Holistic Needs of Infants and Children in a Hospital

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Today I went to visit the nursery at the local hospital. It is the first time I have ever really seen a nursery w/ babies in it, as the hospitals I toured when pregnant had rooming in and no NICU/high risk pregnancies. I also gave birth to my two girls (2 1/2 and 8 mos) at home, so have very little hospital knowledge other than the tours that I did during my 2 1/2 yr old's pregnancy.

So anyways... There were 4 in there, 3 of them appeared to be sleeping, completely naked (no diapers even) with only the umbilical cord clips and one of those stick on pads that monitors your HR. They looked so peaceful, and then I saw the baby that was crying (the room is soundproof...I guess to keep from disturbing the moms). There was only 1 nurse in there, but she walked over with her little notebook, made a note, turned on the heater, and walked away. The baby was obviously a newborn (still had ink on his little foot and goo in his eyes). She didn't pick him up, talk to him that I could see (couldnt hear anything but didnt see her lips move and she was facing me) or even touch him whatsoever. She didnt smile at them or even seem all that interested in their existance at all (although this was just my interpretation from the bored look on her face as she wandered back to her terminal w/out so much as touching/speaking/aknowledging the baby)

So.. this has me thinking... how do we address the holistic needs of children and infants? This is a childrens hospital and has a high risk maternity ward that is supposed to be very good. I'm sure they are medically in very good hands here, but what about the "whole person" needs of infants and children? I hadn't really thought about it, but how is that sort of thing addressed? What happens when babies cry at YOUR hospital? What about when 2 yr olds wake up with nightmares in the middle of the night? Or 6 yr olds throw a tantrum or are scared of the dark? How do you handle these young patients in a way that lets you sleep at night? Because looking at that little baby, seeing him cry without anyone even considering consoling him, so soon after birth (this was the "healthy baby nursery" btw so no medical problems) just made me want to run as fast as possible from infant or pediatric persuits (I'm a nursing student/hospital secretary)

And then... how do you get your work done if you DO give them "attention" beyond that which you would give an adult? (meds/dressing changes/etc)

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No responses at all? Was my intro way too long? I just want to know how nurses address the needs of infants and children beyond the physical/medical?

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Well, that nurse wouldn't be on our maternity unit for long. We don't have a NICU, but rather a standard OB floor, but there's no way those nurses would have let that baby holler without attempting to comfort him somehow. She may not have had alot of time to fuss with him, of course, but it sounds like that nurse did not even make the attempt.

A crying baby is a distressed baby, and like I said, she wouldn't be on OB long before the suggestion to transfer her somewhere....else...would come up.

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Specializes in NICU/Pediatrics.

I work at our local childrens hospital in NICU and PEDs. We are always concerned with developmental care as well as compassion. If you can't relate to kids you don't belong here. But without knowing the entire story I couldn't comment. Course it doesn't take much to offer a NUK or some sucrose to calm.

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Specializes in Pediatric/Adolescent, Med-Surg.

I work with peds (mainly adolesents), but I do occasionally get infants and younger children. A infant responds to illness not unlike an adult, when you're sick, you're miserable. I took care of a 6 month old last week that had just had a G-tube placed, he was crying, and you could tell he was miserable. We brought him out to the nurse's station and passed him around rocking and holding him, which made him feel safe and calm down. Sometimes a baby just wants to hear your voice and wants to know other people are around. I've had babies sleep out at the nurse's station peacefully, because they hate being in their room all alone. Especially with infants, I think it's best we do what we can to help them develop a concept of trust.

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Its protocol at our hospital to seperate any baby that needs care from the "healthy newborns" I guess because we have such a well staffed nicu (there are 2 resp therapists there 24/7 on top of the nurses etc) so I know it was not a medical problem. I think he was just asleep and woke up, since I hadnt noticed him crying immediately.

I'm trying not to judge, just to understand... I just wonder how the non-medical needs of children and infants are addressed in a medical institution. Our hospital, understandably, has a lot more restrictions on volunteers etc on the baby floors for security reasons.

Maybe there is some sort of belief in "crying it out" as a method of teaching babies to sleep?

I guess I just have a lot of mixed feelings about this because a part of me wants to do peds very bad, and I understand that sometimes you have to do things to kids for their health that they don't like, but its the unnecessary sadness/fear/loneliness that I would find it hard to see or be a part of. (kind of why I avoid obstetrics...not because of the necessary interventions, but the unnecessary restrictions/rules/regulations that I've witnessed)

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Specializes in ED.

I think you hit it when you asked if they would have time to do everything if they spent a ton of time consoling the infant, BUT, for me, there's no way I could walk away. but it also makes me wonder, if the infant was healthy, why was it away from the family? just curious. I know, for me, I would not allow any nurse to take my child when she was born, for me it felt unnatural.

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I think you hit it when you asked if they would have time to do everything if they spent a ton of time consoling the infant, BUT, for me, there's no way I could walk away. but it also makes me wonder, if the infant was healthy, why was it away from the family? just curious. I know, for me, I would not allow any nurse to take my child when she was born, for me it felt unnatural.

I believe that there is a rule here about 2 hours of "observation" right after birth for new babies. This is not unusual, as I know first hand that another hospital an hour away has a similar "rule" but I think theirs is for 4 hours (I remember the rule, but not exactly the time) A CNM once told me that the last place you want to have a healthy baby is in a level 1 hospital, because they treat every baby and every mother like they're about to drop dead any minute. We have multiples born atleast twice a week, and had 3 babies die within a 12 hour period the other day, and it was heart wrenching for everyone. Our NICU has many, many, babies in it so I can understand that it may skew the feelings/thoughts on how "risky" childbirth is.

As I said though, this is an area of mixed feelings for me. I did not have my last 2 children in a hospital, and I agree that I don't understand the whole 2 hours away from mom right after birth as "protocol" philosophy. As a mom, I refused to let my babies leave my sight for weeks after their birth, and barely even let anyone hold them because we were bonding and maternal instincts just kicked in.

But I'm trying so hard to get past my personal prejudices long enough to try to see the situation objectively, as a nurse. I have a child/maternal/infant rotation coming up this school year, and I simply don't know how I will be able to get through it because of my personal feelings about birth. I guess I was just hoping to come here and find some reassuring "we do this because...." or "we may not look like we're looking at them/caring for them but its because we do x y and z that is not obvious to the naked eye" kind of thing. I was really praying that going into nursing would help me understand nurses and doctors a bit better, in regards to that which I've seen/experienced in my history of 3 pregnancies.

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Specializes in NICU, PICU, PCVICU and peds oncology.

I think I'm going to move this thread to the Pediatric Forum. You'll probably get more replies there. But before I do, let me tell you that although I work in a PICU and most often cannot pick up my patients to cuddle them, there are many other things I can try to help them feel comforted and secure. A lot of the nurses I work with reach for sedation before trying comfort measures, but that's not my practice. I lean against the side of the bed and get in close so they can see me if they open their eyes and so that they can hear me over the noise in the room. I stroke their head or pat them on the bum, try repositioning, try swaddling, any number of things before I'll reach for the drugs. I got report the other day from a nurse who looked totally frazzled. The patient was an infant who was POD 15 s/p liver transplant for a metabolic disorder. He was ready for transfer, and had hardly slept all night. He was squirming and crying and had a mild temp. Once I was finished assessing him, I bundled him like a burrito, and wonder of wonders, he fell asleep almost instantly. His temp came down to normal. The only time he stirred was if I had to touch him. He was still sleeping at 2 pm when I transferred him to the floor.

I can't explain the behavior of the nurse you described in your original post.

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