Back to Sleep

[Flo1216]

OK, guys I know there are a lot of good nurses out there but lately I have been encountering a lot of bad ones and as a senior nursing student it is killing me. I have had 2 incidences with a pediatric nurse(she has only been a nurse 6 months) about " Back to Sleep, " I was taught that nothing should be in a baby's crib but the baby and a light blanket. I have also researched this on my own. Well, one day I was working and I removed an adult sized pillow from the crib of a 1 month old on an apnea monitor. The nurse came in and said, " Where is her pillow?" I said, " I thought we weren't supposed to put pillows in the crib, " She proceeded to roll her eyes and say, " Whatever," I later found out from the baby's mother that she kept the baby in bed with her because she did not have a crib. She was homeless during the majority of her pregnancy. I told this to the nurse who again rolled her eyes and said, " She has other children...what did she do with them?" (Uhhh...maybe she had a crib then. We are talking about NOW). So I figured a social services consult was in order. The nurse said it was up to the doctor whether or not this patient could get a crib.???? I also went to L&D to get the mother some info on back to sleep, but I couldn't because THERE WAS NO INFO. Last week, on peds there was a detox baby awaiting placement, however the mom comes in frequently. I went to check on the baby and there were about 10 stuffed animals and several pillows in the crib. The baby was on its side wrapped in a blanket with a heavy blanket over her. When I went to change her diaper I found she was wearing TWO outfits. I told the nurse this and AGAIN she rolled her eyes.When the mother came in I explained to her about Back to Sleep and S.I.D.S etc. She was very grateful and told me she never knew that. I am a CNA and I am resentful that I have to teach this mother something that she should have been taught a long time ago by the registered nurse.

And the fact that the registered nurse isn't even assesing her 3 week old detox infant is equally disturbing. I am now working on an education guide for Back to Sleep.

[Q.]

Originally posted by Flo1216

As for teaching, are you saying that because their is a nursing shortage and that nurses are busy that teaching shouldn't be done?

Never did I say it shouldn't be done. It should! But from my experiences lately, it just can't be done adequately - obviously, if patients aren't walking away more knowledgeable.

If this nurse has time to talk to her husband on the phone every 10 minutes then she has time to teach.

I agree.

[Flo1216]

Kitty w-I just read an article written by the National SIDS Resource Center which said that many infants who were found prone at death were originally placed in a side-lying position. Side is safer than prone but supine is safest and preferred. (AAP Task Force,1996). By the way, October is National SIDS Awareness Month.

[OBNURSEHEATHER]

Originally posted by Flo1216

The nurse allowed it because basically she didn't give a shit.

Wow! She said that to you?

Heather

[nell]

Way to go Flo1216!

I'll have you on my unit anytime. Good for you to recognize the need for literature on back to sleep. And taking the initiative to put a pamphlet together? You may be "just a CNA" now, but you will be a very Professional Nurse when you graduate.

We do allow a small stuffed animal, and frequently have a lot of stuff (diaper, extra blankets, etc) at the bottom of the crib on our older babies (we take them up to 3 months) but these babies are all on C/R and Pulse-ox monitors and are visible to at least one nurse at all times. I have taken pillows out from under these baies and explained to their parents that they shouldn't have them and why.

We frequently put the preemies prone in their isolettes - but we stop this practice when they no longer need it for resp. or GI reasons (usually by 35-36 weeks) and once again, they are monitored and visible. We explain to the parents that we do things in the hospital (like use sheepskins) because of the monitoring and they should not do it at home.

Babies who are not visible to a caregiver at all times should not have stuff in their cribs and should definitely not have pillows. They should be on their backs when asleep or when a caregiver is not there. I agree with setting an example of safe practices in the hospital. Those stuffed toys can be taped to the rails where baby can see them instead if being in the crib.

You are right that side-lying is not recommeded either, as the baby can easily end up prone. Those positioning wedges are not recommended either.

More power to you for doing the right thing. Someone needs to advocate for those babies and most parents welcome info that could prevent SIDS.

[Q.]

Originally posted by OBNURSEHEATHER

Wow! She said that to you?

Heather

Holy crap I think I missed that part of the post. She really offered you no rationale for actions other than THAT? I think that calls for some intervention with the NM at least. Not "giving a shit" about your patients to the point of deliberately putting them in harm's way is definitely something to be concerned about!

[Flo1216]

She didn't say that to me-her actions pretty much told me she didn't care . Twice this has happened where I pointed out the situation to her and she shrugged and rolled her eyes and said, " Whatever," Plus, SHE was the one who put the pillow back in the crib after I took it out. She never changed the situation and she never talked to the mothers about Back to Sleep. She did however, find time to look at magazines, talk to her husband and tweeze another nurse's eyebrows. I was the one who fed the baby and changed it's diapers(which was how I discovered all of this) and held the baby when she cried. And when I say there were stuffed animals in the crib, I mean they were EVERYWHERE. Not at the foot of the bed. Plus there were TWO pillows, she was wearing TWO baby jumpers, was swaddled in one blanket with another heavy one over her and she was laying on her side. The mother did all of this very innocently, but the nurse never checked on the baby after mom left. So no, she never said, " I don't give a shit," but her inaction said it for her.