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Ethical Issue - Child Abuse



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  #11  
Old Mar 16, 2008, 09:23 PM
WeeBabyRN's Avatar
Senior Member
Join Date: Sep 2004
Re: Child Abuse

We had a mom of 27 week twins who had her twins at 27 weeks because she checked herself out AMA. She was in hosp on bedrest, receiving Mag Sulfate. They wouldn't let her go out to smoke so she checked herself out AMA. One twin is healthy, the other one has bilateral grade IV's and CLD.

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  #12  
Old Mar 16, 2008, 09:50 PM
SteveRN21's Avatar
SteveRN21 (Male)
dayshift wannaB
Join Date: Apr 2005
Re: Child Abuse

Originally Posted by morte View Post
this actually is the law i had in mind when i made the comment about unintended sequelae.....women stopped getting any prenatal care, when they found out they would be drug tested....
Yep, a lot of them tried that.

Then they show up abrupting due to cocaine use, or infected from the waist up because they were too high to realize it, or delivered kids in the toilet because they were too strung out to realize they were in labor.


And they went to jail anyway.

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  #13  
Old Mar 17, 2008, 12:34 AM
RainDreamer's Avatar
RainDreamer (Female)
RN, BSN
Join Date: Oct 2004
Re: Child Abuse

We don't routinely do drug tests, that seems like an invasion of privacy if there are no red flags. The only time we send an MDS/UDS is when the social situation is "questionable", if mom has had little or no prenatal care, or for abruptions.

To me, the no prenatal care and the drug use is kinda like the chicken and egg thing. Which causes which and which comes first? Drug moms might not receive prenatal care due to the fear of drug testing. But I think they just don't give a damn. I mean prenatal care is something you do to ensure your baby is healthy, right? So what's the point of getting prenatal care when you're smoking crack between visits? Kinda pointless, no?

My favorite drug moms are the ones that are SO incredibly intense and nitpicky about things while their baby is in the NICU. You know the type ..... they complain about everything, they feel their child isn't getting the best care, nothing is ever good enough for their baby. Well no, they're not getting a constant dose of crack like they did in the womb .... but God forbid the sheets aren't completely wrinkle free!

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  #14  
Old Mar 17, 2008, 03:14 AM
elizabells's Avatar
ECMO junkie
Join Date: Feb 2005
Re: Child Abuse

Our hospital policy is Utox only if: Mom is a known drug user w/in past 2 years, mom had no prenatal care, mom appears during admission to be drunk/high, or baby is showing signs of withdrawal. Abruption doesn't count for us. We cannot delay discharge for a pending screen.

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  #15  
Old Mar 17, 2008, 03:38 AM
Registered User
Join Date: Feb 2007
Re: Child Abuse

Originally Posted by dawngloves View Post
Not to disqualify what you are saying, but that would mean that all the babies have a U tox sent. Is this true?
I'm not sure what a U-tox is, but I'm assuming that you mean that babies are screened for drugs.

What happens here, from my understanding, is that many of the mothers are already known "frequent flyers" or come into the hospital absent of all prenatal care (which happens alot here), others are very honest about their drug use or start exhibiting symptoms that tell a different story from what they are, or that the baby does after birth.

No, it's not routine for every baby, but it ends up manifesting itself somewhere along the lines of their hospital stay.

Even our instructor was telling the class, "The normal, married couple, that work, have health insurance...isn't quite what you are going to see a whole lot of."

These are relatively small hospitals that do maybe 8 to 10 births a week.

I was as shocked to hear that as you are. I even looked at the LPN and said, "Come on, 50%? That's half!". My instructor was sitting there nodding her head, "You'll see!".

To put it in total perspective of how bad the social services department is...there was a case here about 6 months ago that made the paper where a guy was driving down a 4-lane highway past a trailer park (where the speed limit is 55 MPH) and noticed there were kids in the middle of the road....and then noticed that one of them couldn't have been more than 2 years old...was totally naked, it was about 55-60 degrees outside.

He called the police, they came out, found out where the kids lived and found the mother naked in the bed, passed out, drunk, with her boyfriend, who was high.

The children were taken away for about two weeks and returned to the mother b/c they said that since the children were not actually harmed...no crime was committed.

Yup...my jaw hit the floor when I read that too.

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  #16  
Old Mar 17, 2008, 08:38 AM
Registered User
Join Date: Jun 2006
Re: Child Abuse

Originally Posted by SteveRN21 View Post
Yep, a lot of them tried that.

Then they show up abrupting due to cocaine use, or infected from the waist up because they were too high to realize it, or delivered kids in the toilet because they were too strung out to realize they were in labor.


And they went to jail anyway.
not all, and you ended up with more dead/damaged infants, didnt you?

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  #17  
Old Mar 17, 2008, 09:58 AM
NICU_babyRN (Female)
Registered User
Join Date: Jan 2007
Re: Child Abuse

Every baby on my unit is "mec screened" always.
We see A LOT of positive mec screens but hardly ever is there much that can be done. Our social workers are AMAZING at their efforts to send babies home to safe environments.
I live in a large city and the drug problems are not sparse...but still, in the last year I know of only two babies who didn't go home to mom. I'm disgusted that I actually discharged a pt home to mom who was in drug rehab...but "she was taking the right steps" so the court felt it was safe.
I learned that this mom relapsed and this baby has been tossed between mom, grandma and foster care for the past 7 months. SICK.

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  #18  
Old Mar 17, 2008, 10:07 AM
jlsRN's Avatar
Senior Member
Join Date: Jun 2007
Re: Child Abuse

Originally Posted by Addy_NICU View Post
Every baby on my unit is "mec screened" always.
We see A LOT of positive mec screens but hardly ever is there much that can be done. Our social workers are AMAZING at their efforts to send babies home to safe environments.
I live in a large city and the drug problems are not sparse...but still, in the last year I know of only two babies who didn't go home to mom. I'm disgusted that I actually discharged a pt home to mom who was in drug rehab...but "she was taking the right steps" so the court felt it was safe.
I learned that this mom relapsed and this baby has been tossed between mom, grandma and foster care for the past 7 months. SICK.
Good Grief!!!

I think the system just must be overwhelmed. They probably don't have enough foster parents to handle this volume of drug babies. How terrible sad.

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  #19  
Old Mar 17, 2008, 06:24 PM
SteveRN21's Avatar
SteveRN21 (Male)
dayshift wannaB
Join Date: Apr 2005
Re: Child Abuse

My last job, we did a meconium screen and UDS for any abruption, or no/limited/unknown PNC moms.

I have YET to see one done here in my new job, and I've been here almost 9 months.

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  #20  
Old Mar 18, 2008, 01:16 AM
Sweeper933's Avatar
Sweeper933 (Female)
Senior Member
Join Date: Nov 2005
Re: Child Abuse

Originally Posted by SteveRN21 View Post
I have YET to see one done here in my new job, and I've been here almost 9 months.
Wow...

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Ethical Issue - Child Abuse

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