Last week Kleneice gave you a sneak peek into her shift as a nursery RN! If caring for generally well mothers and babies interests you, read on to learn about what a typical shift is like on the Mother/Baby unit!
The Mother/Baby unit houses 41 beds divided among three pods with a well baby nursery that is reserved for procedures such as newborn screens, hearing screens, antibiotic administration, and any other emergent tests and procedures. The nurse/patient ratio can be 1:3-4 mother/baby couplets. In order to work on the Mother/Baby unit, a nurse must be certified in Neonatal Resuscitation (NRP). Mother/Baby nurses can float to the step-down NICU nursery, High Risk Obstetrics Unit, or the Gynecology Unit.
The moms and babies we care for on the unit are generally very healthy, although it is not uncommon to see conditions such as Type 1 & 2 diabetes, gestational & chronic hypertension, obesity, anemia, and some psych disorders such as bipolar and depression. In order to come to our unit instead of the step-down NICU, babies must be 35 weeks gestation or greater and not have any obvious medical complications. However, the babies we care for can be large for their gestational age (LGA) or smaller than expected (SGA) which requires close monitoring of their blood sugar and temperature stability. Babies can also receive antibiotic therapy if their mothers spike a fever during labor as a precaution to ward off any potential infections.
The Mother/Baby unit can sometimes get readmissions due to infections and we can also have patients waiting for surgery if the Gynecology unit is full.
Mothers who suffer an infant loss typically do not come to the mother/baby unit so that we can be sensitive to their grieving process.
Some of the common skills we perform on our patients include fundal assessments (to ensure mom is not at risk of postpartum hemorrhage), foley catheter removal, IV management, placement, and removal, IM injections, neonatal IV therapy, neonatal venipuncture, adult venipuncture and infant heel sticks.
Shift Break Down
1923: time to clock in!
2000-2100: initial rounds/assessment of moms and babies, techs get momma’s vital signs, RN gets baby vitals at the beginning of the shift
2100-2200: chart findings from first round, administer any scheduled medications
2200-2300: rounds, address pain control, administer any additional medications, check infant wet & dirty diapers and feedings
2300-0000: chart findings from 2200 rounds
0000-0100: midnight safety rounds, check pain scores, administer medications, check baby’s ID bands, make sure they are safely sleeping on their back in the crib, techs get labs on mommas
0100-0200: chart findings from 0000 rounds, reassess pain, check infant wet & dirty diapers and feedings
0200-0300: my ideal lunch hour! :)
0300-0400: try to have some down time at this point and let my patients get some rest
0400-0500: safety rounds, check pain scores, check baby’s ID bands, make sure they are sleeping safely, techs weigh, bathe, & get vitals on babies
0500-0600: address patient care plans, assess if goals were met
0600-0700: final rounds to check if patients need anything before shift change
0700-0723: finish charting, rewrite report sheets for oncoming nurses
0730: give report and clock out at 0753!
This sample schedule is a pretty laid back version of what I actually do! I’ve truly only experienced this type of shift a few times and that is because you just never know what to expect. For example, if a baby is LGA or SGA, there is a complicated algorithm that must be followed for checking their blood sugars every 3-4 hours and a series of steps we have to take if a baby’s blood sugar falls too low!
Or, if a mom has a history of chronic hypertension and is at risk for eclampsia she would be on magnesium sulfate for 24 hours and would require an assessment and vitals every 2 hours.
If I were to get a new admission at some point during the shift, vitals and fundal assessments must be done every 30 mins x2, hourly x4, and then every four hours x4. And of course, patients call out for pain medicines, help with breastfeeding, and questions about baby’s care at any given time.
Working at one of the top hospitals in the nation with a high patient acuity level guarantees that more often than not, I have my hands full even on a pretty routine unit like Mother/Baby!
Any questions about what it's like to be a Mother/Baby nurse? Are you thinking about pursuing a career as a Mother/Baby nurse? I would love to hear from you! Leave a comment below!