Night Nurses and Etiquette

[StaceyKim]

I am having a night nurse come to the house the for the first few weeks or so after the baby is born. I have a few questions...
Do I have to provide a bed for the nurse? I have a glider and ottoman in the room.
Can I also ask her to do other things while the baby is sleeping such as laundry and light housework (run dishwasher and empty).
I do have a room next to the baby's room where I could set up a tv. Is that necessary?
What about snack foods and drinks? Should I provide food?
I want to do the right thing and I am curious what others have done.

Thanks!

[mama2be]

Stacey a good part of this might be to know if she is an RN or an actual "nurses aide" of sorts (I know folks use the term "nurse" for a lot of different occupations in the medical field...and there can be a huge discrepency between the two. I ask this because you might beable to get an aid or someone like that to help with laundry more so than an RN who might feel like you are paying for her professional services. AND who knows it could be the other way around (personality could easily dictate this)...such things are soooo personal that really the only person who can answer them is the person you hired no matter what her title, pay grade, job description etc... is...

I guess i'm trying to say it's not really an etiquette question as what will she do and what does she expect.

If you've hired her from an agency then they can also tell you because in that case it is what THEY expect from her...

If you have not hired someone yet and you want all of that ...then quiz them and let them know your expectations. Be honest if you want your underwear ironed avoid any problems while you need lack of stress the most and discuss it before hand. AND have a contract with your expectations so when she gets "tired" of doing it your derrierre is covered by what was expected, you sign it and have her sign it.

I know that does not answer your question but I hope it helps you realize some things to do...

Good luck...and keep us posted. Your questions are EXCELLENT and you are smart to think about them now...you will be very stressed by a strnager in your home if she does not meet your expectations I would assume...

[KathyO]

I think Neve has covered the issue well (and I second everything she says) but I'd add that offering some basic comforts to make the nurse's workplace pleasant never EVER hurts the employer-employee relationship. So - show her where the coffeemaker is, and the juice, and where you keep the fruit/biscuits etc. You're not obliged to supply meals, and she'll probably bring whatever she likes/needs anyway. The TV is not strictly necessary, but it would be a very nice touch, since she'll be there all by herself and once the chores are taken care of, it beats twiddling one's thumbs in the dark!

I'm not a nurse myself, but I have nannied, and babysat for years as a teen, and it was always nice to be treated this way. Child care is a tricky relationship. People want you to behave like family in that they'd like you to be as loving and devoted to their child's welfare as they are -- but at the time, some seem to simultaneously reserve the right to treat you like a robot with no feelings. A little warmth in this relationship goes a long way!

Hope that helps. A night nurse sounds like a WONDERFUL thing! Let us know how it works out!

Cheers,

KathyO

[mama2be]

That is so true...just the smallest little thing that makes her feel welcome in your home and treated with respect etc... will go a long way. I remember patients who arrived in a coma to the hospital and you couldn't get to know them...but when their families were good to the staff and treated them with respect you did get to know the patient...and cried when something happened...

A "team" atmosphere, recogition and thanks goes a long way in the medical field...

Please keep us posted though I'd love to hear how it goes...I wonder if you could check references too....

[shopaholic mom]

I had a 24-hr nurse for the 5 weeks (actually 2 nurses - the first one left in the middle so we scrambled to get a replacement - since I had gone through word-of-mouth and not an agency) and also interviewed night-nurses but ended up not hiring one. Most of my friends have had either full time baby nurse or night nurse and here's what's expected:

1) Yes you should provide a comfortable place for her to rest - doesn't have to be a bed - a sofa will be fine. Does the glider recline?

2)Absolutely - she should do the baby's laundry and ironing and wash/sterilze baby's bottles (if you're using bottles) and pump.
But, she should not be expected to do your laundry. Any housework related to the baby is perfectly fair for you to ask her to do.

3)No - the TV is NOT necessary. Its nice of you, but not expected - she can bring a book/magazine/radio/etc - that's up to you.

4)You should tell her to help herself to snacks - at least water/soda/juice and some fruit/crackers, etc - nothing major - whatever you have in the house.

She is only there nights, but it is crucial that you and she get along well and you trust her completely to deal with the baby at night - since that is the whole reason you're hiring her, I assume (so you can sleep). I thought I liked my first nurse, but realized that she made me a little crazy - some baby nurses can be overbearing with first-time moms, so make sure you discuss what you do and don't want her to do. I didn't realize how stressed I was when she was around until she was gone and my replacement nurse came and I was much happier. Also, if you plan on following any particular sleeping routines, etc, its a good idea to ask her to read the same books that you read and very helpful if she shares your philosophy or at least respects it. I sleep trained my daughter from a very early age - followed a combo of Weisbluth, Baby Whisperer and Gina Ford - my nurse read 2 of the books.

