To say I'm completely frustrated and uncomfortable is an understatement. A little background we had a 37 weeker born, hypoglycemic and needed CPAP for 24 hours or so. He is now 39.1 and has had feeding issues from the start. This kiddo has always had a different look about him, he doesn't engage with you, he doesn't wake up for feeds. He was on Enfacare 22 and just did not tolerate consistently having large emesis. He has not nippled well, has been extremely tachypneic and tries to brady-widens his complexes to 102-104-and with that he desats 83-85 and hangs there for 25 seconds or so. We changed his formula to PurAmino thinking maybe something metabolic going on. I am so uncomfortable nippling this kid he is sacked out after about 8 min of this whole scenario. I expect him to get better at feeding not move backwards. It frustrates me that some of our Neos think we exaggerate his symptomatology.
Any and all advice is greatly appreciated.
Nov 7, '17
Ask the neo to watch you feed him. Also (and this is not right- but it might work) have your most experienced nurse approach the docs with your concerns. Sometimes, when you're new- well.....
Nov 7, '17
1. Do you have access to a PT/OT that can assess his nippling?
2. When I was a bedside RN and needed a response, I would phrase it "I am concerned about x, y, z. Help me understand why you're not concerned." Sometimes it takes a direct challenge to make people re-evaluate their thinking. Although that makes me frustrated for you - I'm lucky to work with a practice that really values the bedside nurse's opinion. Good luck!