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Subject:
From:
"Leanne Jewell, Rnc, Lcce, Facce" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 17 Nov 2004 18:41:16 EST
Content-Type:
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Hi this is from SFl.  I am responding to the inquiry about BF in PACU after a
cesarean.  I have worked in different hospitals in the area and currently at
the facility I have been for the last 5 years it is a dream.  A WISH and it
ain't happening here.
Recently had a conversation with one our staff OBs whose wife will be having
her repeat CS with us in late Jan.  He lamented that the babies look so
lonesome in the nursery after delivery and when they had their first baby in Denver
they were able to have the baby the entire time with them.....Oh how lovely.
Our facility is the busiest cesarean hospital in SFL currently. We schedule
at least 6 a day and anywhere from 4- 6 inductions which of course leads to
upwards of 8-9 sections in a day.  Then if Mother Nature has a perverse sense of
humor we can do a few more.  We have done as many as 16 in a 24 hour period.
Thus our 6 bed PACU is often filled to the brim and often with Moms who have
issues. Mag, bleeding, Respiratory and other problems.  If we are really
hopping then we are doing triage or stress tests and even starting labors off in
Recovery.  We will be expanding our Antepartum and Triage in the New Year but
until we are finished we are often swamped.  We have one nursery nurse so she
can't stop and go to the wing that PACU is located with a baby.  They keep us
bare bones staffed.  I felt badly about our new doc and wished I could even come
in and transition the baby.  I suggested that maybe he consider doing the
section at end of day or on a Sat or Sunday because we would be less busy, he is
scheduled for Thursday and that is one of our busy days. I would even think
about coming in on Thursday but I will be in NY visiting my granddaughter on her
first birthday.  I spoke with one of the LD nurses at our Breastfeeding
Committee and she agreed it just isn't practical and the mentality is get them in
and get them out.  We also start our scheduled sections in the PACU  when they
come in so the RN assigned to PACU will be admitting a patient and following a
fresh section.  If a stat comes in then she might get the nurse of the patient
who was sectioned stat to do the recovery while she "catches up" or that RN
will be circulating her section and then pulled to do another labor patient.
Now you can see why I no longer do labor...its like a three ring circus.
Inspite of all this we are considered by South Florida Parenting "THE BEST PLACE TO
GIVE BIRTH IN SOUTH FLORIDA."
When I worked in a small private hospital it still wasn't possible even with
the lowest section rate in SFL due to you were the circulator and recovery RN
and it was the scrub tech and you in Recovery....and it was busy it was bad.
Even though its idealist to wish for mom and baby not to separated you need to
staff for it and by today's standards in our area its not likely.
I would love to indulge this doc because he will delivering my new grandchild
and I am looking for him to be patient and indulgent and not quick to cut.
Yes, I am sucking up to him....and all his partners. I chose them because they
have an idea of what it is to have a mom and baby stay together.
Lovingly,
Leanne Jewell, RN,C, IBCLC-RLC, LCCE, FACCE

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