We currently have a well baby nursery at night for our postpartum patients if they want to use it. We offer both in for the night (with bottles) and out for feeds (breastfeeding).
We feel we take care of 2 patients, the mother and the baby. Our hospital is trying to be "baby friendly" and claims the nursery is not needed. Working nights, we see our mother patients about to loose their sanity if they don't get some sleep... Some mom's handle it well and keep their babies in the room.
How do other units work? Well newborn nursery at night or rooming in? Does anyone have a 24 hour well newborn nursery for moms to get sleep?
I think trouble starts when institutions make decisions for individuals. The idea that a postpartum unit will become more baby-friendly by eliminating nursery options for the mother doesn't seem very sensible, and yet that is exactly what many hospitals have done.
There is also an unrealistic expectation that mothers will behave in a way that is defined as natural without the circumstances and supports common to other cultures. In societies made up of clans and tribes, a new mother had a host of females caring for both her and her new child (even to the point of nursing the wee one if the mother was too exhausted--I'm not suggesting that). She was given special food and drink to restore her strength and relieved of her other duties until a specified period had passed. The baby slept with her and nursed frequently. Both were sheltered and protected and provided for, allowing them to cuddle and bond and develop a nursing rhythm.
In Western culture, we barely give the woman time to nap before we expect her to be up and around and taking care of business. If she's inexperienced and short on examples, we have her watch a video and read a pamphlet. She has two days to get it all together, or four with a section.
Why are we surprised that so many women seem a little shell-shocked and exhausted?
The fortunate woman has mothers and sisters and aunties and cousins who will help her grow into motherhood. She has people who will stay with her at the hospital and help her get rested up before making the transition home. She has been able to watch family members and friends breastfeed and has a wealth of knowledge and encouragement available for the asking.
The less fortunate woman has many demands and little help. She might want to breastfeed but has little reference as no one around her has done it very long. She may have to return to work in a short time and pumping is just one more demand in an already overcrowded schedule. It isn't that she doesn't want to do right by her baby. It's that there isn't enough of her to go around.
It's nice to have all kinds of idealistic hopes and images and definitions of baby-friendly. But each woman, each family has to look at the resources and decide what is best for everyone.
That includes the nights of the hospital stay. I can't bring myself to tell a mom who hasn't slept for two days that I won't take her baby to the nursery so she can finally sleep for three blessed hours.
I'm a pre-nursing student, but have a question, as a woman who has given birth.
In the hospital where I gave birth, I had a section, and my husband was not allowed to stay with me. I sent my baby to the nursery every night, because I wouldn't have been able to get out of bed to get him in the night for feedings, etc.
For those who got rid of nurseries, what do you do with women who have had sections, who are still bed bound on IVs?
I don´t think there is a hospital in Sweden that has a nursery, it´s all couplet care.
All hospitals allow someone (usually dad and siblings) to stay and help mother and child. Dad gets 10 days paid leave from work to be there for his new familymember.
I find it hard to believe that the baby would get the opportunity to feed whenever he/she wants to if they don´t have mom near 24/7 (but I could be wrong.....).
Babies at my hospital all sleep with their parents, babybeds are only given to thoose that actually ask for them. If the baby has any kind of problem (hypoglyc/respiratory) they do Kangaroo mother care 24/7.
Specializes in pedi, pedi psych,dd, school ,home health.
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)
:lol2:
As a new grandmother; who helped my dd while recovering from her emergent c-section; thank God there was a nursery. sil did stay but he is definitely someone who needs his sleep
not only that; but he was helping to take care of dd and dgs during the day as well. They did send dgs to the nursery for a couple of hours at night between bf'ing so that they could rest. I supported that because by day 2 (after a long labor and csection) they were exhausted ..as was I. i told them NOT to sleep with babe in arms; as I too have heard the horror stories. I did go in during the day and help; but gparents are looked upon as "visitors" so I think the nurses were a little surprised when I arrived at 8 am! all are home and functioning just fine , now!
We don't do couplet care. We have a nurse for the nursery and a nurse for postpartum. We try to encourage mothers to keep infants in the room with them but many of them want to send the baby to the nursery at night so they can sleep. And they drop them off every couple of hours so they can go smoke. And someone must be in the nursing station whenever there is a baby in the nursery. What would you do with a baby who is staying longer than the mother? I can't see how a hospital can just do away with the nursery. The couplet care works better if the baby rooms in almost exclusively. Or if the unit is very small.
What would you do with a baby who is staying longer than the mother? I can't see how a hospital can just do away with the nursery. The couplet care works better if the baby rooms in almost exclusively.
Some places admit the baby in moms room but have a 'respite care nursery' that is staffed by postpartum nurses for mom to get sleep, as well as a 'convalescent nursery' for babies who have to stay after moms go home.....antibiotics, bilibed, feeder/grower, withdrawals, etc.
I don't know what the answer is, but I'm interested to see how other places do things.
For those who got rid of nurseries, what do you do with women who have had sections, who are still bed bound on IVs?Ksenia
Our elective section babes go to recovery with mum and then to the ward on the trolley. They stay beside mum who buzzes when the baby wakes. Emergency sections go to our Special care nursery from OT, but often come out as mum hits the floor from recovery. So full on care for mum and bub post CS.
In Australia i suspect most public hospitals would no longer have well baby nurseries. Private hospitals do. Our local one has its well baby nursery stuck in with SCN. No separate staff. The SCN is often understaffed...wouldn't put my kid in there even if I'd had a section!
