Question for NICU nurses . . . . .

  1. I'm about 19 weeks pregnant and brought up the discussion with dh what we would want done if the baby is born premature. Needless to say, it did not go well. So, I present the questions to all of you:

    Knowing what you do, would you want every intervention performed on your child?

    What gestational age would be your cut off for paliative vs. agressive treatment for your child?

    What kind of treatments increase suffering, but don't offer much to help?

    I think being a Onc. nurse has really opened my eyes to how many people are willing to go through or put their family members through futile treatment after futile treatment. I just would like to know what you guys would do.

    Thanks!
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  2. 11 Comments

  3. by   RainDreamer
    here's a great thread relating to this very topic:

    at what gestation would you want your baby saved?
  4. by   NurseyBaby'05
    Thanks Rain!

    It seems like just what I was looking for. I must not have looked far enough.
  5. by   RNin2007
    I think i'll add to this thread since I didn't see the original one. I have two of my own preemies (680 grams - 26 wks & 970 grams - 29 wks). My girl did great, boy not so hot. He had 8 surgeries in all, 5 on the brain. BUT...9 years later you would NEVER know it. He is a happy healthy normal 9 year old. No lung probs, no vision correction, and even had hydrocephalus as a babe and a shunt - has been shunt free since age 2.

    If I had to do it all over again? I would want a 49 week baby...lol jk. But honestly, it has really been tugging at me; "IF" and that's a big IF, I got pregnant again, I would not do anything if the child was < 25 wks. It is really tough watching the tiniest and most premature babies...wondering what sorts of disabilities they may face. I feel so blessed that my two are doing so wonderful.

    Best wishes to you, and congrats on your little one!

    ~J
  6. by   NurseyBaby'05
    Thanks! I just feel like I would be taking a gamble with my child with every intervention and praying I would be the one to get lucky. Dh is still really upset, but we really do have to talk about these thinks ahead of time, I think.
  7. by   Jolie
    Kudos to you for bringing this topic up for discussion, painful as it may be to consider.

    A NICU nurse friend of mine was in Lamaze class when the instructor asked each couple what their greatest fear regarding pregnancy was. Most parents answered with things like fear of labor, uncertainty over lifestyle changes, etc. My friend mentioned the possibility of having a sick or premature baby. Everyone else in the class thought she was nuts, as NONE of them had ever had a personal experience or knew of any friends or family members who had experienced the NICU. I think your husband is like my friend's classmates. The idea of a sick or premature newborn is so foreign that they don't give it any consideration.

    With time, I hope your hubby will be more able and willing to talk about his preferences should the "unthinkable" happen.

    Best wishes to you for a happy, healthy baby!
  8. by   NurseyBaby'05
    He doesn't think I'm nuts, per se. He's one of those people that is always in denial about anything unpleasant. He did say that it would be hard to see the baby if he/she's born early because if he saw it, he would want everything done. I figured this would have to be a mutliple conversation topic, so I brought it up early on. At least the idea will be somewhere in our heads if something like that would happen.
    Last edit by NurseyBaby'05 on Oct 27, '06
  9. by   Gompers
    Quote from jolie
    a nicu nurse friend of mine was in lamaze class when the instructor asked each couple what their greatest fear regarding pregnancy was. most parents answered with things like fear of labor, uncertainty over lifestyle changes, etc. my friend mentioned the possibility of having a sick or premature baby. everyone else in the class thought she was nuts, as none of them had ever had a personal experience or knew of any friends or family members who had experienced the nicu. i think your husband is like my friend's classmates. the idea of a sick or premature newborn is so foreign that they don't give it any consideration.
    i know, i've been through the same thing. i've had family members and non-nursing friends tell me that i have to stop thinking about the possibility of a sick or premature baby. well, when you have a high risk pregnancy and have worked in a busy level iii nicu for eight years...how can you not think about it?!?! they act like i'm some freak or something. truth is, though, none of them have stepped foot into a nicu in their lives. they have no idea what we deal with on a daily basis. luckily about 95% of the population never has to deal with it...

    congratulations to nurseybaby'05!!!!
  10. by   NurseyBaby'05
    Gompers-

    I don't envy your "inside trading info" one bit. It's nervewracking enough for me seeing what my adult Oncology folks go through when they receive futile treatments. You're almost done though. About 10 weeks, no?
  11. by   NurseyBaby'05
    Awwww . . . .

    Thanks for the congrats! I just noticed it. :imbar
  12. by   Spatialized
    While not a NICU nurse, but having experienced this loss, I thought I could weigh in. My wife and I have lost two beautiful children and had to deal with this very question.
    Our first was at 21 weeks (<400g) gestation due to a placental abruption. We did nothing except hold him close in his few short minutes of life. The reality was that was all we could do; aggressive measures would have only prolonged his suffering and not made a difference.
    Our second was born at 26 weeks, but was the size of a 24 weeker, about 620g, this time due to severe preeclampsia (my dw has Factor V Leidens). We knew when my dw was airlifted out of town that premature birht of some variety was a foregone conclusion, we just hoped it wasn't too premature. Unfortunately, she was born 2 days after my dw was airlifted out. Luckily we had time to get betameth onboard so lung maturity was helped along a bit. She lived more 8 days in the NICU before succumbing to severe sepsis.

    Was it worth it? Every minute. Would I do it again? Yes, in a hot second. Sure knowing what I know now, I know that my cut-off would be about 25 weeks, but only time will tell. Would we be aggressive? As far as we could be. Hope this helps...
    Cheers,
    Tom
  13. by   justjenny
    [QUOTE=NurseyBaby'05]He doesn't think I'm nuts, per se. He's one of thos people that is always in denial about anything unpleasant. QUOTE]

    Sounds like my husband. I am the "planner" and maybe a slight control-freak...he doesn't want to think about the bad unless it is practically slapping him in the face. Everyone deals with things in their own way...and you never really know how your going to react when faced with a crisis situation....no matter how much planning is involved ahead of time.

    Sending wishes your way for a loooong and healthy, happy pregnancy!


    Jenny

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