Are we tyrants?

Specialties NICU

Published

The other night, our RT was orienting a new guy to help cover NICU. He was taking him from bed to bed, showing him around and explaining things. I heard one of the nurses on that side of the room tell him "Don't suction my baby unless I ask you to!".

When they got to my private room (with a sick 24 weeker inside), the RT told the new guy: "Be careful with the small ones, because some of the nurses are real tyrants. Especially this guy."

Now, this particular RT is fairly new to our unit, and I have metaphorically slapped his hand several times, because of his tendency to want to suction babies as the answer to any problem. Also not keen on his habit of pouring in the NS when suctioning. So, I've told him to never suction my babies unless I request it. In fact, just don't ever do it...I'll take care of it. If you can't assure me that you got all that NS out that you put into my preemie's lungs, then just keep your hands off.

Me: My heater is beeping, can you reset it?

RT: I'll just suction.

Me: Man, is it really only 4 am?

RT: I'd better suction.

Me: The Texans won!

RT: Hang on, I'll get a gallon of NS and suction!

Most RTs have more experience in adults, where frequent suctioning and use of NS may not have any dire effects. Not so with a micro-gerbil. I know any of you with more than a year or two in the NICU have seen the pulm bleeds and worse that can come from suctioning.

So, my question is: Are we tyrants? Also, is it really a bad thing that we are?

In the interest of being the best I can be...am I out of line on this issue?

I'm also often annoyed by nurses that have no idea whether lab came by to draw blood from their neonate (so, you're telling me someone opened your bed, poked a HOLE in your baby, drew out his life's blood, and you don't even know it happened? Get out!), or who run like a scalded dog every time the portable x-ray machine approaches...so sick of distorted x-rays that you can't even see the lung field for all the crap (lines, leads, ets) in the field.

I was taught by a wise old Neo that we should only be suctioning micros rarely, when we see stuff in the tube or the baby is rattling or if they are displaying sure signs of needing it. The age of q2* suctioning is in the past.

As I would not be apt to ignore my own micro-gerbil in the slightest, I would appreciate a nurse who was of the same mindset. Tyrant, protective, responsible--pick your terminology. I'm all for it!

May I get you your crown, Bortaz? :smug:

I'm not a big fan of this attitude. You are caring for the patient. You do not own the patient. Hospitals for places of collaboration amongst healthcare professionals. This form of extreme territorialism hurts nursing, and is unprofessional.

If the patient was an adult, and the nurse said, "Don't do xyz for my patient" how is that different than saying "my baby" in this context? It's not, really. Yes we all care for our patients but who can deny that the sickest ones we feel a bit more attached to -- because they require more of us. One on one with a tiny infant, yeah, even more so (I imagine). They aren't claiming ownership, they are feeling protective for this tiny life for whom they are providing care and I don't believe that is unprofessional or suggesting ownership.

"So yeah, I claim it as my baby...i'm there to protect them from harm, to get them through the night alive, and to get them home in a few months. I spend hours more time each day, with these babies, than even their parents do"

You still dont get it..... now you have more rights that the parents themselves. It does not matter how much good intention you have. By being territorial only produces a barriers among health care professionals. But forget it. I dont expect you to see that either.

You seriously interpreted what they said like that?? They didn't say they had more rights than the parents. I think it's you who is "not seeing" what everyone is saying. I don't even work with healthy infants and I know what they are talking about.

Specializes in CDI Supervisor; Formerly NICU.

May I get you your crown, Bortaz? :smug:

Sure, with a splash of diet Coke and a few cubes of ice. :)
Specializes in Transitional Nursing.

I would say when it comes to babies there is no such thing as being a tyrant. You are advocating for them and are pretty much their protector while they are in your care. I totally think you're awesome!

Specializes in Surgical,Peds,MBU,LDR.

SaoirseRN: You missed the point and the sarcasm that went with it. The basic point is that being territorial does not help anyone... we are suppose to care for these patients as a team and that we dont own these patients... do you see it now? what is the "protective" nurse going to do on his/her day off? you see?

just dont forget who is the nurse and who is the family. The "territorial" attitude screams unhealthy behaviour......

The initial post seemed more like the nurse did not like that particular RT at a personal level perhaps not sure...and the RN's way was the only way..... that was the point. Again that is an unhealthy behaviour. It does not matter how much you choose to ignore it or look at it is very unprofesional.

I would say when it comes to babies there is no such thing as being a tyrant.

There's no such thing as being a tyrant? Blanket statements like that concern me. Working in a NICU (or any unit, for that matter) does not give anyone the right to act in an unprofessional manner. Just remember this: whatever marvelous acts of nursing you have done during your shift can be completely undone by the next shift, or on your next day off. Be humble, and recognize that fact that you are a cog in the wheel of patient care.

Specializes in NICU, PICU, PACU.

Sure I act like a tryannt at times....my little friends can't speak for themselves and if someone is going to do something that could potentially harm my kid then yea, I will say something. Do it again, I will not be so nice. Especially about normal saline down a tube...not cool. Increase your VAP rates, give the kid a bug that is colonized in the tube....not okay.

And if I am ever a patient in an ICU I hope Inhave a mean nurse to stick up for me!

Specializes in NICU.

I think I understand the territorial-ness better now thanks to this thread. WHen I was a student interning in NICU, it really put me off, but this make a lot of sense. (I was going to look at an alarm to let the baby's nurse know, she saw me approaching and whisper-roared, "Get away from my baby!")

Specializes in ICU, Geriatrics, Float Pool.

I'm in the middle on this one. On one hand nurses should be assertive and prevent anyone from doing harm to the patient. However, you aren't doing your profession any favors by acting like you are the only one who is there for the patient or by embarrassing the RT in front of other staff. That could and should be handled in a professional manner. Being on top of things or being assertive does not give you the license to act like you own the patient. It only causes teamwork to break down among the staff and gives nursing an unprofessional reputation.

Specializes in Pediatrics, Emergency, Trauma.
I would say when it comes to babies there is no such thing as being a tyrant. You are advocating for them and are pretty much their protector while they are in your care. I totally think you're awesome!

This :yes:

I'm on team tyrant...too many risks.

Advocating is NEVER pretty, rosy, or like a sappy classic movie. Sometimes during the advicoting process, too many "reeducations" to a team member, to me equates they don't respect the patient; it ultimately MY responsibility to intervene and make sure that MY patient is not further compromised...adult IS different than Peds...or any one fragile needs to be properly cared for WITHOUT preventable complications....what's MORE unprofessional, IMHO, are the "automatons" (LOVE this, Bortaz, btw! :up: )that go roughshod over ANY patient.

Oh, guess I'm unprofessional...I've had nickname for each of MY patients...:sarcastic:

SaoirseRN: You missed the point and the sarcasm that went with it. The basic point is that being territorial does not help anyone... we are suppose to care for these patients as a team and that we dont own these patients... do you see it now? what is the "protective" nurse going to do on his/her day off? you see?

just dont forget who is the nurse and who is the family. The "territorial" attitude screams unhealthy behaviour......

The initial post seemed more like the nurse did not like that particular RT at a personal level perhaps not sure...and the RN's way was the only way..... that was the point. Again that is an unhealthy behaviour. It does not matter how much you choose to ignore it or look at it is very unprofesional.

I disagree. I think you have missed the point and are looking at this the wrong way.

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