Car Seats...

luvmy3kids · Mar 6, 2008

Hi there. I am a pre-nursing student... but I volunteer on the birthing floor at our local hospital. We as volunteers, and the nurses also, are not allowed AT ALL to even hint about proper car seat installation. It drives me nuts! I have 3 kids and I'm a major car seat stickler. And when someone puts their child in a car seat incorrectly, or has it installed in the car wrong... I have to just sit there and bite my lip.

Many of these poor first time parents are fumbling around with no idea that they are even doing it wrong. I just don't understand why the hospital doesn't have a trained inspector available to assist the parents when they are discharged.

The other major problem I have is when we have a family that doesn't speak English. So not only are they installing the car seat wrong... but I can't explain to them that they need to talk to someone who can help them (car dealership/local LE/ etc). It's very frustrating.

I believe the stats are that 7/10 car seats are installed incorrectly. I just wish I could do something about it.

Jen

EricJRN, MSN, RN · Mar 6, 2008

Our policy is not to get involved. Hopefully someone has warned the family before discharge that it's their responsibility to figure it out.

One recent change we've made: Prior to a few weeks ago, we would not have performed a car seat challenge (or discharged a kid) unless the car seat base was present. Now we're saying that many seats are okay to be secured without the base.

BittyBabyGrower, MSN, RN · Mar 6, 2008

Per our legal department, the car seat is the family's problem. We tell them they need to read the manual before and take it to the firehouse to have it checked. If you help them put the kid in the seat or in the car and something happens then you may be held liable and then be sued. "Junior flew out of the corificeat when we were rearended...the nurse put him in there and secured him, not me, so she killed my baby!" Horrid to read, but I can see it happening in this sue happy world in which we live.

We don't even observe them putting the baby in the car, we go down to the front door, hand them the baby and leave.

Nothing beats the time we had a mom put her kid in a box on the floor of the car. We can't keep them for not having a corificeat. We couldn't get to the phone fast enough to alert DCFS and the social worker! We only have to tell them the law and if they choose not to follow it, then there isn't much we can do except report it.

babiesRmylife · Mar 6, 2008

We're not allowed to show them how to position their car seat properly in the car. Just the infant since we often have to do car seat trials on them. Across the street from us though we have a place that WHEN it's open they can go across the street & they will check it. Only bad part is, it's not always open & sometimes people do leave the hospital really late at night which would mean the information place isn't open. But we're not allowed to show parents how to properly place the infant in the car due to liability issues. How sad is that. Unfortunately I do understand, that some people are too sue happy these days.

justme1972 · Mar 6, 2008

Personally, I'm a little shocked that the car seat is being left as "the parent's problem"...I think this is a good solution that meets the needs of the child along with legal requirements.

When my children were in the NICU, I was told I had to bring in a car seat a few days before discharge for them to do a "corificeat" test to see if they would brady during the ride b/c of positioning.

Granted, babies don't always stay the same amount of time in tne NICU.

However, I was told practically on the first or second day of their stay, to be sure to install the car seats early and go by a police department or fire department, and they would be happy to double check the installation for free, as they said the hospital wasn't allowed to.

My husband and I read the directions, put the car seats in, and rode by the fire department (which we passed every day) and found out it was installed wrong. They fixed it, showed us how to take the carriers in and out, and we were on our way.

So that FIRST TIME we used the car seats to bring the twins home, we knew exactly how they worked.

To me that is a better solution that just leaving parents in the dark over something that is so incredibly important, and 100% takes the liability off the hospital.

Hospitals give area resources for everything else...so why not educate parents on where they can get car seat advice?

SteveNNP, MSN, NP · Mar 6, 2008

The last unit I worked in, we had several car-seat certified nurses who would teach the parents. We were responsible for assessing the condition, age, and size of the seat. On day of discharge, the nurse would watch the parents secure the baby in the seat, then the nurse would carry the baby outside, and watch the parents secure the baby in the car....we never had a problem.

Pediatric Critical Care Columnist · Mar 6, 2008

When I worked neonatal stepdown (many moons ago now) it was a requirement that the nurse discharging the baby assess the condition of the car seat, the baby's position in the car seat and how the corificeat was secured in the car. We could not discharge a child without a car seat. Period. For families that didn't have one, we had a loaner but the understanding was that they would get their own ASAP. For families that didn't have a car (and there were lots of those at this hospital) and were taking a taxi we had a list of taxi companies that supplied car seats on request. Those who rode the bus took the loaner and arrangements were made for it to be returned.

