[curlilocks23]

hey everybody! i need some help with ideas....i work in a level IV NICU. we average 5-7 babies each every shift (NOT FEEDER GROWERS, either). dangerous, i know. anyway......we have NOTHING for developmental care. it was a major battle and took a big deal from JCAHO to even get Sweetease, and they don't even want us to use that. our head neonatologist doesn't "believe" in dev. care. no gel pillows, no snugglies. He doesn't want us to even put rolls on each side of the babies to make them feel secure. he prohibits us from turning out even 1 light, and basically just wants the kid laid out on the warmer naked. i need some ideas for what we can do for these babies, using just what's available to us. thanks!

[dawngloves]

What is his rationale??? And if you can't even do a blanket roll how can you get away with using anything else?
Boy, that guy must have issues!

[curlilocks23]

he doesn't have a rationale. and unfortunately, he is one of those doctors that nobody will question, most people are afraid of him, blah blah. he is just nuts. he has some new obsession every week. this week, it's that the og tubes can't be secured to the ett holder (which means more tape on the babies faces) .who knows.

[prmenrs]

Does he read professional journals? Does he believe in science!!! Sheesh.

There is PLENTY of data out there to support developmental care. Not to mention that these are HUMAN infants we are dealing with, not aan inanimate science project. Developmental care could be supported just by compassion!!

If you are in a teaching hospital, I don't understand why: a. you don't have better staffing, and b. why he doesn't "get it" about developmental care.

If I were you, I would hightail it outta there--you are in such a dangerous situation, your license is @ risk. What a scary scenario. I'd really like to have a word or two w/your neonatalogist, but I'd have to have a lot more Paxil first.

I think you touched a nerve, here...

[KRVRN]

And what is this 5-7 babies sh!t ?!?!

[EXOTIC NURSE]

Wow I would die if I had to care for five to seven babies that were not feeders growers but five to seven feeder growers is too much ...........the most we do is four feeders and growers...which is a bit heavy I think......but I am a new person in NICU so basically any assignment is a task for me......lol......

[dawngloves]

Originally posted by KRVRN
And what is this 5-7 babies sh!t ?!?!

I couldn't have said it better.

[Anaclaire]

I've been pondering this situation and for the life of me can't think of any solution. I've known the "old timer" neonatologists who are set in their ways and love being controlling, demanding, and spoiled. It's an ego thing. We feel most of them suffer from SDS ("short d_ck syndrome").

Anyway, if I worked there, I'd be gone as fast as I could put in my two week notice. The place sounds like a lawsuit looking for a place to happen. (5-7 babies per nurse is soooo way beyond frightening!!!) On the other hand, if you can figure out how to do it, you have an awesome chance to inflict wonderful changes for the better in your NICU. At least you are trying to figure out an answer, thank Goodness!

Being a Level IV NICU, surely you have a Nurse Manager and/or a Clinical Nurse Specialist who can help pull together a list of current information on the benefits of developmental care to give to him. When the bottom line is that the babies get well sooner and better and this leads to less "patient days", this should be all you need to get your Administration to insist your Neonatologist review the literature and explain to them why he doesn't believe in saving the hospital money. I know the NICU makes money for hospitals, but they can still cost the hospitals a lot too. Sometimes these ridiculous physicians need to be hit in the pocket in order to sit up a listen to reason.

All I can wish you is good luck... and lots of it!

One thought: We encourage our Moms to sleep in a clean t-shirt for a night or two and then bring it to the hospital for us to use as part of their baby's "roll" to help the baby get used to their Mom's scent. The Moms usually bring a new one every other day and take back the old one to wash and re-wear. (We encourage colored shirts so they don't accidentally get thrown away.) If he'd let you do that, then at least you'd have some semblance of a roll to use for containment purposes. Do you think he'd "allow" that?

I just wonder where your Nurse Manager is in all of this? Did everyone at your hospital who have any pull at all forget about nurses being Patient Advocates???!!!! I know as a staff nurse your pull is very slight, but for Goodness sakes, surely someone in a position of more responsibility cares!!!

Big Sigh!!!
God bless you all!!!!

[curlilocks23]

thanks to everybody that responded. 5-7 babies is average, but i have taken care of up to 10 on a shift. this is so dangerous, but it's kind of like nobody thinks 5 babies is bad after those 9 or 10 baby days. he refuses to send even little og feeders to other hospitals because he does make so much $$ for the hospital- not that we or the babies benefit from it. i love being a NICU nurse and i know this is my calling, but i'm very frustrated with this right now, and i hope my prn job at another hospital (much more baby-friendly) will turn into a full time thing. i feel like all i'm doing is helping to keep these kids alive, not helping them grow at all. thanks for all the good ideas, and God bless all of you!

[NicuGal]

Okay I have to ask....what is a level IV and what kind of kids do you have? We are a level III and we have everything but ECMO and cardiacs.

1. You have to have a CNS on staff, that is a requirement for any NICU. She should be working with you on this.

2. Where is your unit manager?

3. Where is the legal department?

4. How about a call to the division head?

5. How about a call to the head of the hospital?

6. How about refusing the assignment?

It seems there are many other problems here...one, he doesn't rule your staffing, does he? That is the unit managers job and it seems that she is doing a poor one at that.

Not knowing what a level IV is , I can't tell you what staffing or ratios you need.