Ellen,
        At our hospital we have within the last year gone to LDR's and Mother/Baby
Unit. After the baby is born the couplet stays in the LDR to "recover". The
baby gets a bath, VS, weight and measurements and the opportunity to bond
and breastfeed. We are experiencing some "growing pains" with the "New
Ways" but in general when we are not crazed busy, things work pretty well.
The staff is slowly accepting that this is the way it is going to be, but
there is still some grumbling about "I just wish we could have a Nursery
and PP floor again".
        The couplet stays about 2 hours and then is transferred to the Mother/Baby
unit if all is well the baby never has to come to the nursery. C-section
baby's still come right to the nursery, but go to the RR for a visit or
breastfeeding when they are stable and as mother's condition permits.
        The only thing that I see happening more than I would like is that the
"time limit" to move the couplet to the Mother/Baby Unit turns some of the
care into being very task oriented and doesn't always lend itself to
letting mom's and baby's do things on their schedule.
        The only time that the babies have to be in the nursery is for morning
rounds for the peditricians. I am not going to do any MD bashing here and
we did try to get them to do exams in the rooms but they have held on to
needing better light, their equipment etc. So for now the babies come in
around 8AM and go back out about 9AM. I encourage mom's to request that the
baby not go back to the nursery for any reason and then the pedi will
usually go to her room for the AM exam.
        Hope this helps. Feel free to e-mail me privately if you need any other info.
                        Jodi Smart, RN,IBCLC
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