Disgusted

[kaypyn]

I am absolutely DISGUSTED with the way some of you nurses are speaking on here about "methadone babies"! I can not believe you people are nurses, to be a nurse you need to have compassion and it's obvious a lot of you are judgemental & show no compassion for the suffering mother! You think these people want a life like they have?!! Methadone was the best choice for these people at the time and I can't believe a nurse actually said "herion or crystal meth is Better than methadone". Are you KIDDEN me?! This is disgusting to see this, the last thing these mothers need is a "professional, someone who knows what they're talking about" to judge them! They are already judging themselves! WOW!

[HyperSaurus, RN, BSN]

We're not here to take care of the suffering mother, we are in the NICU to take care of the suffering baby who had no choice.

Now, I am aware that every person has their story and their reasons for why they do what they do. Some of our withdrawal babies are from mothers who have been working hard to get clean or were on narcotics due to legitimate medical reasons. However, there are the moms who are not making that effort and unnecessarily subjecting baby after baby to needless suffering.

[iluvgusgus]

Unfortunately, nurses are humans and they will judge...

[KelRN215, BSN, RN]

Methadone was the best choice? I would think drug free would be a better choice. Choice is the key word here. Adults always have choices, children do not.

Or how about not getting pregnant while you're on drugs? There. I said it.

[babyNP., APRN]

We're not here to take care of the suffering mother, we are in the NICU to take care of the suffering baby who had no choice.

Now, I am aware that every person has their story and their reasons for why they do what they do. Some of our withdrawal babies are from mothers who have been working hard to get clean or were on narcotics due to legitimate medical reasons. However, there are the moms who are not making that effort and unnecessarily subjecting baby after baby to needless suffering.

Mmm...I would actually disagree that parents are not also our patients. No, we don't give them physical care, but we do provide a lot of teaching to them. We teach them how to care for their infant and assess whether or not they can safe take care of their infants. Families are a part of NICU nurse's care, no doubt.

[HyperSaurus, RN, BSN]

Mmm...I would actually disagree that parents are not also our patients. No, we don't give them physical care, but we do provide a lot of teaching to them. We teach them how to care for their infant and assess whether or not they can safe take care of their infants. Families are a part of NICU nurse's care, no doubt.

I agree, babyRN, families are definitely a part of the NICU nurse's care. I was more trying to say that I'm not there to feel sorry for the mother

[TiffyRN, BSN, PhD]

Some of our withdrawal babies are from mothers who have been working hard to get clean or were on narcotics due to legitimate medical reasons.

Yea, and then there's the ones that go through fertility while on massive PO narcs for whatever chronic condition they have (ok, I'm sorry they are chronically ill, don't wish that on anyone). Cause it was more important for them to have what they wanted (a baby, or multiples as it turns out) than the torture their infants will have to endure to get over the addiction their mother blessed them with.

Yep, had to ask to stay away from that, just couldn't fake smile through that situation.

Oh yea, and mom all but refused to room in with both cause the kids were too much for her and dad to handle. Docs are all like "Do it here or we'll find someone who can."

Can I also include the story of the mom who went on subutex cause she knew how bad street drugs would be for her kid. When she saw the weaning process was going poorly she asked could she stay and hold/comfort her child as much as the child needed. We arranged a rooming in room. She stayed non-stop for 4-5 days. They child weaned quickly at that point. I wish this was the standard story instead of the exception for what I see.

[24gaDalek]

Can I also include the story of the mom who went on subutex cause she knew how bad street drugs would be for her kid. When she saw the weaning process was going poorly she asked could she stay and hold/comfort her child as much as the child needed. We arranged a rooming in room. She stayed non-stop for 4-5 days. They child weaned quickly at that point. I wish this was the standard story instead of the exception for what I see.

I love this. Absolutely love this. I wish this were the norm for most of our NAS babies, but alas it is not. Usually, I just get complaints about babies who obviously are not changed enough because they have a raw bottom and aren't well taken care of because they are perpetually covered in vomit. I just grin and bear it but i would like to say that these things are not my fault.

Press-Ganey scores keep me employed.

