why are most babies on methadone weans in the NICU? i used to work in peds rehab and remember getting lots of NICU grads who came to us for narcotic wean as well as parent training, feeding, etc.
Quote from NurseRoRo
thanks for the input. i now work in the operating room and we do surgeries on adults as well as neonates. the hospital just started doing neonate surgeries, and of course we have lots of nurses who are freaked out about doing surgeries on babies (the whole i'm an adult nurse, not a baby nurse attitude). whenever one of our nurses gets report about a NICU baby who's on methadone, everyone sighs and goes "oh geez. another baby who's addicted thanks to mom. they've got so many other problems and drug addiction shouldn't be another one, too...it's so sad...blah, blah"
i have tried to tell them that just because a baby's on methadone, it's not just because of in-utero addiction. unfortunately, i didn't have any other plausable reason, other than long term ventilation/paralyzation/sedation. then i got the "but why do the even use methadone or morphine...we don't use those drugs when we sedate/paralyze our patients in the OR?" can you say, i had a big brain fart and no response???
so...thank you thank you! it's hard to be the newest staff person (and the youngest with the least amount of OR experience) to educate others who are set in their ways. but luckily, i get to do most of the baby cases based on my background (my whole nursing career has been peds and peds rehab) i know i wasn't crazy or delusional when we got admissions for narcotic weans from the NICU. i know not every parent was a druggie!!!
Thanks for the info!
Honestly, any NICU grad that is having surgery and is on methadone is probably on it because WE got them addicted to narcotics, NOT mom. Babies born to moms that are on heroin and methadone don't typically have problems that require surgery, unless of course something happens to them in the NICU. Usually it's a baby that is either surgical or otherwise very sick at full term, and we've got them on narcotics for so long, and in such high doses as they become toleratant, that by the time they're WELL we've got a little bit of an addict on our hands, unfortunately. Many NICUs have pain teams or committees that put out guidelines for things like increasing the pain med every few days so the baby still gets pain relief and sedation as they grow more and more tolerant to the medications.
I've had a lot of people ask me why we use so much IV narcotics on these babies when in the OR they don't use that stuff. Difference: GAS. We don't use anesthesia gasses on young babies, especially preemies. When they have surgery, they get things like pancromium for paralyzation, fentanyl for pain, versed for sedation, etc. We even do surgery IN the NICU for kids too unstable to go to the OR. So that's a big difference between neonatal surgery and adult surgery. After they're full term, I believe gas is okay for them, but I could be wrong.
So yes, if you guys get a baby that is addicted to narcotics post-NICU and also has surgical problems, it's most likely NOT the mom's fault! It's OURS!
Last edit by Gompers on Aug 20, '06