Holy mackeral....we are having an influx of methadone kids!Register Today!
- by BittyBabyGrower Nov 2, '10And I don't mean just one or two, but we have 8 right now...yes, you read that right! The NBN ships them to us because they can't handle them, we don't have the staff to only take one other kid with them and they scream for hours! Usually right next to a micronate who can't stand it either! These poor kids!
We were told there are about 20 more going to deliver in the next 2 months...where the heck are we gonna put them!
Anyone else having an influx of these poor souls? And what do you do with them! We need a long term withdrawl unit just for these kids!
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- Nov 3, '10 by NebraskaRNYes we have a ton of ISAM kids! At least 1 in every assignment it is crazy! Even if they are not screaming you still have to give them Morphine every 3 hours which is a lot of time going to get the medication and getting a witness.
- Nov 3, '10 by mauigalso are we. and belive me these are some really addicted babies with super manipulative mothers! some of these babies need to be a 1:1 assignment because they need to be held so much.
- Nov 4, '10 by ElvishI work in a well-baby-plus, and we generally keep the withdrawers with us, unless they start seizing.
We have had an unusual run of having NO withdrawers with us for a while. Most of the time we have at least a couple. I think our record - for a well-baby, mind you - was six. At one time. For 2-3 nurses. It can get very taxing. I don't mind taking care of them because I can usually settle them (goodness knows we've gotten enough practice), but it's still emotionally draining. I have to give our NPs credit, though...they are very very good about meds. ALL our kids get started on q4h morphine (standing, not prn) for 3 consecutive scores > 7, and phenobarb if they need it. It makes a huge difference.
We also have long since been advocating for a peds room for these kids, so someone can stay with them 24/7 or a 'convalescent' (for lack of a better word) nursery that is separate from both NICU and well-baby. That way they don't stress the micros, and the well ones don't stress them.
- Nov 5, '10 by BittyBabyGrowerWe have suggested the peds floor too so that the moms that are there all the time can room in with them and the child life people can come and sit with them. We have one peds floor that is closed and those girls are getting cancelled all the time. It is like a turf war. But yet, when we are full, the attendings are like, you need to move that screaming kid out of here...it is making that micronate/PPHN kid do bad. Well, where would you like me to put him/her...how about your office?
These kids are so time consuming and the parents freak out if they come in and they are screaming. It is frustrating all around. It is like we need a mom/baby rehab floor lol I have one that is my sidekick all the time....I always joke that he is going to be the next charge nurse in our unit lol
- Nov 6, '10 by prmenrsIf you don't have a volunteer "cuddler" program, now would be great time to start one!! No, this time, I'm not kidding. (If I had my druthers, the folks who run the methadone programs would be required to show up for this activity!) If I lived anywhere near you, I'd be happy to help.
Get a "team" together and develop a drug protocal that works. Morphine, Methadine, and Tylenol can be scheduled in such a way as to keep the kids happy. Scheduled, not prn!!! Last baby I had, couldn't believe the # of times I got "he didn't get any Tylenol, I didn't think he was in pain, just hungry."
Addition of Mylicon and thickening feedings to help decrease the GI motility and irritability, i.e., diarrhea 2nd to overeating/overfeeding. As soon as his/her cord is healed, start giving tub baths.
It's a tough job, but when they finally equilibrate and start getting off the "big" drugs w/o a lot of drama, it's really rewarding.
- Nov 9, '10 by BittyBabyGrowerThey are talking about cuddlers. We historically have not used them because when we did, we had a lot of parents that did not want strangers coming in and holding their kids. But, with these kids, we need someone!
They are also setting up a meeting with the methadone counselors who are hell bent on telling these moms that the kids will only withdraw on day 4 (and how many of them start on day 1...a lot!) and will only be in the hospital 7-10days to detox. Wrong. I have never had one there that short of a time. And they also tell them about the scoring...and they are telling them wrong info. It just creates a bad time all around!
We are actually developing a PI project out of this.