Another St. Luke's NICU nurse weighs in on the changes proposed.
I wasn't able to attend the
hearing yesterday [Prop Q Dec 4] concerning the down-sizing of the Level II
Nursery to Level I, but I want to give you my input. My name is Randy J Gerlach
and I have worked in the Maternal -Child Unit as an RN at St Luke’s going on 30
years, and I have seen a lot of changes.
For the first 25 years I was a
Charge Nurse in the Nursery and I attended thousands of deliveries. Because of
our Mission to service the poor and uninsured, we tend to have a high risk
population. Many times a mother will come to the emergency room, ready to
deliver, without having any prenatal care. This puts both her and her baby at
risk for infections and other problems. The baby may be born sick or born too
early, needing to be resuscitated at delivery, which brings up two issues I wish
to address.
1. Because we are a
smaller unit with fewer resources, it is of utmost importance that there is a
qualified, experienced team to attend c-sections and other high risk deliveries.
On our unit, this necessitates
the presence of two qualified, experienced nursery nurses. One must be without
patient assignment to be available to attend deliveries. If there are no babies
in the Level II nursery, the second nursery nurse should have an assignment that
can be absorbed by the charge nurse or other team members. The Charge nurse
should not have an assignment.
As I understand, the current
plan is to cross-train nurses to nursery and mom-baby. Cross- training is good
to an extent. Four days in the NICU at CPMC may allow you to feel comfortable
taking care of a stable newborn on antibiotics or needing tube feeding, but
attending deliveries, especially high risk, requires a little more experience.
If the charge nurse is only back up for the nursery nurse she will not be
getting much experience as she would not attend that many deliveries. How does
that maintain quality care?
Many of our clients do have
prenatal care and do not have high risk deliveries, however, the baby may be
sick requiring a little oxygen or antibiotics for a couple of days, which brings
up the second point, Family Centered Care.
2. Family Centered Care. As
I have said, there have been many changes over the last 30 years. For many years
the babies were kept in the nursery most of the time and taken out to the moms
for feedings. Visiting hours were limited to 2 hrs 2 times a day and the babies
were viewed in the nursery. Then the babies were allowed in the rooms during
visiting hours, which were extended. The moms were not in private rooms and no
one could stay with them. Next, we moved to couplet care, the rooms were
converted to private rooms and the dad or significant other were allowed to
stay. Now we do not really enforce visiting hours and siblings are allowed to
stay if necessary. Now, Sutter/CPMC wants to transfer newborns needing Level II
care that have historically been well taken care of at St Luke’s, totally
disrupting Family Centered Care.
And they have the nerve to
tell us they're "With Us For Life". Isn't it really we’re "With You For The Life
of Your Wallet"?
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