conteinment of micro premie

[daniela]

:uhoh21: Hi!

I'm an italian nurse and I work in a third level Nicu; it's about one year that my staff have some problems with phisyoterapist who collaborates with us. The question is the correct containment of micro premie; we have a different point of view. The nurses try to work like NANN theach in the last book "Developmental Care of Newborns and Infants", but she reply that is not a good thing because the children cannot correctly extend the arts whith this type of boundaries; i.e.we use also the wrapping to help the childrens to sleep when they are really agitation but she reply that it is not a correct use of wrapping. One years ago I have start to make the bath whith wrapping like videos of Children Medical Ventures but she said that water is sufficient to contain the baby! She doesn't understand that this is ours job and we want make it really well first for the babies! . If someone of yuo want to replay this message I'll be really happy! It is soo hard, every day, try to work in progresse when someone ostacolate you! Thank's in advance Daniela

[prmenrs, RN]

Welcome to allnurses! You have a difficult problem. There is a lot of literature about developmental care. Copy some articles for her to read. There might even be some in Occupational Therapy journals. If this doesn't persuade her, maybe your Chief Nurse or Doctor can approach her boss. She should be able to work WITH you, not against you.

Good Luck!

[Gompers, BSN, RN]

I agree with prmenurs, this doc needs to be educated. You are on the right track and using the NANN guidelines is an excellent idea. We still have problems with many nurses on our unit not properly containing micropreemies, and many of those babies need lots of physical therapy after they go home because of it. True, containment is a way to reduce stress and increase comfort, but more importantly, it guides preemies' neuromuscular development. They learn that their extremities should be flexed, not extended (like your doc seems to want) so that over time, their brain recognizes flexion as "normal" positioning. They're losing so much time in the uterus, where the quarters are cramped and they must be in a flexed position most of the time - therefore their muscles develop appropriately. So it only makes sense that we should mimic those tight quarters by providing boundries and containment once these preemies are born. But it takes so much education to get this point across to some "old school" NICU nurses and doctors.

Good luck, and welcome to All-Nurses!!!

[dawngloves, BSN, RN]

I second Gompers! If they were in utero, would they be flexed?

[TTRN]

Definitely contain preemies as permitted. In our unit I have to say our developmental team has educated the neo's. We currently use equipment such as the bendy bumpers, freddy the frog bean bags, surf-boards made from t-shirts, gel pads, snuggle ups,isolette covers as well as crib covers. Our volunteers sew flannel sheets and pads for our babies to lay on. If baby's are swaddled we cover their eyes. All our kids are seen by speech therapist as well as physical therapist. All have developmental and feeding care plans by the bedside. All in sight for parents, nurses and doctors to follow. Our developmental/speech therapy is initiated upon admission.

We don't see many ballerina babies and stiff babies like we used to 10 years ago.

Perhaps start a developmental commitee or ask for your Nicu educator to sponsor developmental care conferences.

I'm interested in working in Italy, is there a big difference in the NICU?

[daniela]

What exactly are you interested to? About developmental care we try to use the same materials but we haven't allthings so we can make somethings with ours hands. I often think that an american nurse cannot work in Italy so easy like an italian nurse in United States! Why? Because often we have to work, ie. in small place, with many hand made equipment, without developmental team and with many people who doesn't belive in this; but we are really hard people and also positive. If you want to know something in particular you can ask me, you wellcome in italian reality, a difficult land to escape but so interesting! Good Night to everyone!

Daniela

Definitely contain preemies as permitted. In our unit I have to say our developmental team has educated the neo's. We currently use equipment such as the bendy bumpers, freddy the frog bean bags, surf-boards made from t-shirts, gel pads, snuggle ups,isolette covers as well as crib covers. Our volunteers sew flannel sheets and pads for our babies to lay on. If baby's are swaddled we cover their eyes. All our kids are seen by speech therapist as well as physical therapist. All have developmental and feeding care plans by the bedside. All in sight for parents, nurses and doctors to follow. Our developmental/speech therapy is initiated upon admission.

We don't see many ballerina babies and stiff babies like we used to 10 years ago.

Perhaps start a developmental commitee or ask for your Nicu educator to sponsor developmental care conferences.

I'm interested in working in Italy, is there a big difference in the NICU?