Most importantly - take advantage of the nurse being there and get as much sleep as you can! I hope this helps - please feel free to ask any more questions about baby nurses.

[StaceyKim]

Hi Everyone,
Thanks for all of your suggestions. They were great.
I am planning on having the night nurse come to my house in the next month or so to talk about everything and show her around.
I will keep you posted on how things go.
Many thanks,
Stacey
:)

[memedee]

I am VERY interested in your combo of sleep techniques.
I am not familiar with Gina Ford .
I was planning on reading the other two.
I would love to hear a synopsis of what you and the baby nurse did/
Thanks

[shopaholic mom]

Gina Ford is a famous maternity nurse in London - has worked with many celebrity families here and elsewhere in the world. Her methods are definitely a bit controversial, but well-followed here and elsewhere in the world (she's not so well known or popular in the US - I had my daughter in London - that is why I read and followed her book - it is what many people read and talk abt if not try to follow here). Her book, "The Contented Little Baby Book" is all about getting your baby into a routine from Day 1 - which helps facilitate successful eating and good sleep habits. If you follow her methods from the beginning you will not have to "ferberize" or endure CIO periods when sleep training an older baby.
She believes that babies do best on a 7am - 7pm schedule - within those times, feed-times and nap times should be scheduled. She goes 1 step further and provides sample schedules of what a baby should/could be doing at every age - breaks it down into 2 week periods in the very beginning, then 4 week periods, then monthly, then several months once the baby is older. She also provides troubleshooting advice for what do do if your baby isn't following the routines no matter how hard you try - and she offers solutions to most potential problems. Her chapters on routine are titled accordingly - i.e., "Routine for Breastfeeding Baby 8-12 weeks" - different variations for bottlefeeding babies, etc. She spells it all out for you - possibly a little too much for some people's taste (for example, she tells you when to change the baby's diaper and what he/she should be doing during "activity time", but again, its a great guideline - lots of good ideas and information that you can take or leave as you like.

Basically, her sleep advice is based on Weissbluth's research - which in synopsis is: respect your child's need for sleep, put them to bed before they're overtired (most of the time when babies cry inconsolably, its b/c they're OVER-TIRED). And, babies need help learning to sleep on their own for long periods of time - its a skill that you can and should teach them as a parent.

Back to Gina, she also believes in waking a sleeping baby to keep him or her on schedule. I.e., if your baby will sleep a 7-8 hour stretch at night, she says that you should control when that stretch is -- wake the baby before you go to sleep - 10 or 11 p.m. and feed them and then put them back to sleep for the 7 hr stretch at that point so you and the baby will sleep the normal "night hours" as opposed to sleeping from 8p.m. - 3a.m. and waking at 3. She also feels very strongly about keeping the baby on the schedule NO MATTER WHAT (upon first reading her book, my friends and I used to call her the "schedule nazi" - but since we all followed it and had babies sleeping 12 hours/night and 3+ hrs naps, from 12 weeks, we think she's a goddess. Now, I don't know ANYONE who has been able to follow her advice to the tee, so you have to take it with a grain of salt. BUT, her routines are very useful guidelines (some people would rather do 8am - 8 pm than 7-7 or have their baby up later and nap more during the day, etc, and you can play around with it.). If you stick to her guidelines as closely as you can, you will have a "contented little baby".

She is similar to Baby Whisperer (Tracy Hogg, the author is also a British maternity nurse) but goes a step further with the specific schedules - her advice is also relevant past the first few months. Her schedule works for children up to age 3 - she has a follow on book - "from contented baby to confident child". Baby Whisperer's best advice is her opening line "Start as you mean to go on" - if you don't want your 1 yr old sleeping in your bed, don't let your 1 month old sleep in your bed either - lots of people disagree with this too, but I think its very reasonable advice. The other great thing in her book is the body language chart - as a new mom, I had no idea that rubbing ears meant that my baby was tired (thought there was something wrong w/her ears :-)

The way I worked with my nurses - at the interview we discussed what I expected of her and what she expected from my husband and I. Her role was three-fold
1)to help me take care of the baby so I could rest and recover from birth (get full nights sleep for a few weeks)
2)to teach me how to take care of the baby after she left - when I was on my own - (all the basics but also extras like infant massage).
3)to start to get my daughter into a routine so my life would be easier when she left
So, both nurses (my first one left in the middle so I hired another to replace her) worked basically 24 hours/day 6 days a week - got 1 day off and also got 2 hours off per day. I combo-fed so I nursed before I went to sleep and if DD woke up in the night, the nurse fed her EBM or formula from a bottle. And then she'd bring her to me at 6 or whatever time we decided was reasonable for morning. During the day, we'd alternate who was with DD - she would take her for long walks in the park (we have a huge park across from our apt), she accompanied me to the pediatrician for appointments. Sometimes, I'd take DD out by myself and she'd sleep for a few hours. It was kind of like a tag team.

