Our unit moved from an old building to a new one in 1990.  Before the move, management had undertaken several study trips to look at innovations we might be able to implement in connection with the physical move.  For some reason it is easier to get rid of entrenched routines if you also change environments.

They visited a unit in Stockholm where the Nordic notion 'siesta' (ha ha) had been implemented.  There was a two hour period in the afternoon in which mothers and babies were undisturbed.  They were immediately won over after talking to the users and the staff on that ward, and decided we would do it too.

Visitors are kept out, all ward routines are timed so that nobody has to open the door to a room during the siesta, unless the mother herself uses the call bell system to ask for help.  The cleaning is done beforehand, no teaching or lab rounds are scheduled for that time, and no doctors are allowed to examine women or converse with them about their experiences unless there is a life or death issue.  If a baby gets transferred back to the normal ward from ICU during siesta we take it in to the mother, but nothing less than that would justify disturbing a woman at rest.  Staff keep their voices down in the corridors and we strongly encourage women to turn off their mobile phones though that seems to be very difficult for a lot of them! 

In the twenty years since the move, we have been re-organized at least five times, moved to other parts of the building, had staff changes and have implemented family rooms where partners can room in with mother and baby for the entire stay as long as there is available space.  The siesta has persisted throughout every change, strongly supported by mothers who comment in writing about their stay.  They are unanimously enthusiastic about it - 'Don't ever let go of the siesta, it was the best thing about being there' is sort of the general message.  We have made one change.  Originally it was from 1 to 3 pm, ending just as the change of shift report was starting.  Now it goes from 2 to 4 pm, so report takes place while mothers are resting and gives the staff time to have a calmer change of shift, and lets both the day and evening shifts benefit from this low-activity period.

The first couple of years we had to do a lot of explaining when visitors would drop in and want us to just go peek in the room to see if the woman was really asleep (we never did it!).  Now there are many other maternity wards who have implemented the practice, it's general knowledge, and people don't badger us any more.  

My ward is not renowned for its innovativeness, but this is one routine we were the first to implement in Norway and I'm very proud of it.

Rachel Myr
Kristiansand, Norway

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