he can smell her and hear her voice and nurse on demand or bottle feed. No, the baby, who has also experienced the stress of the delivery, even if it is a normal one, and now finds himself in a totally new world, the baby has joined many others in the nursery and he is screaming his head off, protesting his separation from his mom . . . the mom who needs to rest and recoupe. Mom and dad aren't told that with this separation and crying his cortisol level may jump to 7 times the normal amount. This in turn can slow down his gut, the crying makes him gassy, so he may puke and he gets fatigued from hearing other babies cry and crying himself. Then, after 4 hours of crying and fitful sleep, if any, the clock finally indicates he can be taken back to mom to nurse or bottle feed. Back in her arms he may eat some, but then promptly falls asleep, as he is soothed by her heartbeat and smell and voice; only to awaken a short time later back in the nursery where the tragic cycle repeats itself. The last night I floated there were 32 mother/ baby couplets and by 0430 we had 22 babies in the nursery! At any given time 7-9 were crying and we did not have the staff to soothe them all.
When I would take babies out to moms to be fed, dad would be snoring and of no assistance to either mom or baby, so why was he there? If charging moms for nursery care will keep nurseries empty and babies IN THE ROOM where they need to be for their sakes, then I totally support it, except in cases where mom has had a very traumatic delivery or baby needs watching, or mom is drugged and truly has no family or friend to stay the 2 nights to help her. If babies had a voice, I know where they'd ask to be and it isn't the newborn nursery; charge or no charge. Why are we not advocating for them since they have the least coping skills to draw from?

You raise a good point, but fail to address the safety and care needs of infants whose mothers are unable or unwilling to care for them in their own rooms. Inarguably, there are moms who are absent (adoption), physically or emotionally unable to provide the necessary care to their newborns, too exhausted to do so, or simply unwilling. None of those circumstances relieve the nursing staff of our obligation to their infants.

When a mother is legitimately too ill, in too much pain, emotionally or mentally unstable, or so exhausted tht she can't provide safe, nuturing and capable care to her infant, is that child simply to be neglected for lack of a pre-paid babysitting card? What about the babies who are not sick enough for NICU, but require eyes-on observation? Should we give those moms tooth-picks to prop their eyes open?

Those who mention dad and visitors as caregivers, I ask...Do we require family members and friends of any other hospitalized patient to provide custodial care in lieu of additional charges?

Why have I read nothing about providing necessary custodial care in the mother's room by an RN, LPN or CNA? Why is it simply nursery = bad parenting, rooming in = only acceptable option?

Like it or not, mother and baby are both inpatients. Both ought to be receiving nursing care, both skilled and custodial, without additional charge, regardless of our opinions about how "deserving" they may be.

Unless, of course, we are going to be consistent, and charge Granny for every trip to the bathroom and every spoonful of applesauce we feed her.

But that's probably not far off.

Esme12, ASN, BSN, RN · May 14, 2012

Most places have not only a postpartum fee but a nursery fee,so would this be on top of that? We charge separate fees for that, just like if the baby comes to NICU. We always have one nurse in the nursery, even if there isn't one in there.

Above the room charge? Guess they'd be taking me to court. I wouldn't pay it.

Patti_RN · May 14, 2012

What changes dramatically from postpartum day two to postpartum day three? If they can't at least care for their infant while meals are made and served to them, there is no laundry to do, no dishes, and not even stairs to climb, what will they do the very next day at home? And you can't 'bank' sleep to use it for the future. Yes, some mothers had long labors, some had c-sections--I had both: a 36+ hour labor followed by a c-section. I was not only able, but willing and anxious to see and care for my newborn. Diapering was tough and a slow process, but what else was I doing? It's not like hopsitalized moms have busy schedules. A mother's and father's love and instincts should be enough to want to see and bond with their infant. Sadly, when this service is an option, those with the financial resources will be able to shirk their parenting duties.

NicuGal, MSN, RN · May 14, 2012

I do have to agree with some of the others...what happens when you have a baby who is going to be adopted or the mom can't take care of the baby...you take them to the desk with you? We work with high risk moms...some of whom are sick as can be, and the dad is no where to be found and/or is home taking care of all the other kiddies. Or they have twins and one is in the NICU...can't take the other one to visit Bro or Sis. Kind of hard to get out of bed to take care of your baby when you are on Mag or have a central line in place. Or shackled to the bed, as some of our are. I just think that a floor without a nursery is wrong. Yes, we do promote babies staying with mom, but I was happy to take my baby to the nursery to be watched while I showered, then I didn't have to worry about her/him. Sometimes it just isn't black and white. I forsee this hospital having some bad PR coming their way!