Yes! Although I am currently not working in L&D, I maintain my Certified Childbirth Educator status and I am a neonatal nurse at this point in time. I still attend deliveries, but I am there for the infant. However, as we all know, the desire to have a more natural birth experience doesn't end with stage 3 of labor! In my job, I fight for moms to be encouraged to room in, for skin-to-skin contact, for EXCLUSIVE breastfeeding in the absence of medical need for supplementation, etc. I think whether we are working in L&D or Neonatal, those of us who are for natural birth experiences are oftentimes at odds with our peers at work. When I give report and I am excited that a preterm infant is breastfeeding well, I get the rolling of eyes at times, especially from old school nurses. My mother, sister, aunt, and myself are all OB nurses who fight to get nurses to stop doing what's easiest for them and do what's right for the couplet. From encouraging epidurals to encouraging moms to send their babies to the nursery at night to be fed in, we are constantly at odds with certain nurses and some of their practices. I would love to share ideas and encouragement with another RN. I do think that we are in a slightly different spot than the average lay person; because of our education and jobs we can't simply "pick a side". Does that make sense? It isn't such a polar issue that we can absolutely identify with one "side" or the other. We are in an interesting middle ground. There are times that we have to intervene, but we certainly try to avoid it if at all possible. I have had nurses roll their eyes at me for avoiding intervention, and I have had families critisize my practice when intervention is needed for the safety of mom/baby. As I said, we are in an interesting position. Let me know what you think. Where do you practice at?
Hey! Oh my goodness NO! Please tell me they aren't using deep sxn and O2 on most babies! I am (an NRP instructor by the way) such an advocate of NOT deep suctioning most kids. If you give them some time they typically clear all that on their own. People expect these kids to sound clear at 2 minutes of age which is such a ridiculous expectation. We see such an issue with these kids that are deep suctioned then having feeding issues in the next 24-48 hours. They are gaggy and don't want to feed because of the irritation and edema. In terms of the O2, there just isn't any reason to do it. If you give them that first 30-60 seconds when you are drying and stimulating anyway, there typically doesn't end up being a need for blowby anyway. It is so hard to make people change. I think that if the same people who over intervene on these kids were responsible for them over the next 24-48 hours to see the effects of their actions they might reconsider. Sounds like my hospital is similar in size to yours. We have done as many as 13 deliveries in an 8 hour shift...too many! Do your L&D RNs do your resuscitations or your NICU RNs?
Hey Rachel. I think skin-to-skin is great. I don't think you can refute all the studies that show its benefits. The fact that a stabilization in HR and RR is often noted is so cool. Although I don't think we are going to see the famous "crawl" to the breast every time we put a baby skin-to-skin to encourage nursing, I certainly believe that it helps. I often times use it when I help a mom nurses, especially with preterm kids or really sleepy kids. I think it should absolutely be done immediately after delivery. There just isn't any reason not to. Is it your policy to ensure that baby goes to breast within one hour? We also don't separate moms/infants who are vag deliveries. C/S babies go to the nursery for a brief exam only, and Dad usually goes with them, then they are never taken again. I was shocked when someone said that their hospital takes babies into the nursery for up to 2 hours each day. What? Why?! Peds. should do exams in rooms so they can speak with parents anyway. I would love to know some of your practices.