Need advice...this was a first

  1. Hi you guys...this situation has never happened to me before and I am at a loss of how to handle it.

    Last night I had a little one who was crashing when I came it...we had to go to the OR...and was running my ass off all night. It's a sad situation; and the mom does have PPD.

    It's been a while since I had an A care infant (another long story), I felt alittle rusty, but did feel I did very excelent care. The parents came of course after surgery...I was so busy that people were offering to assist as we all do in these situations. Mom was upset and I started to explain exquipment and such. Another staff nurse asked if she could do that so I could do other needed things...I said OK and thanked her. I had before offered the parents (mom) tissues , a chair, and asked someone to get them a room on the unit for the night if they wanted. I had only meet the Dad the night before, never the mom.

    Anyway I come in tonight expecting the same baby and my assignment is different. I asked why...I was told the parents asked that I not care for their baby?! No one will tell me why! The day charge nurse says the charge nurse on nights last night is the one who the mom talked to. No one pulled me asside and told of course I feel bind-sighted! Needless to say I am extremely upset...and am crying (now my eyes will be all red and puffy) ...I come into work early and have 25 mins to get ready.

    So now what? Do I talk to the mom, or should I not approach her? Do I talk to my nurse manager? I feel like this could effect my position's hard enough to get the A care assignments around here.

    Thanks for your advice.
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    About kitty29

    Joined: Sep '03; Posts: 1,658; Likes: 117
    RN; from AZ , US


  3. by   Gompers
    Quote from kitty29
    So now what? Do I talk to the mom, or should I not approach her? Do I talk to my nurse manager? I feel like this could effect my position's hard enough to get the A care assignments around here.
    I'm sorry for what you're going through, but rest assured it DOES happen and it's not your fault. Sometimes when a baby has a bad night, the parents blame the nurse even though he/she had nothing to do with it. It's just a way to get some control over the situation. Other times, in their minds they associate the nurse with that scary night where they almost lost their baby, and it becomes an "out of sight, out of mind" kind of thing. They might have thought you were new because a lot of people were helping you and worry that you don't have the experience to deal with their baby, because they don't know any better - that a nurse with decades of NICU experience would have had people helping out, too!

    I wouldn't talk to the mom about this. If you pass her in the unit, smile and say hello, and ask how the baby is doing - try using the baby's first name, too. I would talk to your manager, though. Only he/she has the authority to tell you why the parents made this request. You can talk to your manager about the fact that you aren't getting more critical assignments, and that you feel you need more experience in that area. This way, your manager knows you are up for the challenge and that looks very good for you.

    It's nothing you did on purpose. The parents are just scared and need some control over the situation. It happens a lot where I work - parents associating certain nurses with unpleasant memories and then request them to be on a "no" list for their baby.

    Take care.
  4. by   Gompers
    one more thing...

    {{{{{{{{ kitty29 }}}}}}}}

  5. by   kitty29
    Thanks "G" (I thought No one was even going to respond)!

    I have talked to my NM about the assignments before; we have a good working relationship now going on 15+ years! I was able to talk with the charge nurse from last night. I guess the mom felt ignored or something because I was so busy. Like I said I ussually go over stuff myself...but other urgent things needed to be done and that is why I allow the other nurse to continue what I had started. I did address the parents when we got in tho; and did other stuff I felt was caring. The mom also said she wasn't comfortable with me...and she apparently wouldn't say anything more. So When she was crying and accross the bed from me (I was hanging IV's)...the dad was on my side...I said I was sorry all this happened and gave the dad's shoulder a don't think she was upset by that do you??? I had met the dad the night before (the couple has other issues).

    Tonight I went in the other room to develop pictures for my new assignments family...well the dad was with his daughter...and I did say Hi and asked how things were (there better) and I said I was glad since last night was a rough one for his baby. Mom wasn't there...and I won't talk to her taking your advice.

    The charge nurse from last night said this wasn't something that was going to the NM at least in her view by the parents. So I guess for now I won't address things unless that changes.

    I do understand what you mean "G" about families emotions. It's just so hard when you work so hard for things to be better for their family and then they slap you in the face sort - to - speak!

    Thanks so much for responding and you advice! I am feeling better.
  6. by   Gompers
    Sometimes it's like you can't do the right thing no matter how hard you try. Had you spent your time talking to the family and caring for THEM, they might have turned around and said you didn't care for the baby like you should have. Or if you cared for the BABY, they'll turn around and say that you weren't very supportive of them. You're damned if you do, and damned if you don't!

    If this is a couple that already has "issues" then having a very sick baby is not going to help them any. Again, it's the control thing and wanting to blame somebody. You didn't do anything wrong.

    When I've got a really sick baby like that and other nurses are helping me, I try to talk to the parents while I'm doing my thing. Like if I'm calling the doc about a falling blood pressure, after I talk to the doc I'll explain things to the parents while I'm drawing up the saline bolus, etc. That way I'm caring for them and their baby at the same time. Or if I have other nurses rushing around helping me, I'll be overly polite so that it doesn't look like I'm scared out of my mind! Like, "Oh, thank you Becky for calling pharmacy for me - did they say how how long until the dopamine drip is ready?" instead of "Did someone call pharmacy about the dopamine?!?! It's taking forever and I need it NOW!" which sometimes I see people doing in front of the already terrified parents.

    If this is the first time you've had a sick kid in a long time, I can see why you were frazzled and maybe the parents picked up on that. They don't understand that it's OKAY to be frazzled in critical care! I mean, who in the world WOULDN'T be frazzled when the tiny baby under their care is crashing? We have the right to our emotions, and that includes being scared and nervous.

    Don't worry about it too much. If you see your manager, you might just want to have a quick chat about needing to be assigned more critical babies, but don't dwell on this family. They have their hands full and you just got caught in the middle. Good luck!
  7. by   kitty29
    Thanks G....I actually did do those things you've mentioned after my co-worker briefed the parents; and asked if they had further questions. I don't feel I appeared frazzled tho. At this point I have talked to other coworkers who know the family (they have been here about 7 weeks); and they tell the mom is a real basket case! So now I believe the issue was hers all along.

    Having said that; I do feel bad for anyone who has to cope with so much when a birth of a baby should be a happy time...they have had nothing but stress. And this stress won't go away; in this situation things are always going to be a challenge for them...on a good day.

    So guess to make a long story short; I'm past my intial emotion over the whole thing. I well know more is going on. I can get past hurt feelings ; as long as I have the respect and support of my co-workers!

    You are surely correct in the catch 22 situation here. It's the down side of any job. I've alway felt bad for other nurses who have gone through this...never thought it would happen to why I don't know! Guess I've been lucky it hasn't happened before!

    Thanks again for your support.

    Another topic: I've been scanning bereavement stuff tonight; found a neat place that will donate memory boxes to hospitals called Heavenly Angels in Need.

    If your NICU is like ours; we Never seem to have funds for essential things like this for families. They have other items too. Check it out!

    Thanks again friend!