code on a baby

Published

I had an awful end to my shift.

We did a c/s on a pt for failure to progress, tracing was fine with an ISE.

I was baby nurse and we had Peds resident back there.

The baby came out AWFUL with no warning.

Apgars 1,1,4,5,7....

We did bagging, chest compressions called the NICU fellow, resus, intubated, placed an umbilical line....

It was terrifying! I felt so overwhelmed and unprepared.

And now I'm beating myself up over what I could have done differently - reacted faster, called resus sooner....

Baby went down to the NICU intubated. At least it's pink now and has a good HR.

How did this happen?!

I'm super emotional about it because my sister in law is in labor RIGHT NOW and all I could think about was that this could be her baby.

I cried the whole way home....

Not a good way to end the year....

Hello. I agree with other writers that in your role of "baby nurse(probably working in normal nursery)" your description sounds like you immediately did the appropriate interventions for this stressed little one. ("bagging, chest compressions, calling the NICU fellow"). I worked in a normal nursery and in a neonatal intensive care unit for several years, and I also agree with posters that, even with experience, helping a baby in serious trouble is scary stuff. Over the years the hospital where I worked made some nursing changes such as: (1)education--requirement for all normal nursery nurses to take a neonatal critical care class; and (2)patient assignments--for all full term c-section patients, a normal nursery nurse was assigned to be present and be prepared for potential problems in the delivery room. Best wishes!

Specializes in pediatrics, public health.

You and your colleagues saved that baby, and you will all learn from this experience and be even better able to handle a baby in distress the next time it happens (hopefully not often!!!!!!!). Even if your role was mainly to recognize that the baby needed someone from the NICU ASAP and call them, that's still important.

Give yourself a hug and a big pat on the back. If possible, maybe you could ask for a debriefing when you get back to work, to discuss things that maybe you could all do even better next time? But don't obsess about it -- you did great!

And how cool is it to have a niece born at 1/1/11 0001 ? Congratulations auntie!

Specializes in Nurse Leader specializing in Labor & Delivery.

Did you find out baby's cord gases?

Specializes in Obstetrics/Case Management/MIS/Quality.

hugs to you! that newborn is very lucky that you were there!

:hug:

Specializes in Inpatient Obsterics, NBN.

Y'all got a NICU?

Specializes in L&D.

Word from a nurse who worked today was that the cause was a hematoma from acynclitic presentation during pushing.

Does this make sense?

The weird thing is the tracing was fine during pushing!

I'll try and find out more at work.

I feel a little better sort of having an explanation.

Baby is still in the NICU I think (we have a level III NICU, one of the best in the area, so he's in good hands)

I'll remember to check the gases when I'm back at work too.

Thank you everyone for your support!

Specializes in L&D.

1 more theory I just came up with on why this may have happened - I think the mom had elevated BPs during pregnancy and had been on bedrest for it.

Maybe the spinal anesthesia dropped her BPs too much during surgery and it was too much of a shock for the baby?

Not sure what her BPs were before and after the spinal, but just a theory....

Specializes in Home Health.

adpiRN,

I am a med surg nurse and I can understand how freaking hard this is. I was called to a code in the ER on a tiny baby. That was the hardest thing to see and be a part of. Be thankful that you have that level 3 NICU and that the baby was resuscitated. It's pretty difficult when it goes thes other way. :crying2:

I think it sounds like you did exactly what you were supposed to do!

Wow OP, what a wild round of emotions for you. I hope that as the time passes you get the answers you need because I know you need them so you can be OK (like me).

Say hi to your new little family member and ENJOY.

Specializes in L&D.

I worked today and it seems that it was a subdural hematoma and once the baby was out and reserves gone, he just deteriorated fast. The neonatologist said that the tracing actually would look fine in this situation, it's only when he was out and supposed to be breathing air, but wasn't, that it got bad. The OB and anesthesia residents confirmed my observation that the baby seemed to get worse after the first minute or so. I heard he had a seizure his first night. But I went to see him today and he's breathing room air. On a drip to prevent seizures and EEG. I don't think he's seized again and hopefully the hematoma will resolve and he won't have any permanent neurological damage. Scary...

But I feel a little better knowing there's SOME explanation and that he's better.

Though some senior nurses I work with were up on their high horse today giving me a lecture about all the things I SHOULD have done. I know they were trying to help, but it just made me feel worse. I can't let it get to me I guess.

Also embarrassing that I cried at the nurses station after the code while charting my note and everyone saw. And I have the feeling that yesterday everyone was talking about how I froze in the code, didn't call the whole resus team soon enough, cried at the nurses station etc.

Whatever.... sigh...

Specializes in Labor/Delivery, Pediatrics, Peds ER.

:hug: Thanks for sharing what caused the difficulty for the baby. Praying all will go well. I'm sure you did your best, and you'll learn from this, and learn to adapt as well, because you care. That's what experience is all about, as tough as it can be. :)

Specializes in Community, OB, Nursery.

Those situations are hard, hard, hard. You did the best you could. And sometimes even when people mean well and tell you what you coulda/shoulda done, it doesn't come across that way and you feel about an inch tall. Been there, done that.

You did what you knew to do, and you have no doubt learned something from this that you'll know to do in the next situation.

+ Join the Discussion