Mothering Forum banner

1 - 13 of 13 Posts

·
Registered
Joined
·
1,810 Posts
Discussion Starter #1
I'm a nursing student in a BSN program and this coming semester we have to write a "change" paper. I'm not quite sure what the parameters are yet, but my understanding is that I need to write a paper on a hospital procedure/policy that I see the need for change in and likely back it up with research about how to change it, why, etc.<br><br>
My ideas so far are:<br><br>
1) I worked in the NICU for a few days last semester, and at one point a baby who came way too early had to be transfered to a different facility- about 6 hours away by car. The baby was going via air ambulance, but they wouldn't take mom too. The nurse in charge of the flight team told me the reasoning was that as mom is still in "fairly unstable" condition after the birth, that they don't have enough staff to deal with any issues mom might have during the flight. She actually said that if mom passed out she'd (the nurse) would have no idea what to do! I was really struck by what an awful situation this was, especially because this was a low-income mama with no car! I think it's idiotic that they won't take mom along (unless mom really is having medical issues, then I can see their point. This mom was perfectly fine, no issues at all).<br><br>
They also wouldn't take the other parent along- no one but the baby.<br><br>
I can see where transport with a parent might be touchy- what if baby dies en route?? I'd personally rather be with my baby either way, but I can see where it might be sketchy to have a parent who is freaking out in the helicopter. My DP also mentioned fuel costs- it's more weight if mom is on board and thus more $$. I don't know about that- I think it's silly (although likely true!)<br><br>
Or<br><br>
2) Why must c-section babies be taken back to the nursery and separated from mom after birth? Why can't the baby be assessed in the OR? There's already a "baby nurse" there, so why can't the baby just stay with mom?<br><br>
Maybe this is just a staffing issue- one nurse to stay with the baby while mom is repaired vs. one nurse to stay with a few babies in the nursery.<br><br>
Okay- so anyone have great ideas for change? Lay 'em on me! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

·
Registered
Joined
·
2,601 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>feminist~mama</strong> <a href="/community/forum/post/7918232"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;"><br>
2) Why must c-section babies be taken back to the nursery and separated from mom after birth? Why can't the baby be assessed in the OR? There's already a "baby nurse" there, so why can't the baby just stay with mom?<br><br>
Maybe this is just a staffing issue- one nurse to stay with the baby while mom is repaired vs. one nurse to stay with a few babies in the nursery.<br><br>
Okay- so anyone have great ideas for change? Lay 'em on me! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"></div>
</td>
</tr></table></div>
There's too many to choose. Routine use of episiotomy, monitoring and pitocin, among others are all issues in most hospitals.<br><br>
That said, I vote for #2 . I was separated from my baby after my totally unneccessary csection for a couple of hours while I "recovered", for no rhyme or reason. He and I were both totally healthy. The distress I had (and have) from our separation could have been completely avoided, if hospital staff had cared one ounce about my need to be with my baby.<br><br>
Although now that I think about it that same distress would apply to the first situation you described too. Maybe you could just address separating mom from baby altogether, and use both situations as examples.<br><br>
I'd be happy to share any personal insight if you'd like, too.<br><br>
Another topic of interest would be eye ointment. Staff put it in my son's eyes even though I declined it. I watched the video my husband took, and it was like night and day in terms of his alertness before they put it in and after. His eyes were open and he was taking everything in visually before the goop went in. So perhaps delay of eye ointment (or ideally none at all) until after mom and baby have bonded.
 

·
Registered
Joined
·
1,484 Posts
I think mom-baby separation in general would be a good idea as well. When I had my first in the hospital, he was born perfectly healthy, I was perfectly healthy, and yet he was taken to the nursery for three hours for a bath/observation. This same hospital still doesn't allow rooming in for moms and babies, as nearly all post partum rooms are shared. There's a LOT of unnecessary separation out there that is done because of status quo and not because it's the best standard of care.
 

