Hi all,
        Just some comments about hospital routines. I am in the middle of this all
the time. So many of our so called routines have absolutely no scientific
or rational reason behind them. Do I see some "study potential" here. So
much of what is done in the hospital falls under the category of  "Sacred
Cow" i.e.- time honored traditions in maternity care i.e. baths, peri-preps
for delivery, moving patients from one place to another, babies to the
nursery for whatever reason etc. We have always done it this way, it has to
be done - you need this or that. These "Sacred Cows" are hard things for
most HCP’s to give up. I have stated earlier that a lot of us are real
control freaks, well meaning but control freaks nonetheless. When you add
the component of most hospitals cutting back on staffing and the mountain
of paperwork that most of us have to do. These routines become almost like
survival skills for getting through the shift. I understand why the
routines are there it just takes some thought to push through just getting
through the work and try to treat everyone individually and meet their
needs. Always a challenge.
        Does this make it right to push parents to do what we want or think is
right for them, especially when they have different ideas. I don’t think
so-  but most parents will just follow the routines without question
because the authority person has directed them in that direction.
        I like to think of myself as a work in progress. I was the ultimate in a
control freak , maniacal - yes Kathy D - Antilla the Nurse. I have worked
hard to question routines, give parents the control and take my cues from
them. This is a conscientious effort and I know that I am not always great
at not giving into the routines, that were entrenched in nursing school and
beyond. I am not great just trying to make a little difference along the way.
        Those of us in the hospital setting need to continually look at our
practice. Try not to freak when someone suggests by-passing or totally
giving up some of those "Sacred Cows". Educate all that will listen. Anyone
that talks to couples prenatally should be encouraging parents to write
birthplans or at the very least discussing how they want their hospital
birth to proceed. It is rare for parents to really come with a focused plan
and step in and say - Does this really need to be done or need to be done
right now? Yes some parents want the baby bathed ASAP, weight, measurements
and passed around to everyone in sight in the first 10  min. after birth.
Some want the exact opposite.  I have changed from the first to the latter.
I love to watch the quiet interaction of parents and baby in those first
hours after birth, without a lot of intervention from us, if at all possible. 
        This leads us back to the all important education and empowering parents
to make their needs and wishes understood and followed.  Sometimes there is
a fine line between providing information and sounding like you are saying
that this is what has to be done, especially when you are hurried. That is
why I think that prenatal or even pre-pregnancy education is the key. 
        Just MHO. I applaud all that have made changes in both their personal and
professional lives. Thanks for this opportunity to discuss these vital
issues. The stimulating subjects help me to grow and continue to learn daily.

Jodi Smart RN,IBCLC
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