Non-viable baby, born alive -parent won't hold him, what do you do?

[enfermeraSG]

OK, so here's what happened - and it's not the first time we've had this dilemma. We had a pt come in with severe, unmedicated schizophrenia, homeless, and imminently going to deliver a 21-22wk baby. Well, she delivered the baby and he was alive. He lived for 3hrs. The pt only held the baby for a few moments and wanted us to take him away. To make a long story short, another coworker and I took turns so he wouldn't be alone for those 3 long hours.

What does your facility do in that situation - when a baby is not viable, but born alive, and the parent(s) don't want to hold the baby? I mean, this was a perfect little 1 lb baby, pink with a heartbeat. We couldn't just leave him on the counter in our back room and occassionally check for a heartbeat so time of death could be recorded. (!) At least, I couldn't. Anyway, just wondering how other units handle this. thanks, SG

[Liddle Noodnik]

Please, let's look at this from a parent's point of view and not be quite so judgmental about "not wanting" the baby.

I was a 25-year-old emotional train wreck when my full-term, 6-pound 9-oz. anencephalic daughter was delivered by C-section, many years ago. I couldn't handle the idea of seeing her, much less holding her, at that time, and while I wish to Heaven I'd been strong enough, I simply wasn't. My husband did see and hold her during her 7 hours on earth; he was also with the priest when she was baptized, and with me when my doctor came in to tell me she was gone.

I thank God he was able to deal, because I couldn't, and the guilt I felt then still is with me in some ways. But as much as I wish I could've done things differently, I've come to the realization that I did only what I could at the time.........if anyone had forced me to hold my dying child, I think I'd have literally gone crazy. I was young, emotionally immature, and I was so close to hysteria that I spent an entire night with the blankets over my head, screaming silently, wishing I were dead alongside my daughter.........the only thing that kept me from crying out loud was the desire not to end up in the psych ward.

So that's why I ask that you put yourselves in the place of a young mother for a moment and try to understand why one might not want to see or touch the baby. Yes, she may wind up regretting it---God knows I do---but everyone deals with things in their own way, and our job as nurses is to support them regardless of how we feel about their decision.

In the meantime, you're right about not letting babies die alone.......I thank the Lord that there was a nurse to hold my child as she took her last breath, and I bless that woman every day for being there for her.

{{{{{{{{{{{mjl}}}}}}}}}} I think it would have been that way for me too - it's not just immature but some of us feel so much - I think however you had to survive at the time was good - you knew better than anyone!

[Liddle Noodnik]

I read all these posts and cried my eyes out . It is so amazing to see all of the nurses with so much love and compassion. I have to say I have not experienced that brand of nursing care here in NY. My oldest son was born five weeks early, weighed 6 lbs 8oz. Doesn't seem very small but he couldn't breath and eat so he was placed in the NICU. The nurses there were the pits. At least they were when I was around to see, maybe they were loving when I was back in my room :uhoh21: . It got so bad that I had to get my husband (ex now) and pediatrician up to the hospital to "save" my baby from the NICU nurses! He was oozing what looked like ground beef from the sites on his head where the internal monitors had been placed and they wouldn't even let me feed him because they were "busy". Those oozing sites were scars under his hair for the rest of his life. He did leave the hospital in good shape and turned out to be very healthy and so smart (IQ of 141). We survived the NICU. That was eighteen years ago. Tomorrow is the 10th anniversary of his death. He survived at birth but ultimately died accidentally-tragically 8 years later. The Trauma nurses left crying that day. What can I say but that God works in mysterious ways. I often read all the posts in the different specialty areas to help decide what area of nursing I'd like to go into. I know I love L&D, NICU and ED but sometimes I wonder how I could care for a dying child and stay detached. KWIM?

{{{{{{{{{{Dee}}}}}}}}}}}] Are you in school now, can you get some of those experiences before you graduate?

I would be scared to try but that's me. It sounds like you went thru a heck of a lot of hurt in so short a time, you got to keep him 8 years, that was priceless. You have to follow your heart - grief is different for all of us. I'm sad for you - glad that you are able to explore this! Take good care Dee!

[Liddle Noodnik]

All of these posts made me cry my eyes out!! I just had my first baby in July 2005 (he is fine). I just noticed that since I have become a mother it is much much harder for me to hear stories or see children/babies in pain or suffering, etc. Before I had the baby, stories like these would upset me, but I actually feel the sadness in my BONES and deep in my heart now. Is this normal? Do others moms feel this too?

I know I do - mine is 18 - it hits me to the core!

Part of it I think is that my mom told me some years ago that she almost had me aborted - and she had NEVER seemed happy with me. So I think of these babes that people DESPERATELY wanted - and couldn't - and I have my Tom - and I just cry for those moms and mostly those babies - that have NO idea what is going on. Big sigh ...

Congrats to you, and to Melissa up above you there!

[wannabeL&D73]

Oh, I totally agree that those who chart are accurate, and I am also familiar with the book (may be dusting it off again in a few months). But I don't actually know anyone in real life who does chart...I just think those women are the exceptions.

