Transitioning babies

[Humbled_Nurse]

I have a question for everyone. Do you transition your infants in the NICU or in NBN. For example, you go on a C-sect and the baby is mildly retracting, flaring, etc... Where I work we would bring the baby back to the NICU and transition the baby. After 6 hours or so we will decide if the baby needs to be admitted or go to NBN. Some babies do end up getting admitted, but most of them go up to NBN. Most of the babies are full term and just have some extra fluid that needs to be cleared and some of them never require 02. I was just thinking the other day that it would be really nice to have a "transition nursery" and have a NICU nurse and/or NBN nurse assigned to work there. Admissions can be so time consuming and it can be frustrating to do all that work and then the baby ends up fine and is transferred back to NBN. Of course it's good for the baby to go to NBN because that means he/she is fine :), but you know what I mean.

What do you do in your NICU/NBN??

[darynash]

Currently, babies that require observation are done in the NICU but we are building a new general nursery and training staff to keep Level II type babies and OBS babies. We are so busy that we do not have the beds available in the NICU to OBS babies anymore.

[cathys01]

In my hospital, if the docs feel the kid needs observation then it gets a full admission to the NICU. Very rarely (I think I've maybe seen it three times in the last year) does a baby go back upstairs to the NBN during its stay. 99% of the time if a baby comes to the NICU it gets discharged home from the NICU.

[camay1221_RN]

I am a mom/baby RN, and we have a Level II nursery we send the babies to for transition if they are showing signs of distress. All of our c-sections are attended by an NICU team, and they decide whether the baby goes to NICU or stays within the birthing center.

[TiffyRN, BSN, PhD]

Currently the infants at our hospital will come to NICU for "obs" from delivery room if showing "issues" (retractions, grunting usually). They can also come from regular nursery if they aren't playing nice (hypothermia, low blood sugar and of course resp. issues). Unlike what an earlier poster mentioned about an MD ordering this move, most of these moves are nurse initiated and the MD is only called if the baby isn't "fixed" within 1 hr, then they have another 16 hours to completely transition while in "obs" or be admitted to NICU. We successfully transition many infants. Many just need some suctioning, CPT or a vigorous bath (to make them scream/expand lungs/absorb fluid). Many of our tachypnea babies turn out to be hot babies that were left under a radiant warmer without a temp probe on. If we can fix them within 16 hours, they are just transferred back to newborn nursery and report is given to the appropriate mom/baby nurse.

Supposedly our hospital is building an "obs" nursery that will manage these very infants and transfer to NICU if they don't successfully transition. Some of our current NICU nurses are transferring to this unit when it opens. Sounds like I great idea, I'll let you guys know how it works out.