NICU nurses resistant to holding babies?

[marnie]

I have a question for all you experienced NICU nurses: is there some reason to avoid picking up and holding certain babies? In our unit, we recently had a full-term baby. He was in an open crib and not on a vent. The poor thing would cry frequently. When I took care of him, I would hold him and rock him as often as I could. Luckily, the nights that I was assigned to him, I had only one other patient who was pretty stable and slept through the night so I could give him a lot of attention.

A few other nurses made comments about "spoiling" him, or asking if there was a problem that required me to hold him? Ironically, these were the same nurses who complained about how they didn't like taking care of this baby because he was so irritable. But when he was held, he was very content!

Also, we had a baby who was born prematurely and was with us for several months. As he got bigger, he was stable and moved to an open crib. He was with us for a long time because he got an MRSA infection. I was assigned to care for him often, and would spend a lot of time holding and rocking him because he would cry a lot when left alone in the crib. Again, comments from certain nurses about holding him so much.

Please note, in our unit we must wear isolation gowns whenever we pick up any baby, so they don't get "contaminated" by our clothing, and vice versa. And the baby with MRSA was in isolation, away from the non-infected babies.

Now, of course, with small unstable preemies you not only can’t hold them, but you must limit your contact so they don’t get stressed. But is there a reason to not hold big stable babies? Actually, it seems to me that when they are rocked to sleep, their sleep is much deeper and longer than when they cry themselves to sleep.

One more question-why do some nurses hold babies away from them in their lap, with the baby facing them during bottle feeding? Is there some reason to avoid holding a baby against you (one arm supporting them, their head in the crook of your elbow)?

[dawngloves, BSN, RN]

Gompers, noy trying to be a smart a$$, but how do you get the babies to sleep through the night? You could make a fortune writing that book! :chuckle

[Gompers, BSN, RN]

Gompers, noy trying to be a smart a$$, but how do you get the babies to sleep through the night? You could make a fortune writing that book! :chuckle

I trust me, I understand what you're saying. This only happens with our true chronics - trached BPDer and gut babies who are now 44+ weeks gestation. All of them just get GT or NG feeds at night, usually continuous. They don't get hungry, so they don't wake up. Most of them sleep so good that we can change their diapers and they don't really notice. It takes a while, but it can happen, and these are kids who are on the unit for months. We try to move them to the quiet corners of the unit, cover their cribs with blanket "tents" or turn off the lights, and then just kind of let them be all night. Now, a kid who PO feeds, of course, this does NOT happen with. They're up crying half the night just like normal babies!

[dawngloves, BSN, RN]

Oh well. Guess that doesn't work in the real world now does it? :rotfl:

We ship out surgery kids and by the time they're 44 weeks and not shipped out for traches we have to PO them. Blah!!!!

[Gompers, BSN, RN]

Oh well. Guess that doesn't work in the real world now does it? :rotfl:

We ship out surgery kids and by the time they're 44 weeks and not shipped out for traches we have to PO them. Blah!!!!

Well yeah, I'm not talking about normal babies here (even older preemies), I'm talking about classic NICU chronics - and in our unit we keep all our surgicals and don't transfer babies to Peds until they're 12 months. Usually by that time they've been sent home or to a nursing facility though. Even at 44+ weeks some of our kids are still NG or GT fed, since many trachs and gut kids are completely adversive to bottle feeding. The one time I did see a kiddo get aspiration pneumonia was a case like this when they forced him to PO feed - the baby almost died that week. (Though the only trachs I see that PO feed well are full term babies who are trached for anatomical reasons at a very young age.) Some of these chronics do bottle feed during the day, if they're not adversive, but are usually ordered to have tube feeds at night. The BPD trachs so that they conserve calories and get good sleep and thus devote more energy to healing at night. The gut babies always get continuous feeds at night due to dumping syndrome. These practices carry over when the baby goes home, and as their bodies grow and heal, their pediatricians start to DC the tube feeds and such.

[iceNICUnurse]

I try to hold the babies when I can, but as many have said it is not possible to hold them all the time. But we really try to do something for them when they are crying.

We also try to help them see the difference between night and day. We dont talk to them or play with them during the night and keep the lights as low as possible. The cronic 40+ kids in my unit usually sleep all night like the ones Gompers has. The parents love us for this, no problems with night wakings when they get home. If they are on PO feedings we just give them a little extra during the day so they dont have to feed during the night (it is wery common that we feed them q3 hours but skip the 02 or 05 feeding) That way they can get undistubed 5-6 hours sleep.

[BittyBabyGrower, MSN, RN]

Man....we take turns lugging those kids around the unit, tube feeding, IV and all! We even have a stroller for the big ones LOL There are sometimes that those kids do just need to cry it out...I found that many of them need to cry before they go to sleep...like a release.

Our big chronics that are tube fed are left alone. We do their baths and procedures before 8pm and then they settle in for the night and woe to the person that bothers them! We even took the one and set him in the fellows room after he decided that he wanted to examine him at 2am...that stopped that little habit LOL We try very hard to get them into a routine. And it is hard to hear then howling, but when you have other work to do, there really isn't anything you can do. Other times I want to run out of the room howling myself after hearing a kid howl and carry on for 12 hours...ekkkkkeeekkkk

[nurseiam]

My pet peeve is that people in our unit think these big chronics need to be at the attatched childrens hospital so they can get "developmental, family centered care". The problem is that that hospital relies on the family to provide family centered care. So if there is not a family member (at night.....) the baby is in a 5-8 combo in his own room. How developmentally friendly is that.

[Gompers, BSN, RN]

My pet peeve is that people in our unit think these big chronics need to be at the attatched childrens hospital so they can get "developmental, family centered care". The problem is that that hospital relies on the family to provide family centered care. So if there is not a family member (at night.....) the baby is in a 5-8 combo in his own room. How developmentally friendly is that.

Oh, I agree! It might be fine for the babies whose families spend hours and hours a day with them - families who WANT to transfer to Peds so that they can spend the night with the baby and everything - but that's usually not the case with a lot of chronics. They get so much more attention in the middle of the NICU than they would in their private room!

[prmenrs, RN]

I'd like to think that any NICU can give "developmental, family-centered care". I don't think that happens everywhere, and that's very sad. It's certainly what I would want for my baby.

I think that's why I really love my volunteer "cuddler" job--all the fun and....no charting!