Unhappy 22 Weeker

Specialties NICU

Published

undefined :rolleyes: This past week I got the assignment from you know where. A s/p 22 weeker on DOL # 210. NO LUNGS or GUT, little vision or hearings. Blood pressures out of the roof, meds (3 pages ) like you would not belive. NPO because that morning he had had surgery #8, freshly extubated CO2 85 (Doc okay with it). This poor kid was unconsolable even with morphine, ativan and methadone. The only thing that helped was the swing and music. WHY DO WE DO THIS TO 22 WEEKERS! This kid has a misserable life! When I tried to talk to the Neo about what would happen to him he looked at me like I was nuts and said" Come on! you know hw is going to die" I still think these little kids are resus to keep the lawyers at bay. I cried all the way home. Does anybody else ever feel like this. I tried to help this kid but I failed. :o

Specializes in Case Mgmt; Mat/Child, Critical Care.

Great post, prmenrs! Especially the part about not spilling your guts the minute you walk in the door! It took me a while to learn that, but it's really better not to! :rolleyes:

Anybody ever think about karma? What you do and how you do it in this life has a lot to do w/what happens to you in the subsequent lives? No, never mind, don't answer that.

It is painful to watch and participate in these fiascos--if you have ethics committees--use them. Social workers CAN help parents face reality. Parents need to be required to spend time each and every day @ the bedside. Sometimes, w/very young moms, it's kinda like, s/he's mine, I'm keeping her. A possession. Very sad.

Spend as much time as your day allows holding the baby; Music can help: lullabies, classical, new age played very softly is what they like. Volunteer cuddlers are a Godsend. A little tylenol goes a long way.

And when you're at home, get as much supportive care as you can-even if you have to provide it for yourself. Indulge yourself. Try not to get into any heavy discussions right as you walk in the door.

It is not supportive to have co-workers come up to you as you're trying to care for this baby, and have the discussion we are having here. Tell them that. If they want to help, they can hold the baby for a while, or do something for you so that you can.

((((((((HUGS)))))))))

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Specializes in NICU, Infection Control.

Fiesty--from the OP, this is a s/p 22 wkr, now a 'chronic'. You are correct, of course, but this baby is of an age now that s/he needs very calm, positive stimuli. In fact, they should not be held in the traditional supine position, but up against your body so that they do not have to make eye contact. The spot I have the baby in my avatar picture is very nice because they can hear your heart beat.

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Specializes in NICU.
Premies should have as little stimulation as possible, especially after a day of being poked with needles and tubes. The lights are dimmed in the NICU and people are instructed to speak quietly. It is important to create a womb like environment. A 22 weeker would not be picked-up and taken out of it's temperature controlled environment - they can't handle the stress. No music allowed and I would never think of putting a 22 weeker in a swing. This preemie is being way over stimulated, which could be the problem.

The preemie this post is about is actually seven months old, according to the original poster. I'm sure we're all perfectly aware that a fresh 22 weeker shouldn't be picked up and stuck in a swing!

:rolleyes:

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Rose, I had a chronic former 23 weeker today and I was ready to jump out the window.This kid has been with us so long he is now 40 weeks adjusted!

He was miserable! Nothing made him happy. Holding, swinging, swaddling, pacifier, the MSO4 we've been weaning him off of for two months. ARRGGHHH!

I can so sympathize with you.

Plus he is so tight with CP he can't be comfortable. *sigh* Where is the quality of life for this little guy.

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a 22 weeker in a swing.

Trying to picture this.....:chair:

:rotfl: :rotfl:

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We have chronic kids on our unit that just won't stop crying. THey seem to be in lots of pain to me, but the nurses usually chart that the kid has no pain or a small amount of pain that requires no pharm. tx to help. Sad, and these kids are CRANKY!!!! Talk about making a shift miserable, a former 22 weeker that is now over 40 weeks that won't stop wailing. I say give the kid some tylenol. It just might help him some.

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Specializes in ER.

He needs pain control...I'm not a NICU nurse, but lets give this poor Cp baby what it takes to make him comfortable.

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You know what I hate? When I chart pain scores of 5 and other nurses put 0. Or a NAS of 9 and other nurses chart 3! How is that possible when you told me in report that the kid cried all night, vomited and has tremors???

And the doc'll tell me, "Oh, that's just his temperment." !

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Specializes in Hemodialysis, Home Health.
We have chronic kids on our unit that just won't stop crying. THey seem to be in lots of pain to me, but the nurses usually chart that the kid has no pain or a small amount of pain that requires no pharm. tx to help. Sad, and these kids are CRANKY!!!! Talk about making a shift miserable, a former 22 weeker that is now over 40 weeks that won't stop wailing. I say give the kid some tylenol. It just might help him some.

wow... makes me think of sth. my Dad told me a long time ago. I had cried for weeks as a wee infant... non stop. Nothing found when they took me to the doc. Still kept on and kept on... at one point he was ready to toss me out the window :eek:... it was so nerve wracking. Was finally admitted to the hospital... days went by... nothing... finally, FINALLY, they found I had two fractured legs !!!

(severe ca+ deficiency, scurvy, etc...)

About a year later, my dear sis refractured those little legs as they were sticking out between the crib slats.. grabbed hold of them and was playfully banging them together... :uhoh3:

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wow... makes me think of sth. my Dad told me a long time ago. I had cried for weeks as a wee infant... non stop. Nothing found when they took me to the doc. Still kept on and kept on... at one point he was ready to toss me out the window :eek:... it was so nerve wracking. Was finally admitted to the hospital... days went by... nothing... finally, FINALLY, they found I had two fractured legs !!!

(severe ca+ deficiency, scurvy, etc...)

About a year later, my dear sis refractured those little legs as they were sticking out between the crib slats.. grabbed hold of them and was playfully banging them together... :uhoh3:

Oh my gosh Jnette - ouch . . . . I'll bet you give her a hard time about that. :)

steph

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Specializes in Hemodialysis, Home Health.
Oh my gosh Jnette - ouch . . . . I'll bet you give her a hard time about that. :)

steph

:chuckle Yeh... especailly since a few years later when I was about four, she slammed the door on my hand and chopped off the top of my thumb !!! :angryfire ( Mom had baked some fresh cookies and called us in... Pati wanted to be there FIRST !!! ) :rolleyes:

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I'm so sorry that you had a day like that..I can tell you I've had lots of days like that! It makes me very angry.Angry at the doctors for holding on too long..Angry at everyone to be quite truthfully..

It seems like I see few miracles in these cases..And the families are expecting a miracle with their little one (who could blame them). The problem is that some of these families don't see what we have to put them through..

We had a premie in our nicu that passed away on Thursday.She was born very premature and had very bad chronic lungs.She had never been off of the vent, just for trials..(she failed every one). She had several surgeries, and last Monday the doc's decided it was time for a trach. Well, 8 hours after her trach she was on a high frequency vent with a trach!! She was 7 months old when she died....

That poor baby suffered for what?

My heart goes out to you...I do feel your pain!!!

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