How common are negative outcomes in NICU?

[LauraLou]

I am a student nurse and have been working in Postpartum this summer. Last week I met a new mother who also has a 2 year old. She told me her first baby was "dead" for 16 minutes at birth before it could be resuscitated and spent 3 months in the NICU. The little girl has severe brain damage, is fed through a feeding tube and can't walk or speak. I saw the little girl and it was so, so sad.

Is that a common outcome in the NICU? Do doctors really try to resuscitate babies who have been without oxygen for so long, or perhaps the mother does not remember the situation accurately? As awful as it sounds, it seems like it would have been better for everyone if they had allowed the baby to die rather than spend her life with major brain damage.

I have always been interested in NICU nursing, but I don't know if I could stand seeing such tragic situations day after day. Is it difficult to work so hard to save a baby knowing it will have no quality of life? Is this something you deal with a lot?

Thank you.

[dawngloves, BSN, RN]

It's not something I deal with day to day. I do see it more often then I like though, being that once is too much.The overzealous code of the birth asphixia,the 23 weekers with the traumatic intubation.

You move on. You care for the next baby and know they'll go home healthy and strong and say a little prayer for those that don't.

[iceNICUnurse]

I think that about 90% of my patients have a cood outcome. That is they go home healthy and happy. The other 10% might not make it home or have some kind of damage that makes them disable for the rest of life.

So you see that most of the time we are working on kids that have good outcomes.

[nurseiam]

A "good" outcome is one persons perspective! I have a ton of empathy for the parents that have no idea what they are getting themselves into. But like I said it is all in ones perspective on what they think a "good" outcome is!

[natasha700]

I really thinks it depends where you work and the general population. I work in a small unit and a medium size and for the most part I don't see too many bad outcomes. When it does it is very tragic and we as nurses try to deal with it. I know there are periods when we get nothing but twins, large babies and a influx of 26weekers. There are bad outcomes in every area of nursing some more frequent than others I suppose. It shouldn't deterr (sp) you from this area. I love the fact that many of these babies do grow and go home. Some come back and look great!

[Mimi2RN, ASN, RN]

In general, we send home good babies, I work in a level II nursery. Unfortunately, we do lose some babies, but others are little miracles. A baby that was a rapid surprise breech, got stuck, dead when he was born, is now a lively two y/o. Another mitey vac baby, major seizures...now walking and talking. We do our best, but we do have help from upstairs. Some babes are destined to be little angels.

It amazes me how quickly we can resuscitate. NALS training showed me how many babies would have been stillbirths, and how effective PPV can be. We resus babies because we have to treat, but it's sometimes a blessing to stop.

Thank God most babies come out healthy, and don't need to see the NICU staff. Even ones that needed a jump start, don't usually need to come to visit us.

[directcare4me]

Several years ago, after being in the NICU for a few, I went through a serious "soul-searching" of whether I could continue to stay and "help" send home the baby with severe problems, whom I thought would have no "quality of life". I felt very discouraged by this; though it didn't happen every day, or probably even every month, it happened occasionally and like a previous poster said, "once is enough".

Someone wiser than me said that we never know what the purpose of someone's life might be; that even a life which has no "quality" might have purpose. She told me of a baby born extremely early, who had every problem in the book. The parents were young, unmarried, drug-users. When finally the baby was able to go home--on Gtube, severe brain damage, meds for seizures, etc---the mom had cleaned up by then and took that little one home and cared for her, stayed clean, basically became a new person.

I know that sometimes I wish the doctor hadn't initiated life-saving efforts, but at the same time, I'm glad it isn't my call. They have to make a decision with life-long consequences in a matter of seconds.

Anyway, this has helped me a lot in my thinking. I do what is in front of me to do, and leave the results up to God.

[neominder]

i have been a nicu nurse for five years, and the overwhelming majority of our patients go home and do well. we have even been suprised by a few we thought would be so badly brain damaged that they would never walk, talk, or so much a sit by them selves were doing all of the above. there have been a few times when i feel we have done a family a disservice, but in that moment you have to decide life or death and if a parent wants you to "save" thier baby at all cost, you have no choice. i can say it makes my job a little more difficult, and i have asked not to care for a baby because i didn't feel we were doing the right thing by that baby, he did eventually die. it is sad, but for every sad story there are so many good and happy endings.