Baby went bad

KellNY, RN · Mar 8, 2007

It happens to the best of us. It happens to the worst of us. Truth is--it happens to ALL of us at least once.

If you believe in God,there's a saying one of my doula friends taught me-"Let go, let God". There's nothing you could have done, and the burden does not lie on your shoulders.

As far as CYA-you might want to talk to risk management if you think/know this'll go to court. Also, I'd keep a personal journal to record the details as best you remember them--to keep things fresh.

Trauma Columnist · Mar 8, 2007

When I've had a bad outcome with one of my patients, I do realize that there is something beyond HERE. For me, religion and my faith in God helped me get through 10 years in an inner city trauma center where death was a constant.

Jolie, BSN · Mar 8, 2007

I am so sorry for your experience. Your anguish is apparent and reading your post made my heart heavy.

Please consider seeking professional guidance, from a mental health professional or member of the clergy, someone outside of your facility. It will help to have an impartial sounding board whom you can trust to keep your conversations confidential.

I also suggest that you consider seeking legal guidance, again from private attorney outside of your facility. The chances are small that you will involved personally in legal action pertaining to this case, but if that should happen in the future, you will be glad that you laid the groundwork for your defense while the incident is still fresh in your mind. If you carry personal Liability Insurance, please contact your company. If not, call your local bar association and ask for a referral to an attorney experienced in defending healthcare professionals. Many attorneys will provide an initial consultation at no cost.

If you are a religious person, please pray for the baby and family, and all of those involved in their care. It sounds like a tragedy for all involved.

muffie, RN · Mar 8, 2007

wishing you brighter days and peaceful nights

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AnnieOaklyRN, BSN, RN, EMT-P · Mar 8, 2007

aaw ((((hugs))))

Know that you did all that you could. You did what you were suppose to, you let the doctor know what was happening with this baby and that is all you could have done given your scope of practice. I know it still hurts inside because you have that guilt that you could have done more, even though you truly could not have. I am praying for you and I know you need time to work through this is your own mind before you let go of the guilt that does not belong to you.

Swtooth

sweetcheekers · Mar 8, 2007

If you believe in God, then know that what we do or don't do, or what we cannot get others to do when we know what needs done are irrelevant in the big scheme of things. I witnessed a stillborn birth a year ago in which we lost heart tones only a few minutes before birth, the code was not successful. In the midst of it all I heard God's voice inside my heart saying, " I am here, and I am in control." I knew then that I am never alone and that God's will prevails no matter what. I don't think we can ever understand the reasoning behind a lot of what we witness, but remember we don't have the full picture. We can't overcome what God has planned. We can only do what we know we should and then surrender control to the One most capable of deciding the outcome. Peace to you. I know it hurts. I still remember everything from that experience last year, the family, the babies name... I don't know that I'll ever forget.

SmilingBluEyes · Mar 8, 2007

I know that we aren't always going to see the happy endings. I can accept that. What I have trouble with is calling a doc, repeatedly, for issues and getting poor responses. At almost the exact same time as the doc finally shows up, we start having heart tone issues. Issues that continued and worsened over the next 40 minutes. Issues that resulted in a very very bad outcome.
My resource nurse was involved, and had been. Everyone who ended up in the OR with us said they didn't know of anything else I could have done. I made the phone calls, gave the appropriate information and documented the responses. I still feel like 3 day old dung.
I can't concentrate, haven't been sleeping since it happened. I've cried more in the last week than I think I have in my entire life. I haven't the slightest idea of where to go from here. This kid would have been fine if I could have picked up the scapel myself, but I couldn't, and I don't know how to handle that. I know there's going to be legal action, and I'm really freaked out by that too. Help, prayers, advice, cya-tips? Anyone? I'm dying here!

Having had a startlingly similar experience myself a few years back, some things come to mind you need to do:

1....JURIS PRUDENCE. In other words, do not discuss this situation with anyone who was and/or is not involved in this sad circumstance. (including ALLNURSES.COM!) Any legal questions and issues, need to be taken to legal counsel. Also, if there are strips, documentation, etc. laying around, get these to your manager and have these things kept there---not for open speculation and discussion by staff. Rumors are not needed nor wise at this time. This is not to "hide" anything, but to keep order to it. And this situation should not be discussed or speculated on by people who have no knowledge or involvement.

2....I hope you spoke to that poor family and conveyed how sorry you are. I don't mean, taking blame (whether it exists on your part or not) but really respecting the fact this family is hurting, terribly, and needs to hear you are heartily sorry and did all you could do to improve or help the situation. They need to hear that the staff all very much care about what happened and that they are truly sorry for the outcome. Beyond that, say little to nothing.

