Child Abuse

Specialties NICU

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rph3664

1,714 Posts

Not to disqualify what you are saying, but that would mean that all the babies have a U tox sent. Is this true?

Our hospital tests the meconium when they suspect prenatal drug exposure because it's a very reliable indicator of exposure that won't show up in a urine screen.

ilstu99

320 Posts

Specializes in NICU.

All of our admits get a mec sent, and infants with a weird presentation or known risk factors will get a U screen. Our providers feels as though the child's right to proper treatment outweighs any perceived privacy issue. After all, it's the child we're testing and treating.

We have a ton of + screens. All we can do is make the call, and CPS takes it from there. They will send a child home with an addict parent who comes every day, completes all the parenting classes, is involved in care, etc. The parents who have kids that don't go home are the ones who are ++ AND argue all the time with the staff, don't show up for CPR/monitor training, only stop by for a few minutes once a week and so on.

Our social worker sucks, but the CPS folks have been very diligent. I just have to let it go when I've done everything I can. It doesn't get easier, though. The ones that stick in my craw the most are the ones who kind of....gloat.....when they leave. I don't know how else to explain it, but it makes my skin crawl.

ruralnurs

142 Posts

Specializes in Psych, ER, OB, M/S, teaching, FNP.

I am not a NICU nurse, I am a rural nurse in a tiny hospital, but I need to hang with you guys a bit more. I was on the CNM page and mentioned about women that smoke and do drugs and that I can't understand how a woman can do that and was totally slammed for being judgemental!

Yes I am judgemental when there is reason to be. You nurses see what happens when mom is so self centered, yes it is an addiction but people stop addictions all the time. Don't tell me it is a disease, you can't quit diabetes, you can't quit RA, you can't quit schizophrenia, but people do quit drugs, smoking and ETOH.

I was told that "some people have such hard lives and we need to be more understanding". Ya, you have a hard life but what kind of life is your baby going to have??

You nurses see the effects of these "poor women" and how "hard their lives are" and how "we need to be more understanding". I can only imagaine how frustrating (and rewarding) being a NICU nurse must be.

I will visit your page more often!

rph3664

1,714 Posts

I am not a NICU nurse, I am a rural nurse in a tiny hospital, but I need to hang with you guys a bit more. I was on the CNM page and mentioned about women that smoke and do drugs and that I can't understand how a woman can do that and was totally slammed for being judgemental!

Yes I am judgemental when there is reason to be. You nurses see what happens when mom is so self centered, yes it is an addiction but people stop addictions all the time. Don't tell me it is a disease, you can't quit diabetes, you can't quit RA, you can't quit schizophrenia, but people do quit drugs, smoking and ETOH.

I was told that "some people have such hard lives and we need to be more understanding". Ya, you have a hard life but what kind of life is your baby going to have??

You nurses see the effects of these "poor women" and how "hard their lives are" and how "we need to be more understanding". I can only imagaine how frustrating (and rewarding) being a NICU nurse must be.

I will visit your page more often!

It's one thing to do terrible things to yourself. It's quite another to do terrible things to an innocent baby.

Atheos

2,098 Posts

This is a really tough subject and one of the saddest things I see ...... makes me the most mad too.

I'm talking about moms that abuse their babies in utero.

That's legal, correct?

Mom can do all kinds of drugs, that's ok. At the worst, the baby will be taken into CPS custody (and even that's not always the case).

So, where does it end? Are there any states that do anything to these mothers? Do the babies have any rights to health and protection? Or since this damage is done in utero, then nothing can be done?

This is quite an oversimplification of a complex issue. While women shouldn't be allowed to use drugs while pregnant, expecting someone to quit an addiction cold turkey is quite unreasonable.

Plus, where is the limit of 'Government' control.

While I understand why people are angry at these women, it is quite apparent that the people most angry have no understanding of addiction. A person in the grip of an addiction is not only no longer in control of their life or body, they can't be expected to make a decision such as 'stopping because they are pregnant.'

The only courses of action would seem to be A) involuntary detention (unfeasible d/t large numbers of addicts) B) sterilizing of addicts (ugh human rights) C) taking the baby (too little, too late). D) Allow addicted women free access to abortions.

So to answer your question... It won't ever end. Even if babies have rights in utero, protecting those rights is not feasible.

The biggest question of course is when does the baby become a separate life. I would imagine that by the time the limit for abortions has passed that the baby is already damaged. Of course if it before the limit, according to the gov't it isn't a baby yet and not protected.

