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Date: | Sat, 10 Jun 2006 14:20:37 EDT |
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I have been reading the postings on the inevitable first bath. We bath our
babies where I work now as soon as the temp is stable after admission the
transition nursery. They are bathed under a radiant warmer with warm water and
scream their bloody heads off, thus resulting in these ruddy red babies.
They are then diapered and placed supine under the warmer to continue their
transitions. They then resemble a bunch of teenagers at the beach crashed out.
Once they have finished transition they are given over the head shirts and
swaddled x2 in warm blankets and boggan hats are placed on their heads. The
nurse caring for the couplet is notified to come pick up her baby and assess it
again and take it out to Mom. When they get to Mom we match the bracelets
and now the real fun begins...it's time to feed this dead to world sleepy
exhausted child.(we are the cesarean capital of Florida, not proud to say). So
unless this baby was one of our rare vaginal deliveries who had the
opportunity to go to breast at the time of delivery, we are now in the "race" to get
the baby to feed because it's now between 4 and 5 hours. Our patient population
is largely Hispanic so there are many visitors in the room who must have
numerous photo ops, and Mom is usually nauseous or has been medicated either in
PACU or upon arrival to the floor for nausea....making her al ittle out of
it. Despite me and the other LC/RNs telling staff to now go to skin to skin
we hear repeatedly the baby is too sleepy to nurse. YoHOO!! no clue.
So one of us will shoo out the crowd, go to skin to skin and after a bit
guess who latches on?
Not great, but enough that the parents think its great. If we have some
trouble I remind them to "reboot the baby" that great concept of skin to skin
and don't mess with the baby for about 30 minutes and allow the kid to reorient
to Mom. It usually works well.
So my question to the nursery staff has been why wrap them in super warm
blankets unless they are not hold temp, not to scrub them to shine like apples.
Where I worked before was an LDRP....low section rate. But I did often a
take off on the LeBoyer bath for the first bath. Immersing the baby in warm
water for a few minutes...yes, under the radiant warmer without the overhead
light on and just letting the baby feel the warm water...no scubbing this can be
done with baby bath in the water. Then gently washing and gently drying. We
also had Jaccuzzis and I was even known to put baby in with Mom after the
delivery recovery time and have her help with the first bath. This was awesome!
Babies even nursed for a few minutes. I would then take baby back to
stabilet and rinse in warm water dry and let them on the bedside stabilet while Mom
chilled out post delivery in the tub with a cool drink. I was able to stay in
the room and finish my notes, check on both Mom and baby. Mom would get up,
shower off and put on her jammies and go back to a freshly made bed with her
baby next to her. It was Camelot! This all took place after the first hour
or so. We weren't a huge unit and we weren't busy. Pt;s loved it and so did the
staff.
I share with you this comparison because out in the world north of South
Florida there are units where these can occur. Our unit is not set up for this
and hospital is just not into that thinking. I have had the opportunity to
bath babies in transition and try to use the gentle bath techniques...it not
so harsh but if you are bathing and transitioning upwards of 15 to 20 babies
on some days its not what the nursery staff has time for. Sad.
Only the patient's complaints can change things in many places these days,
Patient Satisfaction and Patient Safety are the operative catch phrases.
I keep trying but they just don't think that something like that is an
important issue. It's okay for the babies to cry and crash....its to be expected.
Leanne Jewell RNC, IBCLC, LCCE, FACCE
SFl
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