3....Get to a counselor for debriefing. Or better, ask your manager to set up a debriefing session for all involved employees/doctors in the situation. Ideally, this should take place very soon, when feelings and emotions are raw and get them "out" in a safe place. You must not shut down, this must be talked about and you will find your emotions will overcome you if you don't have a professinal outlet to take them to. Trust me on this. Ask about employee "EAP" programs-----they provide counseling----and it won't cost you money to get such help.

4....As soon as you can, "get back on that horse and ride again". Your first instinct may well be to want to stop caring for labor patients or do your job. Take some time you need to get it together---but not too long. And again, if you are too traumatized to return to work , or be effective at work, in a week or two, follow-up counseling is an imperative.

5....Be good to yourself. Yes, you will go over the events of that situation over and over again in your mind's eye. But don't neglect your need for sleep, proper nutrition, TLC from loved ones. Please, do not be afraid to ask for help from those who care when you need it.

6.....Make sure your documentation is flawless and truthful. IF there is an incident report to be done, do it and very soon. Remember, do not assign blame in the patient chart for anything that occurred. These observations are to be made in an incident report. Do not be afraid to get help doing this report from your manager or charge nurse who was on shift when this happened.

7.....Good luck. I have been there and it's enough to make you want to quit forever. I am fortunate ( I guess) in that nothing I did contributed to the situation that occured, rather, it seems the baby had some congenital problems that were unknown that contributed. This does not make things better for the family but at least I knew I did not harm the baby myself by anything I did.

8.....Believing in a Higher Power helped me. I just believe, that soul elected not to enter this life at that exact time, either because timing or the environmental conditions were wrong. I believe that soul would be born when things were right, not before. Babies do die, despite our best intentions. Sometimes, we have to acknowledge we are not any more than mere humans, doing our best and have to give up that sense of power or control that we "did" anything wrong. In no place more than OB, is this harder to do. Outcomes are expected to be perfect each and every time. This is not possible. Prayer is all I could do to get through this, in the end. And knowing, that little soul will join us when he/she is ready, sure helped me. It helped my involved coworkers, too.

9....Going to work may be tough at times, at least in the first few weeks after this occurence. For me, the sense of dread I felt was awful. "Armchair quarterbacking" is so common---everyone thinks they could have done it better and "sees so clearly" all the "mistakes" you made! I had some coworkers who were less than kind and were whispering about me and the others involved. I nipped that in the bud and told them if they had something to say, say it to me directly. I also asked my manager to pull in the reins, if for nothing but again, juris prudence. Discussing this openly meant all of them could be implicated if they were not very careful. That stopped that and soon, I got support from some of them. Others, you can't help. Just be STRONG and take it one day at a time, as they say.

I feel for you. Hang in there and get advice where you need it---be it from Risk Managers, your unit manager, charge nurse, or counselors, or even your own attorney, if that becomes necessary. I feel horrible for that family----just awful. And I feel awful for all involved. These situations are so hard for everyone involved.

muffie, RN · Mar 8, 2007

excellent advice SBE

gr8rnpjt, RN · Mar 8, 2007

Ask someone in human resources about whether or not you have an employee assistance program. They really are there to help (its why they are there) and its usually free. It helps to talk it out.

nursejohio, ASN, RN · Mar 9, 2007

Having had a startlingly similar experience myself a few years back, some things come to mind you need to do:

Wow, lot of good advice. Sorry you had to be put through the same situation to learn it all.

To start, I wasn't planning on posting any more details than I've already written. But I had to say something, ya know? I really felt (still do, truth be told) like I'm going to explode if I don't find a way to blow off steam and vent about it a little bit.

Mom was in no condition to hold a conversation when I left my shift, dad was outside, and I've only been back for 1 shift since. I wouldn't even know where to begin if I spoke to them. I'd end up a blubbering waterfull. They are having a debriefing but I'm going to be 4 states away when it happens.

I can't say the thought of waitressing has no appeal to me, what's the worst that can happen there? I spill some food or get an order wrong? Bring it on!

I had a few people look over my charting that night, and again on my lone shift since. They all said it looked like everything that needed to be charted had been. I'm also lucky enough (although 'lucky' just seems obscene right now) to have co-workers who are supportive, both those who were there that night and the ones who have heard of the fiasco on subsequent shift. Everyone who has said anything simply said they can't imagine how hard it was for me, and that I did everything I could have been expected to do.

Thanks to everyone for all the good advice and support. I can't tell you how much it all means to me right now.

SmilingBluEyes · Mar 9, 2007

What you said in your initial post is not inappropriate. I was just cautioning against saying too much in great detail. Like I said, my heart goes out to you. I know pretty well what you must be feeling. I hope you all get through this situation ok and the wisdom you can gain, will be invaluable. I wish you all the best in the future. Let us know if there is anything else we can do.