Infant circumcision question

[Tammynurse2000]

I recently started working in the newborn nursery of a small hospital there is 2 obgyn who practice here both do gomco circumcisions as I have to assist the docs the newest doc who just started uses a gomco but she don’t not use anything to numb it

1 is there anything I can do or say 

2 is this a normal thing that happens at hospitals other than mine 

3 let me know what experiences you have had with infant circumcisions

[LeChien, BSN, RN]

1. You can ALWAYS (and should) speak up for your patient!

2. Not sure about other hospitals as I don't work in OB.

3. I've personally seen two circs in nursing school. Both babies were locally numbed SQ and also had the binkies with sucrose to help sooth. One baby slept through it, the other cried the entire time.

 

If it were me, I would speak to the doctor before she even goes in to see the baby and start the procedure. You can either straight up ask her if she is going to use local anesthetic, or subtly ask by saying something such as, "Oh, I see you're gathering supplies to start Baby X's circ. Would you like me to grab the lidocaine from the Pyxis for you?"

Good luck!

[NICU Guy, BSN, RN]

We use Lidocaine injection for ALL circumcisions.

We also use sucrose to keep the boys happy while their legs are strapped down. 

[adventure_rn, MSN, NP]

Ahhh! Please advocate for lidocaine!! (Plus sweeties during and tylenol either before or soon after).

This makes me really concerned about how well this provider was trained. Ouch!! ?

[Leader25, ASN, BSN, RN]

I am an anti circ advocate but I am not independently wealthy so I shut up,after I set up everything,I leave and ask to call me if anything else needed.I am firm and no one has every questioned me,but that comes with experience.

I have witnessed too many horrid circs with excessive bleeding that required surgeon to be called back and stiches placed.

Some Obs[make sure you check their credentials for circ] are in a big hurry or too lazy to order pain med,making excuses for not doing so.The gomco itself is supposed to cause compression thereby "numbing" the area.The question is also pain relief for after the circ ,pain  on urination.You can ask the nicu doc to order that for after.

I do not say anything to the parents if they wish this on their baby so be it.I will offer any hospital approved handouts. Instruct carefully on post care, you do not want scar formation or other complications.I am so glad the trend is to do less of them.A normal foreskin does not retract all the way until after one year of age and should never be forced.

Sweetease does offer some relief but could I skin your finger and just offer you some sugar and then pour urine on it?

Please keep an eagle eye on those babes,they can not speak for themselves,if female circ horrifies you the male circ should also,it is barbaric.If an adult male gets circed he gets to have a surgeon,real pain relief before and after.