BittyBabyGrower, MSN, RN · Mar 7, 2008

We have a mandated video they watch and we tell them way ahead of time to bring the seat in and fit it as we will need it for the CSC. We don't loan seats out anymore, one, we weren't getting them back and two, legal advised us not to do this anymore since we don't know if something happened to the seat while it was out of our unit.

Parents do need to take responsibility and be familiar with the corificeat, we tell them this and we have handouts. We are very up front about not being responsible for the corificeat fitting or putting in the car. We give them lists with places to go. If they choose not to do so, it is their problem...as the old saying goes, you can lead a horse to water, but you can't make them drink. If they bring in a corificeat that is obviously dangerous or not appropriate we tell them and if they choose to replace it they can, but we can't MAKE them, we can only try to teach them what is right and what the law is. We can't hold up a d/c due to corificeat issues, just like an adult nurse can't hold up a d/c if the patient isn't going to wear a seatbelt...they will do what they want and there isn't much we can do about it as it is out of our hands once they are discharged off the unit.

In the big scheme of things, with all the years I have in, I can tell you that some of these kids are going home to things more horrifiying than not being strapped in a corificeat right. All we can do is try to get thru the parent's heads that they need to be responsible parents.

nurserynurse55 · Mar 8, 2008

In my hospital, it is rarely a nurse that brings them to their car. It is normally a transportation person. No matter who it is, we may not touch the car seat. We can verbally correct them, but not do it for them. It is a legal thing about getting suid and stuff.

AmericanRN · Mar 9, 2008

Hey everyone!
I was wondering what other NICUs do as far as car seats go.
MANY MANY times our parents come in expecting nurses in my unit to show them HOW to use a car seat and also how to fasten the base to the car.
I once took a VERY young couple out to their car and the dad placed the car seat at the base and I checked only b/c it didn't look secure. I'm REALLY glad I checked it b/c the BASE WAS NOT SECURED DOWN AT ALL!! It was literally just sitting on the back seat and the dad claimed he didn't know any better (which is VERY possible, but a bit shocking).
So...
Do you help parents with car seats? Do you physically show them how to fasten it to the car or even do it for them?
What's the policy for your hospital/state?
I know about the websites and the actual laws...i'm just wondering what is actually being done!
Thank you:)

In my area a parent can go to the local sheriff's office and get a deputy who has training specifically in car seat safety (along with their other duties) to show them how to secure the seat and the belts properly. The service is free and all the parents have to do is show up with the vehicle and car seat. The blanket suggestion is to show up and get this done when one finds out they are pregnant to begin with. That way the early bird babies safety can be covered beforehand.

I have no idea what each hospitals saftey rules and actions are but I say it honestly doesn't matter what they are in this case because only the state's rules matter when it comes to vehicle safety and children.

AmericanRN · Mar 9, 2008

Personally, I'm a little shocked that the car seat is being left as "the parent's problem"...I think this is a good solution that meets the needs of the child along with legal requirements.
When my children were in the NICU, I was told I had to bring in a car seat a few days before discharge for them to do a "corificeat" test to see if they would brady during the ride b/c of positioning.
Granted, babies don't always stay the same amount of time in tne NICU.
However, I was told practically on the first or second day of their stay, to be sure to install the car seats early and go by a police department or fire department, and they would be happy to double check the installation for free, as they said the hospital wasn't allowed to.
My husband and I read the directions, put the car seats in, and rode by the fire department (which we passed every day) and found out it was installed wrong. They fixed it, showed us how to take the carriers in and out, and we were on our way.
So that FIRST TIME we used the car seats to bring the twins home, we knew exactly how they worked.
To me that is a better solution that just leaving parents in the dark over something that is so incredibly important, and 100% takes the liability off the hospital.
Hospitals give area resources for everything else...so why not educate parents on where they can get car seat advice?

Bingo I wish I had seen your post prior to what I posted since you covered it already. The fire departments and law enforcement agencies are the way to go in any area they know the laws, have employees that have training specific to this topic, and on top of that are the only ones who truely know which car seats, bases, weights, etc are in accordance with the area's laws. Where I work I can honestly say that 98% of the car seats seen are installed improperly.