Who does your newborn screen/bilirubin labs?

[samsmom95]

I work in a small, rural hospital where we do L&D, postpartum and nursery. There are only 2 of us working at a time. We're having trouble getting lab to come do our newborn screens and bilirubins in a timely manner when our moms are ready to go home. We find ourselves waiting alot on the lab to make time to get these done because all other pts seem to take priority over them. We have considered doing the heelsticks ourselves but are afraid there could be times that we are just too busy. We don't want to burn any bridges with the lab in case we're in a pinch and need them to draw. My beef with the situation is I think we need to somehow change the attitude of the lab that we aren't the lowest priority. These are somewhat timed tests as well, and we are waiting on the results (bilirubin anyway) to report to the dr. Plus, whatever happened to pt satisfaction? They're getting tired of waiting. So I'm just curious what other hospitals do.

[Mimi2RN, ASN, RN]

On our PP unit, the nurses draw the Newborn Screen, and a Bili is usually drawn by the lab. We 325-350 deliveries a month, and do couplet care, with no Newborn Nursery.

[SmilingBluEyes]

The nurse caring for the couplet where I work, does.

[prmenrs, RN]

Lab does the Bili's on an ASAP basis; the RN does the Newborn Screen, usually after the hearing screen is done.

[33-weeker]

Lab comes around 4 or 5 am and does morning labs. We have them do most of the NB screens then, unless the baby is not close enough to 24/36 hrs. of age - then the day nurses do them later on. Sometimes I draw my own labs anyway so I don't wake my babes in between feeds. I like to turn my babes on their abdomens and swaddled snuggly to get the NBS. They usually cry less if at all.

We can call and ask that lab come draw at other times than the early am draw, but usually we just draw it ourselves - it's just faster that way. If it is a central stick or umbilical line (as opposed to heel) then the nurse draws.

[NPinWCH]

Lab does most bili levels, since we only do them on as needed basis so there usually aren't that many. RN caring for the couplet does newborn screens. We even do all repeats that show up at the hospital as the newborn screening kits are kept on OB.

Occasionally we will draw the bili or other labs for instance if we are doing the newborn screen at the same time or we are starting an IV.

PS: We are also a small, rural hospital roughly 350 deliveries/yr.

[ICRN2008, BSN, RN]

I would bring this up with your manager; perhaps she and the lab manager can sit down and come to a solution together. This way, you won't be alienating the lab techs and phlebotomists in your attempt to increase patient satisfaction.

Good luck!

[rnin02]

We do all of our own labs on our babies, for everything:( Makes the mornings very hectic! We are currently set up with a separate nursery/post partum area, but we will be changing to mother/baby couplet care soon. But so far the plan is for nurses to continue to do the heelsticks (or venous for cultures) themselves.