[babyNP., APRN]

Yea, and then there's the ones that go through fertility while on massive PO narcs for whatever chronic condition they have (ok, I'm sorry they are chronically ill, don't wish that on anyone). Cause it was more important for them to have what they wanted (a baby, or multiples as it turns out) than the torture their infants will have to endure to get over the addiction their mother blessed them with.

Yep, had to ask to stay away from that, just couldn't fake smile through that situation.

Oh yea, and mom all but refused to room in with both cause the kids were too much for her and dad to handle. Docs are all like "Do it here or we'll find someone who can."

Can I also include the story of the mom who went on subutex cause she knew how bad street drugs would be for her kid. When she saw the weaning process was going poorly she asked could she stay and hold/comfort her child as much as the child needed. We arranged a rooming in room. She stayed non-stop for 4-5 days. They child weaned quickly at that point. I wish this was the standard story instead of the exception for what I see.

Are you saying that mothers with chronic pain problems like fibromyalgia or on psych medications like SSRIs shouldn't be allowed to get pregnant?

[TiffyRN, BSN, PhD]

Are you saying that mothers with chronic pain problems like fibromyalgia or on psych medications like SSRIs shouldn't be allowed to get pregnant?

SSRIs cause minimal to no notable withdrawal symptoms. I've seen mild jitteriness and a little sneezing in just. a few of the kids exposed.

Narcs on the other hand, in the case I spoke of was heavy-duty daily dosing capable of causing major withdrawal in infants (which it did).

Yes, I'll go out on a limb and say if you are on heavy-duty opioids, you should avoid pregnancy. If it happens, then it happens. But forcing pregnancy (with fertility tx) while on heavy opioids . . . that seems wrong.

[babyNP., APRN]

Well, I guess this is where you and I would disagree because while NAS isn't mild, it does go away after 1-2 months and as far as I'm aware, there is no research saying that there are any long-term health effects. And to deny an otherwise fine mother the chance to have a baby based on passing along a medical condition which will resolve within 1-2 months and that the infant will never remember seems unnecessarily cruel. I also don't see what infertility has to do with it...many women have infertility. It's just another avenue to help a mother have a baby.

There is also research to show that the effects of NAS are similar with a wide-range of doses, which is why mothers won't be weaned completely off of the methadone during pregnancy because it doesn't make any difference in length of stay for the infant. So being on a "heavy duty" dose doesn't necessarily make a large difference in length of stay for NAS.

[TiffyRN, BSN, PhD]

I think we can respectfully disagree on this topic. I know the research consistently shows there isn't a difference in severity of symptoms regardless of dose but I am sadly vulnerable to the anecdotal incidents I witness (though I will spout the evidence if asked).

Also, at least in the case of the mom with twins I described, there was polypharmacy involved. Pretty much every sedative, hypnotic, benzo, or any other psycho-active drug legally available, she was on it. Her poor kids only got treated for their opiate withdrawal.

In addition, the fact that we had to threaten protective services involvement to get her to room in with her kids. She didn't have help planned at home, and hubbie was about to start traveling out of town. We needed to determine if she was safe to care for these infants.

[babyNP., APRN]

I guess I'm curious then...would you also tell women not to have children if they were at a high risk for something like CHD, cystic fibrosis, or trisomy 21? Those are lifelong conditions that cause suffering for the infants throughout their lives, but I wouldn't venture that many people would say that women shouldn't be allowed to have children due to that.

What I am trying to get at here is that NAS is an emotionally charged diagnosis in the NICU. I don't feel that many people make rational opinions/judgments when it comes to this type of problem as it has such a high stigma. A lot of confirmation bias goes along with it as well. Most people would not feel bad about disparaging a mother privately amongst co-workers even if she has a legitimate reason to be on opioids. OTOH, most people would not disparage a mother with a history of left-sided heart disease for having another child, even though she runs a great risk of having another infant with CHD.

In the end, it's okay for us to agree to disagree. I just want to give people the chance to self-examine why they think the way they do because humans are biased, if nothing else, and it's important to remember this when we tackle emotionally charged issues.