·
Registered
Joined
·
2,123 Posts
I'm an RN who has done interfacility transport (though I'm not neonatal) - I am definitely heartsick at the thought of leaving mama behind while baby is transported, and I think I'd fight tooth and nail to keep them together under most circumstances. Lord knows I would have gone crazy if they would have separated me from my kids.<br><br>
That being said, air transport is pretty different from ground transport. There are important weight considerations, particularly when you consider neonates travel with heavier equipment than adults do (their isolette for an aircraft is $%^& heavy). Also, if mom isn't a 100% healthy person, travel by helicopter may not be the best option for her after childbirth (remember Boyle's law and all of the other gas laws - human physiology has quite an adjustment when you put a body up in the air that far). Finally, air transport is a whole different story from ground when you think about transporting family members along. Ground transports can get away with it if you put a family member in the front seat of the ambulance, weight-wise and "taking care of the family member-wise" (awkward phrase, but YKWIM) - but if you put someone in the front seat of a helicopter, next to the pilot, that person cannot be a distraction to the pilot or the staff caring for the patient (i.e., can't need monitoring or checked on herself). I'm not sure a fresh postpartum mom qualifies for that. In fact, I'm sure she doesn't.<br><br>
At the risk of being flamed flamed flamed -- I don't think I'd put her in my helicopter.<br><br>
I sure as [email protected] would find a way to get her to the hospital, though. That is why NICUs have social workers, though. They rock at that kind of stuff. No way should mama be completely left behind to deal with getting there herself.<br><br>
Anyway, I just wanted to throw that out there because this "change" has so many factors that need to be taken into consideration that I would never have known about before I started practicing.<br><br>
Good luck with your change paper. It must be a requirement of BSN programs - I had to do one, too, a "few" years ago! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"> However, it was right before I graduated....so that means you must be close!?!?....congratulations!!!!!!!!!!!!! I know how good that feels - and I'm glad there are people like you entering nursing...who know that under most circumstances mamas and babies shouldn't be separated. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> I think that principle is a good idea for your paper - esp. the c-section part. Perhaps you could "interview" a few L&D nurses for it. I'm sure there are a few who could give you some good quotes for your paper. They aren't all evil separation-mongers. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
Anyway - rock on!
 

·
Registered
Joined
·
658 Posts
I think the mother baby seperation change is a great topic.<br><br>
It would probably be rather easy as well. There are lots of documented reasons why mothers and babies should stay together, esp. post op.<br><br>
My experience of c/s births is a bit different. Both times my baby was assessed in the OR and then given to my husband and brought to me while they were still working on me. My kids were both healthy at birth and didn't require extra care.<br><br>
I also got to spend over an hour in recovery establishing breastfeeding and adoring my new babes.<br><br>
After that there is a mandatory 2 hours in the nursery. The first time I was so exhausted and spent that I fell asleep and didn't argue. The second time was senseless. I really didn't want to be seperated from my baby. I felt really good and wanted him with me.
 

·
Registered
Joined
·
3,428 Posts
I gave birth in a progressive hospital with my first. I had a waterbirth - they're the only hospital in the state that i know of that offers waterbirth. Very low c-section rate, etc. My birth was normal. They said while I changed rooms, they'd take her for a quick hearing test. I said ok. My husband went with her. It probably took 15 minutes to change rooms, then I sat, and waited, and waited, and waited, at least an hour but probably more. I sent my sister, I was like, "BRING ME MY BABY!" I cannot even explain how wrong it felt to be separated from her. Even in hospitals where they do everything in the same room, shortly after birth the baby is taken from contact with mom and put on a warming table, weighed, measured, etc. IMO these things could wait til the following day if mom is staying that long. Who cares if the birth weight is off by an ounce or two? No newborn procedures need to be done immediately after a normal birth with a healthy baby.<br><br>
I was determined to have zero separation from my 2nd when she was born, so of course, I stayed home for that birth. Much better.
 