Shannon

[cardiacRN2006, ADN, RN]

Oh, I totally agree that those who chart are accurate, and I am also familiar with the book (may be dusting it off again in a few months). But I don't actually know anyone in real life who does chart...I just think those women are the exceptions.

Shannon

Check of fertilityfriend.com

You will see thousands and thousands of women who chart.

[LiliRN]

I was in a situation about 15 years ago where a young woman came in alone and delievered at 22 wks. It was about 0400 and myself and the other nurse delivered the baby. We were in a small rural hospital.

We called the ER doctor to come up stat. He picked the baby up from off of the bed and said to the young woman "I'm sorry your baby was born dead". He handed the baby to me and I was going to hand it to the Mom and he said "No clean the baby up first". The Mom was crying so hard she didn't say anything.

When I got the baby to the nursery I noticed that he was alive. I ran to get the ER doctor. He said to me in the hall. "I know the child is alive but he doesn't have a chance, Let him die, clean him up and let the Mom hold him. We don't need to get sued for doing nothing." I stayed with him for 4 hours in the nursery and rocked him until he died. I let one of the day nurses take him to his Mom and I went home.

The entire time I was rocking him I felt so guilty that it was me and not the Mom holding him. I've often wondered if he had been born at Vanderbilt would he have lived? I do know that if I had it to do over again I would have taken him to his Mama no matter what the ER doctor had said. At the time I was scared of doctors and was not the least aggressive as I am now.

I don't understand, maybe I'm not getting something. If the Dr. said clean him up and take him to his mother, why did you hold him for 4 hours? Why didnt' you just give him to the mom right after you cleaned him? Does it take 4 hours to clean a baby?

[wannabeL&D73]

Check of fertilityfriend.com

You will see thousands and thousands of women who chart.[/quote

I know! it is amazing how many women do! But I have never met anyone in real life who has done it...I guess I just must have really fertile friends IRL or something!

[ragingmomster, BSN, MSN, RN]

We are a large unit and when we have a non-viable infant who is born alive s/he is left alone in a basinette in the dirty utility room and a nurse has to check on them every 1/2 hour. I have only worked here for 4 months, but I am not the only one who is disgusted by this pattern, any thoughts on how I can be an "agent of change"?

[fergus51]

We are a large unit and when we have a non-viable infant who is born alive s/he is left alone in a basinette in the dirty utility room and a nurse has to check on them every 1/2 hour. I have only worked here for 4 months, but I am not the only one who is disgusted by this pattern, any thoughts on how I can be an "agent of change"?

That is absolutely horrifying. Has anyone brought this up to the manager? Mentionned it in a staff meeting? If you mention that this has a very negative effect on staff morale, I would hope your management would be receptive to the idea of changing things.

[wannabeL&D73]

We are a large unit and when we have a non-viable infant who is born alive s/he is left alone in a basinette in the dirty utility room and a nurse has to check on them every 1/2 hour. I have only worked here for 4 months, but I am not the only one who is disgusted by this pattern, any thoughts on how I can be an "agent of change"?

OMG...that is so inhumane. Somebody needs to speak up...that is completely out of the realm of anything acceptable.

[jillhall]

i haven't seen any hospital policies for this issue. i can only share with you what i have done. i have been in this circumstace three or four times. the first time it happened i was a fairly new nurse, and so i remember this incident the most. i took the infant and wrapped it in blankets. i put a little hat on the head, and sat in a rocking chair and rocked the baby until he/she passed on. actually, those moments are quite memorable for me. very soreal.

[Jolie, BSN]

We are a large unit and when we have a non-viable infant who is born alive s/he is left alone in a basinette in the dirty utility room and a nurse has to check on them every 1/2 hour. I have only worked here for 4 months, but I am not the only one who is disgusted by this pattern, any thoughts on how I can be an "agent of change"?

Thank you from the bottom of my heart for trying to change this awful situation!

Why, on God's Earth would anyone believe that this is acceptable treatment for a living human being? Do we take hospice patients or trauma victims and leave them alone in utility rooms to die, simply because that is what we expect to happen in a matter of minutes or hours? EVERY patient deserves comfort care. Warmth, moisture for the lips, a peaceful environment, at the very least. Holding and cuddling would be ideal. Certainly there would be volunteers available to assist, if the staff is unable due to time constraints. Heck, call me, I'll come in and do it!

On an even more disturbing note, I find it inexcusable that a living or deceased patient would be left unattended in a utility area. Has no one considered the possibility that an infant's body could be inadvertently wrapped up in soiled linen and discarded. That actually happened at a hospital where I once worked. An IUFD delivered during the night. The body was taken to the morgue, but due to lack of space, was left on a counter. When the cleaning service came thru, they mistook the bundle of blankets for dirty linens. (The body was not wraped in a shroud, or tagged.) The linen service called the police the next day when they discovered an infant's body in the soiled laundry. Because the linen service was located across state lines from the hospital, numerous law enforcement agencies became involved. Such a horror for the baby's family to have to endure the news coverage.