Comfort Measures...what does this mean to you?

  1. Hey, ya'll... I just got home a little while ago after a pretty rough night. I knew a friend of a friend who was pregnant, and last night she had SROM and out popped her little 19 weeker, right there on the bed, before the doctors could even be called. They held the baby for forty-five minutes, but after being born with a heart rate of 48, they couldn't take watching the baby fade away and asked for it to be brought to the nursery. Mom was SO heartbroken, it just killed me- first baby for her, so excited. I mean Jesus, I have the gift for her shower here in the closet. The baby was brought to us at three-thirty a.m. and finally went at five-thirty a.m. ON THE DOT. It was kind of eerie (sp?) because we were all sitting there, each of us cuddling a baby (first time I'd sat down all night), and we had all the lights off. The only light was the monitor glow, and we were just sitting there, watching the heart rate dip lower and lower, until, when it finally hit zero and stayed there, just about all the alarms went off on all the monitors and babies who had been in a sound sleep became restless, setting off RR or HR alarms. We all just looked at each other, like, whoa. This poor family, I just got to my car after the shift and cried and cried. He looked like a little bruised bird, the eyelids were fused and everything. The baby was like, less than 250 grams. It almost seemed like a shame to have to touch him to do an assessment when he first came in. Anyway, it got me thinking- what do you guys do for comfort measures? In situations like these, and also for the longer-term babies that have had DNR's signed and what-not? Just curious what other facilities and people did.
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  2. 11 Comments

  3. by   renerian
    How very very sad......

    renerian
  4. by   baseline
    I'm sorry. What a terrible experience.
  5. by   ucandoit
    First off let me tell you that you probably made that poor baby's last moments a little more secure just by cuddling it. I have had 2 premies and believe me they, especially the younger ones, need all the cuddling in the world. I dont know what other facilities do, but the ones I have been in really emphasise touch and the sound of a warm , soft voice. It really does make a difference, and even if the prognosis isn't good at least they dont leave this world cold and alone.You did a good thing and god bless that family.
  6. by   dawngloves
    How sad! We don't even get them on our floor if they are <23 weeks. They stay on L&D. I haven't had a comfort measures only admit, so I'm not sure of the policy on assesment. That would seem pointless to do it one that little one.
  7. by   kids
    I have never done NICU but have been with many adults, chilren and older babies when they passed...you did the right thing.
  8. by   BadBird
    Wow, how awful for the family and nurses. I could never work in NICU or PICU for that reason alone, it would just kill me. I love babies but I will stick with the big babies. I can't even imagine how the poor mom is feeling, it is just truly awful.
  9. by   NicuGal
    We don't get them that young. They would stay with the mom. Was mom there, or didn't she have the option? I don't see the rationale of taking a teeny baby like that away from the family and hooking it up to a monitor.

    Your poor friend
  10. by   kids
    NicuGal...kristi's original post:

    "They held the baby for forty-five minutes, but after being born with a heart rate of 48, they couldn't take watching the baby fade away and asked for it to be brought to the nursery."

    (very emotoin provoking issue, 'sok to not to have caught it the first time)
  11. by   babynurselsa
    usually we just put them in a warm isollete, no monitors or such. If it is a previable. If it is a kid we have been caring for then MS prn. and no code.
    My personal philosophy has always been no baby dies on the warmer. If hte parents aren't there to hold then I will.
  12. by   BBnurse34
    Originally posted by babynurselsa

    My personal philosophy has always been no baby dies on the warmer. If hte parents aren't there to hold then I will. [/B]
    My thoughts exactly (standing ovation) to you Elsa
  13. by   prmenrs
    You don't really need an assessment on that small of a fetus. You can put a sat monitor on to keep track of the heart rate intermittently. Hold the baby, keep it warm--use heat lights, it actually helps them die a little faster. Keep them wrapped--it's actually like burned skin they have, so the less air that touches their body the better.

    Take pictures and foot/hand prints. Some people have a little memory box--if you have appropriate stationary, you can write a little condolence note. We had a Resp Care Practitioner who made plaster castings of the feet and hands from a kit she got from ?Zany Brainy, I think. She'd color the plaster pink or blue, write the baby's name in it. We also had special tiny outfits and blankets for them. And the real tiny diapers.

    It was a REAL baby for that family, so doing all this helps them w/their grieving. Needless to say, Social Work is very involved, and if the family wants spiritual support, baptism, etc., we would help w/that.

    It's amazing that even when it's really busy, somehow, time is found to help families that have lost an infant, even a 17 weeker.

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