Pregnant and terrified NICU nurse here...

rn/writer, RN · Jun 25, 2006

Hugs to you and your little one.

You have a lot to think about. I won't tell you not to worry--how futile is that!--only to try to direct that revved up energy into thoughts and actions that are productive and health-seeking.

1. If you aren't totally in synch with the information you are being given, you should probably try for a second opinion. Perhaps a reproductive endocrinologist would be a good meeting of the two specialties areas you need. Someone like that would be likely to understand the risks versus the benefits of using glucophage.

2. Our adopted son had serious psych issues and needed repeated hospitalizations. The only in-network facility was the hospital where I worked on the very unit that he would have been admitted to. I explained this to our insurance company and reminded them that if they insisted we use this facility, they would be forcing us to submit to a plethora of HIPPA violations. They were only too glad to okay an altenative facility at in-network rates. Don't know if you have access to anything as good as your own unit, but if you do, this might be the route to go.

I hope you end up with a good pregnancy, a decent labor and delivery, and a happy, healthy baby to show for all your efforts.

Do keep us updated on your progress.

Gompers, BSN, RN · Jun 25, 2006

Thank you very much for your advice!

Well, I did see my reproductive endocrinologist from 5-10 weeks and I trust him completely. He really feels it's up to the OB to decide about the Glucophage - he says he supports their opinion either way. I only talked to the high risk OB about it. I see the regular OB next week so that will be another opinion. Craziness!

I'm glad things worked out well with your son! I do wonder, then if that kind of situation might benefit me. There are many many other units around, so it is something I can consider. Not only for HIPAA reasons, but also so that I may return to work if necessary.

I hope all this thinking is premature, no pun intended!

gauge14iv, MSN, APRN, NP · Jun 25, 2006

You might look up treatment guidelines for gestational diabetes since it would have info about those drugs. The issue with Glucophage (and just about every other category C drug) is not that there is known risks per se - but that there is no good evidence that there is NOT risk. In any case - the risk vs benefit is something you and you party of docs is going to have to decide upon. There may be new guidelines or new studies available. Do a medline search and check the ACOG website to see what you can find.

As for going to your own hospital...that is something you will have to decide for yourself. One of my fellow nurses in the NICU stated that she never made lifelong friends out of patients and families because she would always have the unfair advantage of knowing more about them than they would ever know about her and some of it wouldnt be pretty. I have heard people who delivered elsewhere say they wished they had had their own co-workers and NICU with them during a difficult time - or were glad they did, and others say they were glad they didn't. I think a lot of that boils down to the environment in your unit and the relationships you have with your coworkers.

Gompers, BSN, RN · Jun 25, 2006

You might look up treatment guidelines for gestational diabetes since it would have info about those drugs. The issue with Glucophage (and just about every other category C drug) is not that there is known risks per se - but that there is no good evidence that there is NOT risk. In any case - the risk vs benefit is something you and you party of docs is going to have to decide upon. There may be new guidelines or new studies available. Do a medline search and check the ACOG website to see what you can find.
As for going to your own hospital...that is something you will have to decide for yourself. One of my fellow nurses in the NICU stated that she never made lifelong friends out of patients and families because she would always have the unfair advantage of knowing more about them than they would ever know about her and some of it wouldnt be pretty. I have heard people who delivered elsewhere say they wished they had had their own co-workers and NICU with them during a difficult time - or were glad they did, and others say they were glad they didn't. I think a lot of that boils down to the environment in your unit and the relationships you have with your coworkers.

Thank you for your advice. What you said about Glucophage is exactly what the high risk OB said. She told me that there is no gaurantee I'll get gest diabetes, so trying to prevent that with a category C drug has more risks than benefits. She did say that if I was diagnosed later, they would probably do the Glucophage as their first choice since I've already been on it - but that we'd cross that bridge if and when we came to it. She said that in pregnancy, most OBs prefer not to use medications unless necessary. Makes sense, I do understand that.

Well, I do love my unit. We're a huge family. Most of the nurses have been working there for 15+ years. I've been there for 8, and my mother-in-law has been there for 20 years. Yes, we both work there! This baby would be a VIP, for sure. I do think that I'd trust my coworkers (both docs and nurses) over strangers if the kiddo was really sick. There is nothing in my medical history that I want to keep secret, so that isn't a problem. I just worry because it could get weird, and if I wanted to go back part-time before discharge, it wouldn't be an option. If I do end up with a preemie, you can bet that I'd be taking home that baby on O2, NG feeds, and monitors ASAP!

gauge14iv, MSN, APRN, NP · Jun 25, 2006

Heh - had to laugh - If your MIL and you BOTH work there - chances are, there's nothing left to tell! LOL j/k :lol2:

BittyBabyGrower, MSN, RN · Jun 25, 2006

First congrats!!!! How exciting! Lots of hugs to you!