So what can you do?

Specializes in NICU.
While I understand why people are angry at these women, it is quite apparent that the people most angry have no understanding of addiction. A person in the grip of an addiction is not only no longer in control of their life or body, they can't be expected to make a decision such as 'stopping because they are pregnant.'

I definitely understand addiction. I was angry when I made that first post months ago ..... after watching that baby die due to mom's choices.

I understand it's hard for these women to just stop doing the drugs even if they're pregnant. But 8 pregnancies later ..... 8 drug-addicted babies later ..... and a handful of those babies are dead or non-functioning ..... I'm sorry, but that makes me SICK.

There's a way to stop pregnancy from happening. If they want to continue with their addiction ..... they need to keep from getting pregnant. And that's not that complicated. IMO.

Atheos

2,098 Posts

I definitely understand addiction. I was angry when I made that first post months ago ..... after watching that baby die due to mom's choices.

I understand it's hard for these women to just stop doing the drugs even if they're pregnant. But 8 pregnancies later ..... 8 drug-addicted babies later ..... and a handful of those babies are dead or non-functioning ..... I'm sorry, but that makes me SICK.

There's a way to stop pregnancy from happening. If they want to continue with their addiction ..... they need to keep from getting pregnant. And that's not that complicated. IMO.

It is when they are out having sex trying to get a fix. At that point, there is no reasonable way to expect them to think about safe sex. Not with a fix on their mind...

This was my main point. Someone under the influence of drugs and someone that is jonesing is not in their right mind and can't be expected to make a rational decision. That's what I meant by people not understanding addiction. At that point in time, the only way to prevent sex from leading to pregnancy is an outside influence.

Everything is complicated with addictions. Opinions notwithstanding...

Specializes in NICU.

I'm definitely not in favor of the government stepping in and holding our hands ... telling us what we can and can't do. But some people (these drug-addicted moms in this case) obviously need someone to hold their hand and tell them what they should/shouldn't be doing. You're right, they're not thinking rationally. So do we offer free birth control? Free abortions? Free tubal ligations? I don't know if "free" is the actual answer though .... it might not be all about the money. It's, like you said, about the fact that they're not thinking rationally.

You're right it's complicated. And there's really not a damn thing I can do about it, except vent and share my opinion.

Elvish, BSN, DNP, RN, NP

4 Articles; 5,259 Posts

Specializes in Community, OB, Nursery.

After spending 12 hours in the nursery last night with a tight, jittery, miserable, screaming methadone kid and doing my damndest to take care of her bleeding raw bottom, I can understand that vent completely.

ilstu99

320 Posts

Specializes in NICU.
While I understand why people are angry at these women, it is quite apparent that the people most angry have no understanding of addiction. A person in the grip of an addiction is not only no longer in control of their life or body, they can't be expected to make a decision such as 'stopping because they are pregnant.'

It's quite possible to both understand addiction AND be very angry when you watch a child die due to said addiction.

And for the record....no two addicts are created equally. Some are quite capable of quitting. I don't buy that the addict is always the victim of a horrible monster over which they have zero options or control. If that were the case, no one would ever even begin the road to recovery.

Mimi2RN, ASN, RN

1,142 Posts

Specializes in NICU.
After spending 12 hours in the nursery last night with a tight, jittery, miserable, screaming methadone kid and doing my damndest to take care of her bleeding raw bottom, I can understand that vent completely.

I'd love to see these moms go off methadone cold-turkey! We see them get into a program a month or so before delivery, then have a baby who has started out life on heroin/methamphetamines/marijuana/alcohol/cigarettes (take your choice), and now gets methadone added to the mix! Poor babies! And because mom is in a program, she will take the baby home, which seems to be real potential for child abuse.

Then mom goes home while we take care of her kid, and has methadone as long as she wants it. The last one didn't like the way it made her feel, so she quit the program and went back to self-medicating!

We often put the little ones on methadone, and wean as they grow.

Then there are the moms who use legal narcotics for various aches and pains, who have the same drug babies, and want to breast feed! At least the babes have a steady intake, which is easier on them. Hopefully they don't breastfeed for years.

Elvish, BSN, DNP, RN, NP

4 Articles; 5,259 Posts

Specializes in Community, OB, Nursery.

We usually wean our methadone kids on morphine. Wish we'd do it on methadone. It might take a little longer but their scores are so much better.

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