Curious to hear NICU nurses perspective--23-wkr, NEC m - page 2

Parents fighting hospital to continue aggresive measures.... Read More

  1. by   BittyBabyGrower
    gompers, you're probably right about the IV fluids...we just leave them on TPN.

    I agree, prmnrs....it is hard not to be cynical....I hate situations like this. I was very bothered by how they are lashing out at the staff on a public forum...how they wish that people would quit looking at them, etc. It would be very hard not to have a bit of resentment towards this family since they took this to the media and have made the hospital out to be the bad guys. The media loves this kind of stuff and it is going to make it worse. And I know that that staff is going to need a lot of support during this terrible time.

    I hope this little girl goes quietly....I hope that the parents will at least let hospice come in for her.
  2. by   NotReady4PrimeTime
    Whatever happened to criteria for treatment of microprems? I've been out of the neonatal loop for a while, but it used to be that the fetus had to be 24 completed weeks or >500 grams before treatment was expected. This poor babe never had a chance and needs to be allowed to die.
  3. by   BittyBabyGrower
    jan, anymore it almost anything goes. If it looks like they can intubate it, they will. We occasionally get the 22wk kid that is almost 500g and it is awful. Docs are too afraid of getting sued. There was a case here in the states that a father sued over his 23 week twins that were devastated and died...he said that they didn't do everything that they could and now that has sort of set the precidence (sp?) for all kids.

    We cringe when we hear that there is anything under 24 weeks over in L/D....the parents just don't understand even after the fellows go over and consult on them
  4. by   dawngloves
    :yeahthat: If parents want a full code on their 22 weeker because they have a cousin who's friends niece was a 21 weeker and is normal, we will code that kid. And if we can't get a tube down their throats, we will put it on CPAP until they die of sepsis.
  5. by   NotReady4PrimeTime
    How terribly sad! Instead of really being with their child for whatever time is permitted by our Higher Power, they choose instead to spend thier time with lawyers and reporters. I'm glad in a way that medical malpractice is very hard to prove in Canada and that the settlements handed down by Canadian courts aren't worth the trouble. But even in my world of bigger kids we see a lot of things done because the family wants them, not becuase they actually are good for the child. It's so hard on the nurses who have to provide futile care, and I so hope that those involved with Emmie-Rose have support in their workplace.
  6. by   Gompers
    Quote from janfrn
    Whatever happened to criteria for treatment of microprems? I've been out of the neonatal loop for a while, but it used to be that the fetus had to be 24 completed weeks or >500 grams before treatment was expected. This poor babe never had a chance and needs to be allowed to die.
    I believe the current NRP guidelines are 400 grams OR 23 weeks. So every once in a while we'll get a 500 gram 22-weeker or a 300 gram 25 weeker, things like that. They are a little lenient sometimes because dates can be off and you don't know for sure until the baby is properly assessed. Where I am, if we know for sure that they are less than 23 weeks we won't do anything, and under 24 weeks the docs usually try to talk to the parents first about letting the baby go instead of intubating in the delivery room.
  7. by   RainDreamer
    You want my perspective and opinion on it? I think it's sick and selfish what they're doing to this poor little baby. My heart really goes out to the parents, as I can't imagine what they're going through. But this baby is suffering and there's nothing that can be done. They're keeping her alive for their own selfish reasons. So so sad.
  8. by   Mimi2RN
    Quote from RainDreamer
    You want my perspective and opinion on it? I think it's sick and selfish what they're doing to this poor little baby. My heart really goes out to the parents, as I can't imagine what they're going through. But this baby is suffering and there's nothing that can be done. They're keeping her alive for their own selfish reasons. So so sad.
    :yeahthat:


    Then they will probably sue the hospital and everyone else involved!
  9. by   t2000JC
    Oh these situations just put a pit in my stomach. It's funny, right, how "God's will" can be interpreted (translating to giving life-saving support or taking it away--it's all up to the interpretor!) I guess the ignorance bothers me, how people would interpret this as heartless medical professionals sticking it to loving, devoted parents. Plus the posts on the nurses are on the one hand grateful and on the other hand condescending..It really annoys me how all the posts have such a us against them attitude on the blog..But..this debate is definitely an issue in neonatal care, and needs to be addressed. Who decides what's the best thing? And if we can do something, does that mean we should?
    Bottom line, I think this is another case of poor communication. The parents think they know what's best, and maybe there is noone they can trust telling them why the MEDICAL PROFESSIONALS made their decisions. But what care should be stopped and what shouldn't? And then again...I have never been in their shoes, and who knows what my reaction would be.
    sorry this post is kinda confusing..it's late..t.

    ETA: I think I am a little confused about the whole witholding TPN thing; and how that translates to a baby that has no small bowel? And who's vented? And just making that decision of witholding all these things when the parents are clearly against it? I guess I want to know more of the story than I got, and what I got is one-sided.
    Last edit by t2000JC on Sep 20, '06
  10. by   Nikki730
    I read on their website this evening that their baby passed away. I'm sure they are devastated. It is so sad--yet it sounded like their child couldn't recover--she was just barely surviving, so they kept hoping...
  11. by   BittyBabyGrower
    Rest in peace little girl. I wonder what kind of media circus this will be
  12. by   MarySunshine
    Very sad

    When I was in end stage labor with my 23 week old twins the neonatologist explained the situation to me in detail. He really did not offer me the option of resucitative measures (and I didn't ask). I'm glad he didn't because then I wouldn't have known what to do. It doesn't seem fair to torture all of these kids when only a minority survive. Now that I look back with more medical and spiritual understanding, I'm glad they went peacefully.

    I believe that this education should be done early on in pregnancy so that parents NEVER have to make a wildly uninformed, emotional decision in an emergency situation.
  13. by   justjenny
    Quote from janfrn
    Whatever happened to criteria for treatment of microprems? I've been out of the neonatal loop for a while, but it used to be that the fetus had to be 24 completed weeks or >500 grams before treatment was expected. This poor babe never had a chance and needs to be allowed to die.
    Our hospital resuscitates 23 weeks and up - any 22 weekers get the "option" of being resuscitated (Neos and parents discuss - if parents want everything done the Neo can still say "no way - kid is too" small once it comes out and is evaluated) but I just admitted a 22 6/7 585 gram the other day and we had a 23 weeker 440 gram not too long ago....

    Jenny

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