Now, I have a good friend and co-worker that had a baby in our unit for over 6 months. She was a 26 weeker and had multiple heart and lung issues, then some feeding issues. It was VERY hard for her to come back to work, she had to be on the other side of the unit or on postpartum. She couldn't be in the room with her or in the adjacent rooms (we tried this, but she would hear her monitor going off and run over...just mom instinct taking over). But, she felt very comforted in that we took care of her little one as if she were our own and she knew all the docs and therapists. Sometimes she would act like a nutty mom (and we told her LOL) but that is part of being a mom. We would also remind her that she was the MOM not the nurse when she was with her....let us worry about all the other stuff, just concentrate on your little one. The only bad thing was that when things got really tough, she would snap at us , sure, we knew it was stress, but sometimes it did hurt our feelings. It was also hard because when she was back at work, we would have to remind the parents in the room that she was here to visit her baby, not do things for them.

It boils down to what you are comfortable with.

beautifulb · Jun 25, 2006

Gompers, first of all, congratulations!

I understand your anxiety. You have valid reasons. While I was pregnant, I was a nervous wreck. I had to take several category c drugs and was petrified that I would either miscarry or that my baby would be pre-term or have a significant abnormality. Thankfully I went full term without complications and my baby (who will be one in 2 wks!) is fine. Because of the medications that I was on, my doctor referred me to a (? genetic) specialist who spent a lot of time with me and reviewing my meds. This definitely helped to put my fear aside. Because you are considered "at risk" this may be an option for you.

Gompers, BSN, RN · Jun 25, 2006

First congrats!!!! How exciting! Lots of hugs to you!
Now, I have a good friend and co-worker that had a baby in our unit for over 6 months. She was a 26 weeker and had multiple heart and lung issues, then some feeding issues. It was VERY hard for her to come back to work, she had to be on the other side of the unit or on postpartum. She couldn't be in the room with her or in the adjacent rooms (we tried this, but she would hear her monitor going off and run over...just mom instinct taking over). But, she felt very comforted in that we took care of her little one as if she were our own and she knew all the docs and therapists. Sometimes she would act like a nutty mom (and we told her LOL) but that is part of being a mom. We would also remind her that she was the MOM not the nurse when she was with her....let us worry about all the other stuff, just concentrate on your little one. The only bad thing was that when things got really tough, she would snap at us , sure, we knew it was stress, but sometimes it did hurt our feelings. It was also hard because when she was back at work, we would have to remind the parents in the room that she was here to visit her baby, not do things for them.
It boils down to what you are comfortable with.

Thanks for the congrats!

You know, that could work. I could always be floated to NBN, Peds, or PICU. We get points on our clinical ladder for crosstraining - maybe I could even make a positive out of it and cross-train to PICU during that time to keep my mind off things. It'd suck, don't get me wrong, because I hate floating. But I do suppose it'd be a good way to make some money. Thanks for the advice.

Gompers, BSN, RN · Jun 25, 2006

Gompers, first of all, congratulations!
I understand your anxiety. You have valid reasons. While I was pregnant, I was a nervous wreck. I had to take several category c drugs and was petrified that I would either miscarry or that my baby would be pre-term or have a significant abnormality. Thankfully I went full term without complications and my baby (who will be one in 2 wks!) is fine. Because of the medications that I was on, my doctor referred me to a (? genetic) specialist who spent a lot of time with me and reviewing my meds. This definitely helped to put my fear aside. Because you are considered "at risk" this may be an option for you.

Thank you, that is an idea...

Gompers, BSN, RN · Jun 25, 2006

So I had written this post before I went to bed last night. This morning, I woke up with a dream fresh in my mind. VERY interesting, to tell the truth...

My husband and I suddenly had a lake cabin in Wisconsin right on Lake Michigan, where my dad grew up. But for some reason, it was an ocean instead. We had my parents and brother with us, and our little one ( :) ). His cousins came to visit us as well and were staying in the dining room (a Filipino thing about always having your relatives stay with you - gone extreme!). So we're on the beach and I see a tidal wave heading towards us. I have the baby in my arms and I'm trying to run back to the shore but the wave overpowers me. I look up and see it forming a ceiling over me. It hits the beach and then turns to mist, so I am able to run up to the shore without really getting even getting wet. I look back and see more waves coming, so I convince everyone that we need to leave. There are weather reports saying that the environment is unstable and we need to evacuate. Everyone tells me to sleep on it! I am dumbfounded! So I sleep on it and wake up at 6am, then convince them we all have to leave. The sky is horrible looking over the lake/ocean. So we get an airport cab to pick up his cousins and the rest of the family loads into a few cars to get out of there. I try to put the baby seat in the back and find out later on that my brother, who was sitting next to the baby, didn't bother to tighten the seatbelt. But there was no problem and the baby was fine - but still it scared me. Then as we're driving home we find out that it was a fluke and nothing happened. No more tidal waves. We cancelled our vacation and I freaked out for nothing.

I told this to my husband when I woke up. He said it was pretty obvious that I know I'm freaking out for what is probably nothing. That there is the threat of bad things happening, but that it will probably be just fine. That I need to calm down a bit, or else I'm not going to be able to enjoy the good things in life.

Weird!

dawngloves, BSN, RN · Jun 26, 2006

Preggo dreams! :lol2:

Congratulations Gompers!!!:icon_hug: What the heck are you worrying about??

Glucopahge? If it were to cause any defects wouldn't you know by now? You've been having ultra sounds, right? Your baby is formed?And you won't know for weeks if you'll have GD and even then you could just be diet controlled.

And work, why don't you cross that bridge when you get to it. At least you know they'll give your baby first class care.

Now enjoy your pregnacy,darn it! :trout: