Thanks Neil
Care of well babies in KZN, South Africa, varies based on the level of
care.
Our provincial guideline stipulates that all well babies can be assessed by a midwife but that those at risk or sick and small should be assessed (examined) by a doctor.
Most (but not all) well babies have a documented first examination.
At our secondary or tertiary hospitals many well babies are assessed by an intern or doctor as these deliveries tend to be higher risk. These may include paediatric or obstetric interns.
I agree that not all well babies receive routine (temperature, pulse, breathing, colour, activity) observations in the postnatal ward.
Often wards are using routine blood glucose tests as a proxy assessment of well being with no other observations being performed.
There is very limited support for breast feeding.
Assessment and care of well babies is included in basic midwifery training but not in general nurse training.
There is limited content in post graduate midwifery training covering care of the sick and small baby.
Therefore if lower categories of nurses or nurses without midwifery training are allocated to the postnatal or neonatal units they will not have been trained in the care of newborns. This is a common situation.
In addition currently there is no postgraduate specialist nurse training in the care of sick and small babies.
Currently our neonatal units are therefore staffed with a combination of the following nursing categories:
- Student nurses
- General nurses who may have trained for 6mths / 2 years / 3 years / 4 years (including basic midwifery)
- Midwives (who have completed post graduate training specialising in midwifery)
- Specialist nurses with post basic training in paediatrics/child health or intensive care nursing
Post natal staffing categories would exclude the last category.
We have developed and piloted a family observation tool to support mothers in the observation of their own babies during the neonatal period (both in hospital and at home). We hope that this may empower mothers with knowledge and confidence in observing and caring for their babies, increase the frequency of observation of newborns, increase the detection of problems,increase health care seeking behaviour and thereby reduce neonatal and early infant deaths.
God bless
Ruth Davidge RN RM RPN, Cert. Neon Intensive Care, *f*ANSA
KZN Neonatal Coordinator
CHIFA profile: Ruth Davidge is Neonatal Coordinator at PMB Metro, Hospitals Complex Western, Kwa-Zulu Natal, South Africa. She is President of the Neonatal Nurses Association of Southern Africa, NNASA. She is a Registered Nurse and on the board of the Council of International Neonatal Nurses, COINN. ruth.davidge AT kznhealth.gov.za www.nnasa.org.za
