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Date: | Fri, 14 Jul 2006 09:45:23 EDT |
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This is in response to Merrilee's question about the hospital bed issue.
Our unit is all private rooms. Our Pavilion rooms are small room for only a
sleeper chair and maybe a straight back chair and THE BED. Our Suites have
more space (originally designed as LDRP rooms but soon delegated to 14 LDR
and 15 Postpartum Suites) We have glider rockers and now new sleeper sofas.
Patients pay extra for the extra space on a first come availability after
delivery. Sometimes you will find women on late day 2 or 3 (we are the cesarean
capital) out of bed in the chair. Chairs are for our large families.
But in a society were Childbirth is viewed as less than Normal and Natural,
but as an event that entails medications and interventions and no one thinks
that it's anything else, then you must see that Mom is relegated to the
hospital bed. Their families support this whole heartedly.
As a Mother Baby nurse and a Lactation Consultant I encourage my patients to
get out of the bed....I want them to shower...dressings are removed first
thing in a.m....I encourage them to sit on edge of bed or at the tables in the
larger rooms to eat. Drink lots of fluids ( so they have to get up to
void...it gets them out the bed). Walk in the hallway and please go to the Mother
Baby class held daily where they will hear about breastfeeding and how to
care for their baby. Mothers with babies in NICU are out of bed, but they
perceive themselves ill because their baby is in a place for sick babies. This
also the generation of not doing for anyone but themselves...it's all about me.
It is amazing how many moms want you to be there for every feeding and they
find it difficult to initiate getting the baby to the breast....a lot
literally want to have you their to hold their breasts for them...They are amazed
when you strip the baby down for skin to skin....take the blankets away and
strip off the mittens.
"Why would you undress the baby to feed?" "The baby needs the mittens so he
doesn't scratch himself."
The Reva Ruvin Model of Postpartum Nursing should always be kept in mind.
The taking in, taking hold model is just too pertinent to hospital nursing and
postpartum for most patient care. Never forget this is a life altering
event. Yes, its is a Normal process but if they birth in a hospital, hospitals
are set up no matter how Mother Baby Friendly they are to be just that a
hospital. The patient who tells you when I get home, I will do it this way...but
while I am here....well, she may change because of her environment; while the
patient who delivers at a birthing center or at home may and most times take
hold much more effortlessly. But it all boils down to how much the birth
process has effected this mother.
So as a Lactation Consultant what can you do to encourage getting them into
these other spaces...be patient with them...get their families out of the
chairs and maybe out of the room...or get the patient into the chair before the
family plunks themselves comfy for the day.
Get your staff to help to get them up early and shower early, encourage
wearing their own clothing as opposed to the lovely and flattering hospital garb.
Get the beds made early ...who wants to mess up a lovely bed...it's too nice
to rumble. Take the pillows off the bed and put them in the chair...make the
chair the more comfy place. Tell her how good she looks in the chair or
couch. Our chairs pull out so pull the foot out so she can have her legs up.
Remind her she should try nursing laying down at least once while in hospital so
when I encourage my nap time I will try to get them to nurse on their sides.
Can we do this all the time,
probably not. Why, because hospitals are stretching us all too thin...we
are getting busier and patients are often more ill...but if you impact one or
two in a day, for only a day...you may go away feeling like...I got to do my
job a little better.
When the unit is due for a capital improvement suggest to your managers what
you think would be a better solution. When a room is empty have a meeting in
the room with them and ask them to look at the things from a nursing family
perspective. The decorators never do.
Good luck.
Leanne Jewell RNC, IBCLC, LCCE, FACCE
South Miami, Florida
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