NICU Burnout...need to cry

  1. Last pay period I put in 105.5 hours. Being part-time I am nowhere near that amount this pay-period...Thank God! In these last three weeks I have had the sickest of the sick and the saddest of the sad. One baby is already gone from overwhelming staph A. Those of you who know what that does knows how horrible and revolting it is. Think of a neonatal burn patient. Another with chromosomal defects that are really rare. Term. PPHN. Blown up like a tic. No urine output for WEEKS. Parents blindsided and angry, directing it at the medical staff. She is now partial code...meds only...but she keeps hanging on. She wont make it...its just a matter of when. The third is a boy who has circled the drain so many times we thought he must be invincible. He has been with us for 9 months. His Mom has witnessed everything to the point you want to shield her from it because you truly care about her and what she has gone through so far just to see it probably end this way. Last night,as I was bagging him for a HR in the 60's and sats in the 50's, she calmly explained to her mother what we were doing. I'm thinking ***??!! How can she be so calm while I am trying to be cool and not shake like a leaf? God Bless Her. Last week there was a big debate over whether we should send him to PCN. Full feeds, nasal canula. He has been with us for nine months. He finally wore out and coded. Cor Pulmonale. I have had to care for him for the last two nights. HFJV, iNO, drips...you never know when he will try to die or for what. I started the shift bagging him and ended the shift bagging him. I dont care what anyonyone says...if you bagging a kid on iNO you are getting alot of NO in your own system. By 0640 I wanted to sit down and cry. I had to stop myself from melting down right there. I can't help but to stop and wonder if anything I did different would have helped. I know I did the best I could. Now I am at home and wish I could just cry but all I feel is numb. I turn 40 tomorrow, I hoped it would be a happy birthday but right now I just want to cry and can't. Thanks for listening I think I can cry now.
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  2. 19 Comments

  3. by   Gompers
    :angel2: (((( HUGS )))) :angel2:

    I'm glad you have a place like this to get your feelings out and let yourself cry when you need to. We work in such a unique area of medicine - not many people understand what we go through. It's great that we have each other, even if it is over the internet.

    When I experienced my first neonatal death, one of the nurses on my unit told me that it was okay to cry. She said that when the death of a baby STOPS affecting you, then it's time to get out of the NICU. It's always heartbreaking to lose these babies. Sometimes it's even more heartbreaking when they hold on for too long and we have to watch them suffer. There are worse things than death, don't you agree?

    Where we work, there are such highs and lows. You can take care of a baby that is sicker than a dog one day and come back three days later and find out that the baby has turned the corner and is doing amazing. Babies are so resiliant!!! You can also take care of a stable feeder-grower who gets sick and is dead in a matter of hours. When the kids are doing well, it's wonderful - we're watching miracles happen and are so happy for the families when their babies get better. But when the kids are doing poorly, it's downright heartbreaking. Not many people have to deal with the death of a baby, but we do it all the time. Sometimes I wonder where we find the strength.

    I hope you have a good cry and take care of yourself over the next few days. I'm so sorry you're having a rough time at work.

  4. by   muffie
    be sad and blue today but please be happy tomorrow.count your blessings and maybe treat yourself to breakfast out. your pts are very sick. i can't imagine facing that stress everyday. you help families through some very difficult times. please be good to yourself and of course have a great 40. 40 is terrific.
  5. by   iceNICUnurse
    ((((((Big Hug to you)))))

    I hope you will feel better tomorrow.

  6. by   suzanne4
    And as stated above, in the NICU, you will have good days and you will get horrible weeks. But we do it for those that can be helped.............and will be helped. There will be those that leave the unit and ready to go out and live, and others that do not make it out, but remember, you were there for them.

    It can be a very trying unit to work in, and some weeks you want to give it all up. Perhaps taking a few days for yourself...............it won't make the ugly days go away, but can give you a bright one to focus on.