During the day or at night, when DD was sleeping, the nurse washed/sterilized the bottles and pumping equipment. She did DDs laundry. She also had down-time - she read, watched TV, etc. My first nurse didn't cook, but the 2nd one cooked dinner for my husband and I every night (that was a HUGE bonus!). My 2nd nurse also pureed organic fruits and vegetables and froze baby portions for me so I'd have enough first baby foods to start solids.

One of her biggest jobs, though, ended up being crowd control. With all of our family members coming over from NY to see us and DD, it got a little overwhelming - so she would help figure out who should come when (b/c to have 15 people in my 2BR apt at once was too much :-)

I hope this is helpful - probably more info than you were looking for. Please let me know if I can offer any more info on baby nurses or on Gina Ford. IMO - baby nurses are wonderful - if you get along with them - someone living in your house is definitely a challenge. But, it can be amazing if you get the right one. Also, they're expensive $100/day. Mine was actually a gift from my grandmother - she wanted me to have help in the beginning since we were far away from family and close friends when we had DD. With my next baby, who will be born when we're back in NY, I'm already planning to fly my British nurse out to NY to be with us for an even longer time - I told DH that is what I want as my "baby" present - to me, the sleep and help is worth more than any piece of jewelry :-)

HTH

[mama2be]

I got it at the same place I bought another one from...these companies prices are great...

Look to the right and you'll see the New one for 3.99

I just ordered it
http://www.amazon.com/exec/obidos/search-handle-form/103-1134682-1335817

Note:the company is book close outs or something like that...not really Amazon I don't think...

[memedee]

Thank you very much for your detailed descriptions. I read it and printed it for future reference. I will also try to find the book.
It all makes perfect sense to me and I am very much in favor of trying to be consistent with the schedules.
I particularly agree with START AS YOU MEAN TO GO ON.
Thanks again.
London is a great place to shop isn't it?

[smilequeen]

OK...what exactly does a night nurse do? Take care of the baby, feed, change in the middle of the night? Is this something worth looking into if you plan to exclusively breastfeed...you'd have to get up every time to feed the baby if you were right? This is definitely not common around here...

[Momof3Labs]

I found it on half.com from the same seller for 3.99, also, and shipping was a tad bit cheaper than through Amazon. I ordered it, too, although I'm not sure it is for us - but I can still probably glean some information from it (I did NOT like the Baby Whisperer).

Neve, GO WRITE YOUR THANK YOU NOTES!! You are really setting yourself up to go into labor tonight...

Lori & Colin 9/28/02

[StaceyKim]

You hire them in the beginning so you can sleep. Yes, they feed, change, burp, etc. during the night hours. If you are breastfeeding, it probably doesn't make sense because you are up anyway but I do have a lot of friends who were breastfeeding who had full-time nurses to help out. Most people I know either have live-in nurses for about a month or go the night nurse route. My husband and I didn't want someone living with us and plus my mom is coming out for the first month too. Do you have family that lives nearby to help you out in the beginning?

[egoldber]

Even if breastfeeding, you can set it up so that the nurse gets baby, changes them, brings them to you and puts the baby back to bed once the feeding is over. Sort of like the hospital, if your baby was in the hospital nursery and you breastfed. One of my mommy friends had a "post-partum doula" who was essentially a night nurse, only she came whenever you wanted her.

I have thought about a postpartum (as well as a labor) doula for when I have my next baby. They can also just comeover, take care of mom for awhile, cook, do light housework, etc.

My friend is the only one I know personally besides my MIL who had a night nurse type person. My MIL came and stayed with us for 3 weeks after Sarah was born. She was telling me that in "her day" everyone had a "baby nurse". She said she had this nurse until the baby started sleeping through the night!!! She also told me that when the nurse stopped coming she was at a bit of a loss as to how to take care of her baby by herself! She said that I seemed much more in tune to my baby and her needs than she had been to hers at the same age. (Which I think is one of the nicest things my MIL has ever said to me.)

