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Warmer, open crib, or isolette, head is toward the wall. In nine years I've never ever seen it any other way. Don't know what the rationale is, other than tradition. Frankly, it would upset my mojo in all kinds of ways if my baby were 'upside down'. Last kid I saw on an oscillator they had finagled the oscillator between the warmer (not in the isolette) and the dozen or so drips keeping him alive.
In our unit, when the babies are in a crib, our parent resource and developmental care nurse (that's her title) tells us to alternate the babies every do-up. So they first face one end of the crib and then we flip them over to the other end. Apparently this is so that the babies can lie on both their right and left sides (of their head) and still interact with the outside world (since our cribs always have one side up by flipping them around they don't face the crib side up). Though quite a few docs rotating through tend to comment "er...did you know your baby is upside down?" Lolol.
I've guess the units I've worked on are opposite from everyone else! If in an isolette, we have the feet towards the wondow/wall and the respiratory equipment by the head. I feel all out of sorts if they're in the bed "upside down". If the baby is in a crib, we can do a little of everything because the rooms are pretty big.
Head at the wall end, but flipped the other way if on the oscillator. This is the only way we could fit the tubing through the isolette and get to the babies' heads.
There was talk that we would be alternating all the babies every week (with baby's head against the wall one week, then where the feet usually go the next). The rationale was that babies like to look at the side where you stand and have been getting flat heads on their right, which is where we stand while doing care. But some people didn't like that idea and it never went into action. I thought it was a good idea as long as it was helping the baby, but I think some people are set on old ways and had a problem with this idea of change.
The babies in our L3 NICU are generally in the bed with their heads at the wall end. However, if they are on an oscillator or jet, it is the opposite.
In our L2 NICU, there is less space available, so any baby on CPAP has their feet to the wall. Often, once they are off CPAP, they remain that way.
Honestly, I have no preference either way.
In our unit, most incubator babies are feeder/growers with temp problems. Rarely they might have a PIV but nothing else. Our incubators are oriented parallel to the wall and babies heads are usually on the left side. I like to change my babies position from time to time and will put their head in the other direction because they do get a bit flattened on one side (and I like to mess with the next nurse's mind!).
katierobin23
147 Posts
Which way do your babies heads go when they're in incubators? In my unit, the head of the baby goes at the end with the display, but I see pictures of other units and the babies are at the other end. How is it in your unit? Is there any rational to having them one way vs the other? Just curious! :)