Well baby nursery at night

rn/writer, RN · Apr 7, 2008

We try to strike a balance between baby-friendly and mom-friendly. I work nights and share your concern for moms who are simply exhausted and just want a couple of hours of sleep. Some of them labored for a couple of days before giving birth or having a section. It isn't at all rare for a mom to have been without sleep for 36 hours or longer. I'd rather have her send the baby to the nursery than fall asleep with the wee one in her arms.

Elvish, BSN, DNP, RN, NP · Apr 8, 2008

We have a 24/7 nursery as well. We encourage rooming-in but if mom hits the wall in the middle of the night or is ill for whatever reason, it is there.

Edited to add - the couplet nurse is responsible for the baby at all times but while baby is in nursery (if at all) the nurses in there usually take care of him/her.

cherokeesummer · Apr 8, 2008

We do care for two patients, our care is couplet care. I usually have 4 couplets (and new admissions go to each of us in turn) except on busy days we get more couplets. Anyway we have nursery but we also have rooming in. The parents choose to keep the baby with them or in the nursery. And they can choose to have the babies out on demand.

I have heard that our hospital would like to be more on the line of no nursery and babies completely rooming in but frankly they'd have to do a lot of convincing. While we do have many moms who want baby with them a lot we have just as many who would rather the baby stay in the nursery as much as possible so they can smoke, walk, sleep, etc. I promote the baby coming to the nursery if mom is tired and needs rest. I let the parents make the choice though, its up to them.

BlueRidgeHomeRN · Apr 8, 2008

i have heard that our hospital would like to be more on the line of no nursery and babies completely rooming in but frankly they'd have to do a lot of convincing. while we do have many moms who want baby with them a lot we have just as many who would rather the baby stay in the nursery as much as possible so they can smoke, walk, sleep, etc. i promote the baby coming to the nursery if mom is tired and needs rest. i let the parents make the choice though, its up to them.

i could not imagine getting rid of the nursery. :nono:

some of these moms, besides tired, etc, may still be on mag, antibiotics, or pca narcotics!!

they are, really, sick. let mom getter better before she's responsible for an unstable neonate (they are all unstable for 48 hrs!!):bby:

webbiedebbie · Apr 8, 2008

I have worked in many hospitals, from separate nursery staffed with nurses, to nursery only used for circumcisions. No kidding...the last hospital I worked at was newly built with a huge nursery, but ONLY used for circs!!!!

At another hospital which was a teaching hospital, we did couplet care...but 2 nurses were staffed in the Nursery and ALL babies had to be in there for assessments and then taken out to moms. Since the nursery was staffed, babies were allowed to be in there if mom chose to sleep, yet I was still responsible for the infant's care in the nursery during the night. By that, I mean: stools and voids, labs, vitals, etc. On nights and having more couplets to take care of, not being on the floor for the moms, etc...I found it very demanding! Especially if some babies were not rooming in and going out to feed, I had to go to nursery freq during the night...back and forth to bring babe in for assessments, labs, hearing test, etc.

Please don't get me wrong...I have worked just Postpartum and just Nursery separately. Each one I enjoyed doing. For me, if a floor is couplet care, then not needing a Nursery except for a procedure room for circs, etc.

I don't necessarily see a need for a large Nursery anymore...one I worked at had closed windows, so visitors could NOT see any of the infants.

Just my :twocents:

akacyndi · Apr 8, 2008

I find it difficult running back and forth to the nursery as well... I think management thinks it is easier for us to have a nursery; and it certainly is not! I just know that some moms are too tired to take care of the baby and I find the baby in bed with her while she is sleeping soundly and that scares me. In their search for baby friendly they are forgetting about mom friendly care. Many moms today work up till they come in to have the baby and haven't slept good in months.

amethystrndrp · Apr 8, 2008

In the nursery where I volunteer one night a week they have a small-ish nursery. They do the billi-lights in there, antibiotics, and then "babysit" the babies whose moms want to sleep. They can only have X number of babies, though (ratio to # of medical professional staffed in the nursery), so if the nusery is full, they usually rotate the babies out - the ones that have been in longer go back to the Moms so a new mom needing some sleep can send the baby in. They usually staff one nurse and one CNA in the nursery and then each baby has its own nurse that brings them in to do vitals etc. While in the nursery, though, it's the nurse, CNA, and whatever volunteer that might be there to care for the babies when they need to eat, be changed, or be held. I volunteer at night, though, so I'm not sure how the nursery operates in the day but I assume it's pretty much the same.

babyktchr, BSN, RN · Apr 8, 2008

we do not have a nursery for any kind of nightime care for newborns. we are strictly rooming in. we had resistance at first, but now it is just second nature. we really do encourage a "support person" and not just someone to sleep there, but someone who really helps mom with the baby. i am still amazed at the number of moms left alone first night c/s. we do try to take a cranky baby if we can, but we are so busy lately that there is really no one to watch it. we do couplet care (4 couplets/nurse). the nursery is for transitional kids or sick ones that are being transported, or for circs.

bagladyrn, RN · Apr 8, 2008

In too many places where the nursery has been eliminated I see it as just a ploy on the part of management to cut staffing.

What happens in reality is not moms keeping their babies all the time (unless that was her preference and would have been even with nursery available) but babies at the nurses station being watched by the staff after mom has a meltdown from exhaustion. Not good as every time you need to leave the desk to go to another patient you have to ask someone to watch your baby. (and probably something of a security risk as well) Having someone stay with mom is fine in theory, but those dads that stay frequently sleep better than mom, who then tells you "Oh, but he's just so tired"! (That's when I tend to turn on lights and "Oops!" bump that cot repeatedly as I move around the bed - Ms. Passive-Agressive, that's me)

OzMW · Apr 9, 2008

We got rid of our well baby nursery many years ago. I don't think this was a good thing, although there were particular midwives who would automatically send all the babies to the nursery at night for a comp, so she wouldn't have to deal with them!! We now mind those unsettled babes in our office which is a PITA as they have cut our staff recently and we are generally flat out.

There was a recent coroners case here is Australia of a baby who was in bed with his exhausted mother who fell asleep and suffocated him. The midwives had busy patient loads. Really sad and wouldn't have happened if there was some leeway with the baby/mother friendly stuff.

luvschoolnursing, LPN · Apr 9, 2008

Gotta say as a mom back in the olden days (my kids are 14 & 16) I was really glad to have the babes in the nursery. I was exhausted and in the case of my son, had had a tubal on the delivery table and had all kind of gas pain. We bonded just fine during the day and after we got home. OK, you can tell me I'm a bad mom now...:nuke: