Moshe Adler wrote: "BTW, I've practically stopped using home phototherapy
because we've had so
many problems with the home health agencies here. They can't seem to get
the
lights set up in a reasonable time (well over 6 hours), have trouble
drawing
the blood, and don't always get it to the lab without the specimen
degrading
(probably left out in the sunlight). It's so much easier to admit the
baby."
I know that everyone is short of time, but I am wondering how "teachable"
this agency is. Although everyone is "trained", there are some health care
providers (NPs and MDs included) that I wouldn't take my dog to (just a
figure of speech - flame shields up <G>). But I think there are a lot that
are educable - some have had a set way of doing things and need "a fresh
approach"/an update, some need to see the importance of prioritizing things
like light set ups (we use a "bili-blanket") and care/handling of lab work.
Everyone has their own way of doing things. They need to realize that the
referring agencies are THEIR bread and butter, and flexibility is the name
of the game. IF they are receptive to learning, taking the time to teach
at this point may save you time and money down the line. And getting to
know exactly who you can trust (and then request) will be an added benefit.
Eve Switzer wrote: "last time I relied on some
parents to observe for jaundice, they returned to the office 3 days later
and the baby's bilirubin was up to 22. Could they tell? Nope... Plain as
day to me..."
Gotta smile when I think of these poor parents. My second breast-fed child
was jaundiced in the nursery but, being an NP (and the pediatrician having
been my preceptor years before), we were comfortable going home and
"watching". Back in those days (15 years ago), we pumped for a day and
formula fed. THIS parent was looking at this child all the time - calling
everyone over - "do you think she's more yellow than this morning?" - "gee
I'll bet it's the yellow sleeper, the yellow blanket making her look this
way" - "what if she gets nipple confusion and won't breast feed after
this?" - "is she at the level yet where she'll be brain damaged?" - and
countless other worries that I didn't need post partum! Unlike my thinking
now (like Dmtink's), I had assisted many umbilical transfusions for levels
of 20 back in the 1970s. Anyway, after all that: (1) I've found that I
can't be truly objective about my own kids, especially after staring at
them for prolonged periods of time <G> and (2) if there is ANY doubt that
the child is not definitely IMPROVING, they need a recheck (me, reliable
home health, and/or lab). -Diane, CNP
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