Doctors Keeping Very Sick Babies Off Life Support

[Bortaz, MSN, RN]

http://www.foxnews.com/health/2011/07/08/doctors-keeping-very-sick-babies-off-life-support/print

Thoughts?

We're currently treating a 24 weeker that everyone on staff feels should be allowed to expire. Grade 4 bleed, probable dead gut (they were scheduled for exploratory lap on my first day off, don't know results yet), and all the other myriad things that go wrong at 24 weeks. The young parents refuse to make her DNR, though, and insist that we "do everything you can to save her".

At what point do we have the moral obligation to say "enough!"? I've been fighting a bit of guilt over praying that the baby expires and takes the matter out of our hands. It's heartrending to see the obvious futility and suffering.

As a fairly new NICU nurse, I don't know whether it's "bad" to have these feelings, but as an old human, it's the best I can do.

[Guest505077]

please don't feel guilty for feeling the way you do, you're being honest and recognizing what you feel.

it is always difficult when dealing with such a extremely premature infant... the odds are against them, so many hurdles to overcome, some have a brief journey, some such a long journey - however, it is not up to us to decide what happens... we as the caregivers, are there to provide the best care possible to the infant as well as the family ... to help them on their journey

believe me- even when we (the medical staff) are sure that it would be best if the baby's journey ends when we want,and the parents agree to ending the life support- it is never easy to deal with the passing of that little life...

I wish you well in your nursing career- you will touch many lives

[tntrn, ASN, RN]

Back in the 70's and 80's, most of our 26 or 27 weekers were allowed to pass because we just didn't have the technology to save them. Usually, the staff already knew whether an attempt was going to be made or not. And we had a level III NICU.

[Elvish, BSN, DNP, RN, NP]

It sounds like a very normal human reaction, and you don't stop being a human at work. :redbeathe

I've caught 19-weekers born alive that live for several hours, and I pray for them to die quickly. That may sound cruel but so is watching them live and breathe and knowing there's nothing I can do about it.

[NICU_babyRN, BSN, RN]

I see it all too often that we keep babies on life support until the parents say enough. It's specially tough because we have several attending physicians who all think differently. We had one physician encourage parents to hold and let baby die (a 23 5/7wkr) and then during evening sign out another attending dared say "she's a fighter, hanging in there for a long haul" right in front of the parents.

Mixed signals to ALLLLL of us + the parents.

It's totally normal to feel how you feel. Just try to remain neutral and support the parents on any decision they make. They do have the ultimate say on "doing all" or "doing nothing".

:)

[Dani75RN]

I don't think it's bad at all to pray for peace for the little one... Been in the NICU for 5 1/2 years & I have prayed that prayer many many times... Currently, we have a little man in our unit who was born at 24 weeks.. He celebrated his 6 month birthday with us last week & has never been able to enjoy life outside the hospital walls... Two days ago, he got re-intubated, b/c at 12 #, he has outgrown his lungs.. It's so heartbreaking to see him go through this same routine, time & time again.. He had surgery July 4 for a fundo/GT placement/circ/hernia repair & his parents were convinced that would "fix" him... I'm afraid he's never gonna get outta there.. What makes it even worse is that his head is perfect, no ROP, he totally interacts with us now, sticking his tongue out at us, pouting, etc.. It just breaks my heart to see him constantly struggling just to breathe. He has had multiple round of Decadron, etc. but his lungs are still too immature to support his need & he's constantly air hungry..