·
Registered
Joined
·
66 Posts
With the birth of my 1st child, I had a mini-stroke right after (from epidural). They took me to the ICU, and then took baby to the NICU because they were worried she "might" develop something. They snapped a polaroid and that is all I got to see of her for 3 days until I just up and walked out of the ICU on my own, went down the elevator and insisted I see my baby. btw, I was fine 3 hours after the initial incident - so all the stress was for nothing.<br><br>
So, my vote is for change on the separation of mom/baby. They could have done something different so I could have seen/nursed my baby.
 

·
Registered
Joined
·
148 Posts
<div style="margin:20px;margin-top:5px;">
<div class="smallfont" style="margin-bottom:2px;">Quote:</div>
<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">
<div>Originally Posted by <strong>feminist~mama</strong> <a href="/community/forum/post/7918232"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">2) Why must c-section babies be taken back to the nursery and separated from mom after birth? Why can't the baby be assessed in the OR? There's already a "baby nurse" there, so why can't the baby just stay with mom?<br><br><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"></div>
</td>
</tr></table></div>
at my current facility they have completely done away with separation of mom and baby. they are following a model of family centered care. we have a nursery that accomodates only 5 newborns and that is for adoption cases and moms who are to sick to care for their babies. so this might not be as big of a problem in some area anymore.<br><br>
you could look into magnesium sulfate administration for pretem labor. up until a couple of months ago we mag'ed moms for PTL but research does not supprt this theory anymore.<br><br>
another thing to think about is the number of mom wanting elective c/s (BAD) and how this change will impact the future. a lot of MD's especially in OHIO can not afford to do VBAC's b/c of malpractice so all of theses c/s will lead to more and more c/s.<br><br>
just a coupld of ideas... good luck on you BSN.. i am just finishing my MSN... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

·
Registered
Joined
·
148 Posts
i dont work till friday to get the articles (from the green journal of MFM i think) but we now just use procardia (nifedipine) dosage depedant on the circumstances and limited IV hydration. it is hard b/c we are the largest hospital in the area for multiple counties so we get a lot of transports who are mag'ed prior to arrival. we just stop it and transistion. i dont believe that we have had any more deliveries than prior to the change. i think it has been a great advancement for our moms... mag is the worst!
 

·
Registered
Joined
·
1,447 Posts
I do NICU interfacility transport. There is barely enough room for the isolette and the crew. These are NOT big aircraft. Weight has to be calculated very carefully. Lot's of safety issues.<br><br>
SOmetimes they can transport mom or she leaves hospital early IME.<br><br>
Depends on the reason she delivered early or baby was sick. If she's got HELLP for instance, she might be pretty sick herself.<br><br>
We could assess baby in the OR. We do. They go to the nursery just until mom's in recovery though there's no reason they couldn't stay with mom.
 

·
Registered
Joined
·
130 Posts
I also vote for number 2, I am an L&d rn and it irks me that baby can't just stay with dad during a routine section. Although, those babies can be super hard to start-hence going to the nursery for further assessment.<br>
But as a circulator in the OR I don't have time to be held responsible for baby care too. I have a lot of charting and mom care to do. Not to mention whatever the surgeon needs. Or anesthesia.<br>
So some of that might be simple staffing.<br>
You have to remember this is major abdominal surgery. Things go wrong, but I guess at that point dad can go with baby to the room and leave the OR.<br>
Our nursery RN has a mom baby assignment, so she can't just stay back in the OR.
 

·
Registered
Joined
·
327 Posts
Idea #2 seems to be getting the most votes here....<br><br>
My labor and delivery job in nursing school, and where I eventually worked as a nurse, was at the county hospital in Cleveland. For all the bad press it got, it was pretty progressive. In the early 90's they had long ago done away with mom and baby separation after c sections. It's how I learned it, and it's all I knew. So going to other hospitals and seeing it done, with solemn reasons of why it was still necessary, was very puzzling-followed by the thought-"How archaic. How retro. How WWII era."<br><br>
SO anyway-I know it's a paper, but I'd make the argument-in a place as big, busy, and supposedly backwards that county hospitals are supposed to be, why can't smaller hospitals do the same thing? Are their standards actually BELOW that of a county hospital? <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink">
 
1 - 13 of 13 Posts
Top