What would you do with a baby who is staying longer than the mother?
If there is room on the unit, mom may stay as a guest (in her old room) and feed and care for the baby who is still considered a patient. We don't provide any meds or vitals or nursing care for mom, only phototherapy, abx, or whatever else baby needs.
We had a rare instance a few weeks ago where baby was discharged and stayed on as a guest with mom who was still a patient. Baby still got vitals q shift, but otherwise was left to mom and fam to be cared for.
Things become more difficult if census is high. Then baby goes to nursery and mom comes in for visits and feeds. We try especially hard to accommodate moms who live far away (we get high-risk women from all over the state who are transported prior to delivery). Most of the time, we're able to let mom stay in the room with the baby. This is the least stressful solution for everyone.
If there is room on the unit, mom may stay as a guest (in her old room) and feed and care for the baby who is still considered a patient. We don't provide any meds or vitals or nursing care for mom, only phototherapy, abx, or whatever else baby needs.
Things become more difficult if census is high. Then baby goes to nursery and mom comes in for visits and feeds. We try especially hard to accommodate moms who live far away (we get high-risk women from all over the state who are transported prior to delivery). Most of the time, we're able to let mom stay in the room with the baby. This is the least stressful solution for everyone.
We do this too, and it usually works pretty well. When census gets REALLY high and we get slammed sometimes we have to have Mom vacate the room at inconvenient times. They know this may happen from the get-go but I still feel bad when it does.
We have a small LDRP unit without a nursery staff. If a mom sends the baby to the nursery (and they almost all do at night), a nurse has to watch them. It is a staffing problem, HOWEVER; I know that these patients are being billed several hundred dollars per day for a "Nursery" bed charge. They certainly should be able to use the nursery!!
These hospitals that are telling moms that they must keep their babies, are they taking that charge off? I bet not.
I think this is terrible. They are not doing what is best for the babies or for the moms. They are looking out for their own bottom line.
I personally know of 2 babies dropped on the floor due to mom falling asleep holding in the night, and 1 baby being suffocated by a mom falling asleep holding in the night. There will be MUCH more of this if moms don't have the option of nursery care.
You are right, if they are being billed for the nursery, they should be able to use it. If they don't, then the charge should be removed from their account at their time of d/c. That is fair enough.
Funny though - I have never had anything untoward happen to a baby, and I would estimate that at least half of my patients sleep with their babies in the bed. I have them lower the head of the bed, put up the siderails and pad the 'crack' with a bath blanket. Baby's on her back beside mom, and everybody sleeps better that way. I guess it could depend on the make of the bed and other things. I certainly wouldn't give a mom 10 of Ambien & put baby in the bed w/ her, but under most normal circumstances, everybody does fine. Just my account.
I think it is irresponsible of the hospital to "force" a mother that is recovering from a birth to feel that she has to watch her child in the hospital when she is supposed to be focused on healing.
Those of us who are mothers know: You don't sleep as well knowing that YOU are responsible for that newborn vs someone else that you feel is 100% capable of caring for your child if you have to sleep.
It's just instinctive b/c you feel like you have to sleep with one-eye open as well as an ear.
I read somewhere on this board awhile ago where an RN had left a baby with a large woman to breastfeed, she "set her up" and left and said she would be back to check on her.
The nurse came back 20 minutes later to find that the mother was so exhausted that she fell asleep with the baby in her arms, and her breast had actually smothered the child to death.
Could happen that quick...but to me, that is an assessment issue.
:lol2:
rn/writer, RN
9 Articles; 4,168 Posts
I think trouble starts when institutions make decisions for individuals. The idea that a postpartum unit will become more baby-friendly by eliminating nursery options for the mother doesn't seem very sensible, and yet that is exactly what many hospitals have done.
There is also an unrealistic expectation that mothers will behave in a way that is defined as natural without the circumstances and supports common to other cultures. In societies made up of clans and tribes, a new mother had a host of females caring for both her and her new child (even to the point of nursing the wee one if the mother was too exhausted--I'm not suggesting that). She was given special food and drink to restore her strength and relieved of her other duties until a specified period had passed. The baby slept with her and nursed frequently. Both were sheltered and protected and provided for, allowing them to cuddle and bond and develop a nursing rhythm.
In Western culture, we barely give the woman time to nap before we expect her to be up and around and taking care of business. If she's inexperienced and short on examples, we have her watch a video and read a pamphlet. She has two days to get it all together, or four with a section.
Why are we surprised that so many women seem a little shell-shocked and exhausted?
The fortunate woman has mothers and sisters and aunties and cousins who will help her grow into motherhood. She has people who will stay with her at the hospital and help her get rested up before making the transition home. She has been able to watch family members and friends breastfeed and has a wealth of knowledge and encouragement available for the asking.
The less fortunate woman has many demands and little help. She might want to breastfeed but has little reference as no one around her has done it very long. She may have to return to work in a short time and pumping is just one more demand in an already overcrowded schedule. It isn't that she doesn't want to do right by her baby. It's that there isn't enough of her to go around.
It's nice to have all kinds of idealistic hopes and images and definitions of baby-friendly. But each woman, each family has to look at the resources and decide what is best for everyone.
That includes the nights of the hospital stay. I can't bring myself to tell a mom who hasn't slept for two days that I won't take her baby to the nursery so she can finally sleep for three blessed hours.