So I usually work on the regular in pt peds ward, but we are often floated to the NICU because they have staffing issues to say the least. But that's a whole other thread for another board.
Any how....I was floated to the NICU. I was assinged two babies, while I'm getting report on my 1st baby she begins to desat so the day shift nurse repositions her, suction, CPT, but no improvement. So we provide blow by and get the DRs. In the middle of this the day shift nurse for my other baby comes up to me and ask to give me report on my other baby. So I take it...go back my 1st baby. The charge nurse sees what's going on and ask me if I want a to give up my 2nd baby and just have this one or take 2 other babies. I wanted to focus on the one really sick one. I'm not scared by the situation...I used to work in and adult ICU so I've had a lot of experience with pt's trying to go to the light. But this is my 1st experience with a baby.
So I took the one baby. To give you some hx on this baby: She was 41 wk baby, born perfectly healthy. At 12 hol the baby arrested; mom was breastfeeding and talking on the phone at the same time. When she got off the phone (after 11 min) she noticed the baby was acting funny and discolored. So the nurse was called and took the baby out. The baby was blue; baby was coded. Not breathing; no heart beat. She was intubated and est. heart rate. She then was flown to our hosptial's NICU.
She remained intubated for a couple of days, was extubated then intubated again. Then extuabated again. So when I came on she was on room air.
The family had been educated on her condition, and her long term quality of life. She was without O2 for more than 10 mins so all of you know that she has major brain damage, and can't do anything on her own.
So back to my night....we continued bb and got a gas. CO2 was something crazy like 72! So dr's called the family to make sure they still wanted everything done, and they did at that time. So we applied NC and she maintained her o2 sat really well at that. Before we gave her he O's she had that "death rattle" while breathing. Also, she was still having alot of thick secretions and needed suctioning frequently.
The DR had another talk with the family about DNR order and letting the baby pass. A couple of hours latter they est. the DNR order, which included standard no cpr or intubation. It also included stopping the feedings, removing NJ tube, and no labs. We kept TPN/Lipids and o2 and added q4 morphine. And they were to remove the crm/po monitors later on on tuesday.
It was such an emotionally draining night. The family stayed at the bedside for several hrs before the order was written, then left not long after. Of course they were very upset...crying...etc. Before they had the DNR made both mom and dad wrote the baby letters and put them in the crib. That just broke my heart; i'm crying just thinking about it.
Its a young family. Dad's marine who was deployed when the baby was born, so he's never seen her healthy. He was flown back right after this happened. Everything about this breaks my heart. This is way different than dealing with adult pts whom are at the end. And this is why I want to go back to the ER or the adult ICU!
How do you experience NICU nurses deal with situations like this? And what do you say to the families?
Sorry for the long post...I just wanted to share with all of you.
Specializes in ER,ICU and Progressive Care Unit,Peds.
I'm not sure about the autopsy part; I don't really want to ask. But I did get the parent's address, and I'm going to send them a card. I know that at this time in their life that words are futile, but I just want to let them know I'm thinking of them.
As far as moral support from the NICU staff....not happening. They just see me as another body up here. I'm in the military and at our hospital the NICU is the only area that is mostly civilian nurses, and I feel like the civilian nurses up here don't show the proper respect the the Navy or the military nurses. So I don't feel so welcomed when I'm up here. I don't have a choice about being in the NICU; I go where I'm told. Like I said in my OP the NICU have a lot of issue with staff and have someone call out about every day. So they use the Peds staff, PICU,and Mother/baby staff as the float pool for NICU.
And I just can't call out if I know I'm going to be floated up here; you actually have to be sick and get a chit saying so to be able to go home.
On the night that this happened I wasn't happy about getting floated up to the NICU in the 1st place then this happened. There's alot of other issues going on with management that I"m not pleased with, and just other issues. So to say the least this hasn't been a good week.
Wow. That is really a toxic situation. Makes me doubly glad you came here. We'll give you all the TLC you can handle.
It's a shame when nurses--or anyone, for that matter--can't see beyond the trappings and recognize that we're all just people trying to make life work. Kindness and caring repay far more than they cost and can reap dividends long after they've been extended.
You were good to these parents. That might not register now in the shock, but at some point, your caring will begin to show up in their memories. You have planted a seed that you likely will never see come to fruition, but it's there, nevertheless. That seed will be a bit of shelter in the storm of their emotions, their struggle to make sense of the loss of their baby when they never saw it coming. Your compassion will mean something to them down the road. Thank you for being there with them and for them.
In the meantime, talk to your own colleagues for comfort. Losses in peds are not all that common, but I'm sure you have them occasionally. Try to hook up with any nurses anywhere who are more interested in connecting heart to heart than feeling territorial and threatened.
And, since you are in the military, see if you can find a chaplain who is a real person and who might be able to offer a listening ear. Most of those guys are top notch.
The power and worth of a caring soul never cease to amaze me. You were a candle in the dark for this young couple who were parents so briefly.
navynurse06
325 Posts
I'm not sure about the autopsy part; I don't really want to ask. But I did get the parent's address, and I'm going to send them a card. I know that at this time in their life that words are futile, but I just want to let them know I'm thinking of them.
As far as moral support from the NICU staff....not happening. They just see me as another body up here. I'm in the military and at our hospital the NICU is the only area that is mostly civilian nurses, and I feel like the civilian nurses up here don't show the proper respect the the Navy or the military nurses. So I don't feel so welcomed when I'm up here. I don't have a choice about being in the NICU; I go where I'm told. Like I said in my OP the NICU have a lot of issue with staff and have someone call out about every day. So they use the Peds staff, PICU,and Mother/baby staff as the float pool for NICU.
And I just can't call out if I know I'm going to be floated up here; you actually have to be sick and get a chit saying so to be able to go home.
On the night that this happened I wasn't happy about getting floated up to the NICU in the 1st place then this happened. There's alot of other issues going on with management that I"m not pleased with, and just other issues. So to say the least this hasn't been a good week.