There are certainly a lot more options out there for help after the baby comes than a lot of people realize. Certainly I didn't.

[memedee]

Why didn"t you like the baby whisperer?
My daughter said she didn't hear good things about it either?

[Momof3Labs]

I felt like she really didn't know as much as she pretended she did. For example, she claimed that it was true that people who adopt are more likely to conceive (after years of infertility). That is complete bunk!

I also didn't like her tone. I felt like a bad parent when I was reading her book. As if, this is what the baby wants to do (e.g. nap, sleep 12 hours a night) and if he/she isn't, it is because the parents are doing something wrong. Plus, she didn't present anything that helped with our issue - a baby who just refuses to nap (but does sleep 12-13 hours most nights).

I just received Weissbluth this afternoon and will start reading it tomorrow on the train - I think that I will like him much better.

I don't know - maybe I was just being touchy - but the Baby Whisperer did not impress me.

Lori & Colin 9/28/02

[shopaholic mom]

Glad that you found the info helpful. Having read all the books, which I'm glad I did, and taking pieces of each, I found Gina's to be the easiest guideline to follow since it was so detailed. I can honestly say I have a contented little baby (as do about a dozen of my mommy friends here who all read and followed the book (to different degrees) and I think a large part of it is due to following those guidelines (and I DEFINITELY messed with them a lot and twisted her schedules to fit better with mine, although I did find that DD did best when I stuck with 7-7 - I guess she's onto something).

London IS great to shop! Even better, though is its proximity to Paris and all the Italian cities (1.5 hr flights)!

[shopaholic mom]

I completely agree that its well worth it even if you are EBF. As Beth said, in the night ALL you have to do is feed the baby. More importantly, if you have a live-in or even night nurse, when the baby is sleeping, she can do all baby related laundry and cleaning and organizing, and possibly even cook for you (or make baby food to freeze for a few months down the road :-), which is very helpful, especially if you are EBF - you will be more exhausted - I found that BF most of the time (night feeds were bottles) still sucked the life out of me.

I think it is the best gift you can give yourself or if your parents or family want to give you an expensive baby gift - ask them to pay for a nurse for a few weeks - a lot of my friends get this as gifts from their parents.

I have heard a lot of good things abt Doulas as well. The most impt thing is having help that you are comfortable with and not becoming too dependent on it. The last week that my nurse was here, I basically did everything - bathed, changed, etc...and the nurse just supervised so I could get comfortable doing it when she was gone and she could give me suggestions, etc.

Also, a good baby nurse will be a wealth of knowledge and before mine left, we sat down for 2 hrs with a notepad and she gave me tons of useful advice about weaning, solids, teething, sleeping issues, etc - all of which I refer back to. And, using a nurse once does entitle you to call her or email her with additional questions - I still keep in touch with mine and she has definitely helped me out a few times since she left.

Good luck.

[StaceyKim]

Hi!
Thanks for the detailed message. I went out and bought Gina Ford's book "The Contented Little Baby Book" and read it cover to cover. I like the 7am schedule that she talks about throughout the book but I have a question:
When do you get to do anything else?!

I know you said you do not follow everything exactly in the schedule
because I think it would be impossible to have a life outside the baby! I envisioned taking my DS on walks around the neighborhood and meeting friends for lunch with DS in stroller or car seat especially since he will be a Spring baby and I would like to get outside and get some exercise. So do you just put baby in stroller at 12pm and have him take the nap then and wake him up after the 2 1/2 hour nap is over? When do you do errands?
I do plan on having a babysitter on specific days to get some errands done but what about the other days?

P.S. The full time nurses here run you from $180-240/day!

[LisaS]

Stacy,

I agree that the schedule as is is definitely a bit restrictive...but, you can follow the schedule and still have a life outside of the baby. The key is to initially use naptimes as errand times (gina disagrees but I had to do it and it worked fine for us for a little while)...I found that after getting into it for a few weeks, I did have lots of free time. The main thing that I did differently was that I didn't always put DD in her room to nap - I used her nap times as my time to do errands since she'd sleep in her carriage (I had an Emmaljunga w/a bassinet - super cushy bed on wheels) or car seat (not as well as in the carriage but in the beginning for short naps it was fine - I was always very conscious of not letting her stay in the car seat for too long at a time).