    And give yourself a big hug from all of us...................
  7. by   RebeccaJeanRN
    Thanks for using this site to vent. I don't know how I believe this so strongly...maybe from the obvious way in which you are affected by your recent patients...but I have a strong sense of the blessing that you are to so many (patients and families alike). I think that the price for caring so much is the inevitable occasional meltdown, which you should allow yourself. Please come back and keep venting. We are listening.
  8. by   BlueYYsRN
    My husband and I went to the local comedy club tonight...we had a great time and laughed alot. When I got home I saw that my nurse manager had called and when I called her back she told me that my baby had died about an hour after I left this morning. I will attend this funeral but I don't really know what to say to this mom. I sat by this babys bedside most of the night. I was the last nurse she saw him with alive. This is the worst of our world.
  9. by   EricJRN
    It does really sound like you've been seeing some worst case scenarios lately. I'm really sorry to hear that it has seemingly all decided to hit at once.

    With the mom, don't underestimate the value of a hug, an 'I'm sorry' and a listening ear. Your actions in his last hours have probably already told her more than any words ever could.
  10. by   RebeccaJeanRN
    Quote from BlueYYsRN
    My husband and I went to the local comedy club tonight...we had a great time and laughed alot. When I got home I saw that my nurse manager had called and when I called her back she told me that my baby had died about an hour after I left this morning. I will attend this funeral but I don't really know what to say to this mom. I sat by this babys bedside most of the night. I was the last nurse she saw him with alive. This is the worst of our world.
    Oh, I'm so sorry to hear this. But not to worry about finding just the right words for the baby's mother. What speaks more clearly to this mother than any words is simply the fact that you did all you could plus you cared. What mother could ask for more?

    When little ones have to suffer and die, I agree with you...it is truly the worst of our world.
  11. by   dawngloves
    I totally understand. Last month I was given the sickest sickys we had for days in a row. The ones on the highest settings, 100% o2, maxed out on Dopa, just waiting for them to expire. I finally had to ask for them to stop assigning me the kids walking toward the light because I couldn't take anymore.
    Talk to your NM.Tell them you need some respite from the high accuity and would like some feeder/growers for a couple of weeks. Hopefully you have a NM that understands.
  12. by   CHATSDALE
    my grandsons baby born premature is in nicu as we speak...
    when first born needed assistance breathing, could not maintain body heat,
    needed ng tube due to absense of sucking reflex-jaundice

    in a week he has progressed still has ng tube but is taking at least half of nourishment from bottle, O2 weaned down to minimum was to be removed yesterday evening, turning into beautiful little new born, in a large part d/t a nicu nurse like you

    the things that you do makes a BIG difference in these families and in these babies...you can not save them all but bless you for being there and making such a contribution
  13. by   Gompers
    BlueYYsRN, I'm so sorry to hear that "your" baby passed away. Nine months is a long time to be with this family. I'm sure just your presence at the funeral is enough - there really are no words necessary. Just a hug and an "I'm so sorry" are usually all you can do. Parents really do appreciate seeing their babies' nurses at the services, as we knew their children better than most of the people there. I go to the funerals for my own sense of closure as well. (((( HUGS ))))

    Quote from dawngloves

    Talk to your NM.Tell them you need some respite from the high accuity and would like some feeder/growers for a couple of weeks. Hopefully you have a NM that understands.
    I agree. I've had to ask for this several times over the years myself. We always try to assign nurses to feeder-growers after they've been having a rough time in our NICU. After the trauma of losing a sick baby despite our best efforts, sometimes the only thing that makes me feel better is to hold and feed a growing preemie to remind myself WHY I'm doing this.
  14. by   BlueYYsRN
    The third baby passed yesterday morning at 0100. I had a long talk with my nurse manager yesterday and she was very supportive and told me I had done a wonderful job taking care of all those sick babies. It was really nice to hear and it was really nice to vent. For the 9 month old we are going to take our time and put together a scrapbook for his mom. We tend to take alot of pictures and I know we have many of him. The staff will write their own recollections and thoughts in there as well. This will be the second time we have done this since I started working there almost 4 years ago so I guess its good it doesn't happen that often.

    Thank you all for being there and being so supportive. Internet hugs are just as comforting as real ones.:icon_hug:

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