Are we tyrants?

[Bortaz]

The other night, our RT was orienting a new guy to help cover NICU. He was taking him from bed to bed, showing him around and explaining things. I heard one of the nurses on that side of the room tell him "Don't suction my baby unless I ask you to!".

When they got to my private room (with a sick 24 weeker inside), the RT told the new guy: "Be careful with the small ones, because some of the nurses are real tyrants. Especially this guy."

Now, this particular RT is fairly new to our unit, and I have metaphorically slapped his hand several times, because of his tendency to want to suction babies as the answer to any problem. Also not keen on his habit of pouring in the NS when suctioning. So, I've told him to never suction my babies unless I request it. In fact, just don't ever do it...I'll take care of it. If you can't assure me that you got all that NS out that you put into my preemie's lungs, then just keep your hands off.

Me: My heater is beeping, can you reset it?

RT: I'll just suction.

Me: Man, is it really only 4 am?

RT: I'd better suction.

Me: The Texans won!

RT: Hang on, I'll get a gallon of NS and suction!

Most RTs have more experience in adults, where frequent suctioning and use of NS may not have any dire effects. Not so with a micro-gerbil. I know any of you with more than a year or two in the NICU have seen the pulm bleeds and worse that can come from suctioning.

So, my question is: Are we tyrants? Also, is it really a bad thing that we are?

In the interest of being the best I can be...am I out of line on this issue?

I'm also often annoyed by nurses that have no idea whether lab came by to draw blood from their neonate (so, you're telling me someone opened your bed, poked a HOLE in your baby, drew out his life's blood, and you don't even know it happened? Get out!), or who run like a scalded dog every time the portable x-ray machine approaches...so sick of distorted x-rays that you can't even see the lung field for all the crap (lines, leads, ets) in the field.

I was taught by a wise old Neo that we should only be suctioning micros rarely, when we see stuff in the tube or the baby is rattling or if they are displaying sure signs of needing it. The age of q2* suctioning is in the past.

[Bortaz, MSN, RN]

Has anyone had a discussion with the RT about why neonates shouldn't be suctioned as frequently as he thinks?

Oh yes. And with his management as well.

[prmenrs, RN]

There was one particular RT @ the Level 2 who could not grasp the concept of too much O2 on premies. He wasn't happy unless they looked like a stop sign. And the delivery room didn't have air outlets, so while you were in there, your only choice was 100% O2. I kept talking abt hurting the baby's eyes, making it harder to get the umbi lines in when the O2 was too high, etc., I don't think he ever caught on or agreed w/that principle.

Head to desk x 3

[applewhitern, BSN, RN]

I worked pediatric ICU for years. Nobody was allowed to touch the babies and kids but the RN's. We did all lab draws ourselves, all blood gases, all vent changes and suctioning. When radiology needed a bedside film, we assisted. The whole point was just to protect the little ones.

[ArgentumRN]

Right... we are responsibles for the care of patient. But dont call your patients "my baby" understand they are NOT YOURS! and when you act "territorial" it does not make you a better nurse. It makes you look insane and unprofesional. If the RT is "pouring" a gallon of NS then EDUCATE NOT DICTATE.....you depend on that RT to better care for your patient. Just remember those patients dont belong to you. You dont own them.

[AJPV]

If it was my kid, I would want you to be a tyrant!

[Esme12, ASN, BSN, RN]

I think that is why Critical Care Nurses have the reputation of being mean pains in the ass. The sicker the patient the more territorial we become.

My patient.... My Room....my meds.....my responsibility.

DO NOT TOUCH WITHOUT PERMISSION!

[sapphire18]

I think that is why Critical Care Nurses have the reputation of being mean pains in the ass. The sicker the patient the more territorial we become.

My patient.... My Room....my meds.....my responsibility.

DO NOT TOUCH WITHOUT PERMISSION!

^THAT^

[Bringonthenight]

Right... we are responsibles for the care of patient. But dont call your patients "my baby" understand they are NOT YOURS! and when you act "territorial" it does not make you a better nurse. It makes you look insane and unprofesional. If the RT is "pouring" a gallon of NS then EDUCATE NOT DICTATE.....you depend on that RT to better care for your patient. Just remember those patients dont belong to you. You dont own them.

I like this.

Also neonates are babies, not micro gerbils!

[RNperdiem, RN]

This is the reason that my hospital tries to keep a few RTs who work only in peds and NICU. They are fully familiar with the special needs of little lungs and develop a good working relationship with the nurses.

When you fully trust your team, the patient benefits and you don't have to be as territorial.

In adult ICU, a good suction goes a long way, so I do understand that mindset.

[Bortaz, MSN, RN]

Just for future reference, I DON'T CARE ONE BIT what people think about my pet names for these babies that I put my heart and soul and tears into keeping alive and making healthy. Not one single bit.

[wooh, BSN, RN]

Don't worry Bortaz, I think your term of endearment is cute. They are about the size of a gerbil. A teeny gerbil. I'd probably be calling them mouses. :)

Of course, I call my patients pumpkins and burritos and monkeys and pookies and all sorts of things. :)

[lub dub]

"Don't suction my baby unless I ask you to!".

I'm not a big fan of this attitude. You are caring for the patient. You do not own the patient. Hospitals for places of collaboration amongst healthcare professionals. This form of extreme territorialism hurts nursing, and is unprofessional.