I also took DD out when she was awake (I know Gina says not to do this often as babies often fall asleep in the car seat stroller at a non-nap time, but I'd do it a little bit before or I'd stay out after she'd just woken up). I did have to make a transition from her carriage to her crib at abt 5/6 months...she stopped sleeping well in her carriage - I think its true what Weisbluth says that motion sleeping just isn't real quality sleeping but many ppl will disagree. And she also was too big to comfortably spread out - she started sleeping on her tummy when she was able to roll both ways.

But since I started doing naps at home, I love it - yes it means I can't go out during her nap - for both of us (she doesn't nap well out and will be cranky and she and I will then both have less than stellar afternoons), but it also means that I have time at home to get stuff done around the house - cook, make calls, email, etc. I will still meet friends for lunch, but an early lunch...noon...and push DDs lunchtime nap till 1...(its very possible to be flexible w/Gina's schedule)

Here's what our days were like when I followed Gina's schedule the first few months.

7a.m. wake the baby up (she usually got up within 30 minutes of 7...and I'd let her sleep till 7:30 or even 8 if she would and I was tired, I'd just adjust the schedule for that day).
Feed DD
Playtime (we'd stay inside this playtime - gymini, tummy time, swing, etc)

9a.m. Nap - I'd go power walking with DD outside at this nap - I used to meet a group of mommy friends and a personal trainer in the park for a stroller-cise type class. She would always fall asleep on the way there and the class was 1 hr, so it was perfect. I didn't do this every day (didn't start till she was 4 weeks) did it 2x week. The other days, she'd nap at 9...sometimes out, I'd go power walking on my own, or to the grocery store - or elsewhere - errand related. I took her out of the house from when she was 6 days old - shopping, etc. Or, if we were home, she'd nap in the carriage, her basinet or even in our bed...(another Gina NoNo, but this was only on Saturdays, when the nurse had off and my husband was home - it was family cuddle/nap time - but we only did this for that a.m. nap...and only till she was 8 weeks)

10a.m. wake-up (I would let her oversleep this...and sometimes she woulnd't go down as well at noon, but more often than not, she did). Gina has it starting as 1 1/2 hr nap and slowly shrinking...I left it longer for longer than she reccommends but I didn't have problems.

Then she suggests top and tail - I didn't do this - we just had bathtime at night.

Then we'd play at home, go to a mommy group or baby class or do more errands (if we hadn't gone out in the a.m.)

10-11 Then, its time for another feed...

Then by close to noon, she's already getting ready for another nap - this nap would be at home (if the baby nurse was there) or when she left, I'd go out - meet friends for lunch and DD would stay asleep (this just started changing around 4 months or so...she'd wake up in the middle of her nap unhappy).

Noon - 2/2:30 - big nap (almost always went out for this and did errands, lunch, etc)

2/2:30 Feed again

Afternoon playtime/awake time - at home, with friends

4:00 nap - again - out or at home.

5:00 already start feed and then bathtime routine...
6:30 bedtime feed
7pm bed

I won't get into nighttime stuff as it doesn't really affect getting stuff done. We didn't go out with her at night though. Lots of people will take their kids out to dinner and they'll sleep in the car seat. From pretty early on, I was always pretty strict about she is in her room from 7pm - 7am. I went to her for feeding, comforting, etc - whatever she needed, but we didn't take her out of her room. We used to...till she was abt 6/8 weeks...but then we stopped.

The other thing I didn't follow was all of her times for pumping, but I wish I had.

I have many friends who have followed similar modified "gina schedules" with great success...all of them, though (unless they had full time help to stay with the baby on an ongoing basis while they did errands), had the baby nap while out. But all of them also, started having the baby nap at home eventually - usually around 5/6 months...some earlier and some later. But, its not such a problem then as you can go out with the baby awake then - they don't fall asleep every time you put them in a car or stroller.

Also, by that time, I had a babysitter 2 afternoons a week, so I could get errands that couldn't be done with the baby taken care of.

Anyway, I hope this helps.

Lisa S (AKA Shopaholic Mom...have 2 names from a time when I couldn't log onto the site)

PS - I've heard that good nurses are abt $120-$150/day. Ours (in london) was paid weekly - equivalent of $800/850 for a 6 day week.

[StaceyKim]

Hi Lisa,
Thanks for the quick and detailed response! This definitely makes me feel more at ease about the sleep, feed, etc. schedule. I bought a Bertini stroller that is great for newborns because it lies flat like a pram and it has great suspension for city street walking. So I think this will be great for talking walks & meeting friends for lunch during "nap" time. I guess the rest I will have to play by ear and see how it goes and tweak things as I go along.
Thanks again! I am printing this out!