Nurse Practitioner (Mother) leaves 21 month old in car for 8 hours

Nicole, NP, left her 21 month old baby, Remy, in the car where Remy remained until Nicole returned at 4:30 when her shift was over. Remy died and Nicole was left to blame herself forever. How do mistakes like this happen? Nurses General Nursing Article

Nicole was by all accounts a competent, caring Nurse Practitioner. Her patients loved her and her coworkers spoke highly of her.

She was also the proud mother of Remy, short for Remington. Nicole and her husband had tried for 15 years to conceive and they were overjoyed when they had Remy, now 21 months old. Coworkers said she loved to show them photos of little Remy. By all accounts, Nicole was a loving, responsible parent.

In the morning of June of 2018, Nicole was working at Evergreen Family Medicine in Roseburg, Oregon. That morning, she drove into the clinic’s parking lot as usual. She got out, locked her car, and went to work her shift at the very busy clinic- as usual.

In doing so, she left her 21 month old baby, Remy, in the car where Remy remained for hours until Nicole returned at 4:30, when her shift was over.

Nicole discovered Remy unconscious and blue. Nicole screamed for help and attempts were made to revive the toddler, but she was pronounced dead.

Supporters and Haters

The community quickly divided into supporters and haters. What happened to little Remy is almost too horrific to contemplate. Sides were taken.

Both sides felt empathy- empathy for the mother and the suffering she would never escape from. Empathy for Remy, a vulnerable child who suffered a horrible death.

The supporters felt ‘This could happen to me”. An understanding that “There, but for the grace of God, go I.” They found room for forgiveness and compassion.

The haters responded with “She isn’t competent to be a mother”. Some called for Nicole to be punished. Initially charges of second degree manslaughter were filed but they were dropped.

How could this happen? As we understand more how the brain works, we understand better how mistakes can happen. To anyone.

She Was Out of Routine

Usually Nicole’s husband dropped Remy off at daycare, but he had worked night shift as an EMT and Nicole wanted him to sleep.

Thankfully, being out of routine usually results in errors such as remembering to bring in a journal to work but forgetting to take your lunch.

I forgot to lock my car! I always lock my car. Oh, right, I was waving at my neighbor when I got out and walked across the street to talk to her.

She Was Distracted

Nicole no doubt was thinking of her shift ahead of her at the clinic. There was a lapse in temporal memory. Her brain was filled and looking forward. Maybe she was wondering who the medical assistant would be on duty that day, or if the antibiotics she prescribed the day before had helped her patient.

She had to remember to ask her boss if she could order large size disposable BP cuffs and she had to renew her license soon. Did she have enough CEs?

There was no trigger to cause her to look in the back-facing car seat, where Remy was soundly asleep. No visual reminder. No audible alarm.

I was interrupted by my phone during med pass and thought I unclamped the secondary tubing for the antibiotic.

She Was on Autopilot

In the police affidavit, Nicole said “I thought I dropped her off at daycare this morning”.

I thought I took my birth control pill this morning. Or was that yesterday?

Called inattentional blindness, we all have operated on autopilot. Memory experts tell us that the basal ganglia takes over and suppresses the prefrontal cortex for many reasons, including when we are tired, as in the case of new parents.

Kids in Heated Cars

Kids do not do well in heated cars. Approximately 30-40 children each year succumb to death in overheated vehicles. Some were forgotten in cars, others accidentally locked themselves in.

Babies and young children are particularly sensitive to the heat as they have larger surface areas and less efficient cooling mechanisms. A child’s temperature rises faster than an adult’s, up to 3-5 times faster. The temperature in a car can rise to 125 degrees in just a few minutes.

The prevalence of back facing car seats accounts for the young age, as infants and small children can easily be asleep or not able to communicate. Rear-facing car seats look no different whether or not there is a baby or toddler inside.

Conclusion

What happened to Nicole can happen to anyone. It will happen again this summer, when the death toll from kids in cars typically rises.

What would prevent this? Jailing Nicole would not prevent this.

Maybe educating parents similar to education around infant co-sleeping and the use of seat belts. Public service announcements. Supporting initiatives to increase awareness such as Look Before you Lock and occupant detection systems.

Perhaps placing a necessary item in the back seat next to the child, such as a purse or cell phone. Kids and cars.org even suggests placing your left shoe in the back seat.

Most of these suggestions are to trick the brain out of autopilot and the brain state that allows these accidents in the first place.

Mistakes are not intentional but prevention and compassion are.

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Best wishes,

Nurse Beth

Author, "Your Last Nursing Class: How to Land Your First Nursing Job"...and your next!

Specializes in NICU.
8 hours ago, Nurse Beth said:

The prevalence of back facing car seats accounts for the young age, as infants and small children can easily be asleep or not able to communicate. Rear-facing car seats look no different whether or not there is a baby or toddler inside.

It is beyond horrible what happened but all this "safety" stuff with infant seats and the use of the the rear of the car instead of the front seat where they used to be located,is partly to blame.I know they said the air bags could cause harm if deployed to an infant in front part of car but is this tragedy any better?

Most of us drive alone in the car and as I for one have forgotten just purchased food for dinner or tomorrows lunch in a hot car in the back seat.I am not comparing a baby to food ,only that it is easy to be lost in thought and forget the back seat.

Perhaps a reminder alert like the one that tells you the lights are still on or the door is open could help someone.I know it is not recommended to leave even an older child in a locked car even for those quick store drop ins.The worse and most least expected could happen.

With the nuclear family almost gone and few have extended family,raising children is much more difficult and tragedy prone.

God Bless the mothers of today,they have it tough,too many distractions,gadgets,and not enough hands.

My son was too noisy for me to leave him in the back seat. He always had non stop babbling. Even now at 6 years old, he won't be quiet. I love him to death tho.

Oh, what a horrifyingly sad event. I cannot imagine how that baby suffered, and what that mom is going through. I have compassion for both, but of course I relate more closely with the mom, having been a parent much more recently than I was a baby. The little one's pain was brutal and physical, the woman's pain is emotional and life long. I hope she has a good support system and a very strong marriage. I remember being furious at my husband for leaving my then toddler son unattended long enough to jam his thumb in a window. How they will get through this is beyond my comprehension.

I know I need to be extra mindful when my routine is disturbed. Some things that come automatically may not if someone is distracted. This is an extreme, tragic example of that.

Specializes in kids.
18 hours ago, Workitinurfava said:

I wonder sometimes. Deciding to work and have children at the same time is not easy, doable but there are cost.

And sometimes life changes AFTER you have a child, death (no control over this) divorce, often no control...so before we go down the road of working vs stay at home parents...let's just not

Unfortunately this points to a larger problem...we are all trying to do too much. Whether it's a sour relationship, stress on the job, multiple responsibilities, we all need to take a step back and remember to be mindful of ourselves and those close to us. Pay attention to what we are doing each and every moment of the day. Have a plan when there are too many things going on to just separate yourself from the extraneous. Too many sad stories such as this.

More than likely an unpopular opinion here but I think her husband or her should have worked pt or not at all till the baby's in school. Rushing around with a demanding career and a toddler would wear anyone out. If you waited so long to have a child then raise them yourself. It wont put you on the fast track at work but its worth the sacrafice. I work to live, not live to work. BTW I do have sympathy for her, there is nothing more devastating than loosing a child, especially under these circumstances.

1 hour ago, NutmeggeRN said:

And sometimes life changes AFTER you have a child, death (no control over this) divorce, often no control...so before we go down the road of working vs stay at home parents...let's just not

Hey you took it there and I wasn't going in that direction. The point is that it is a challenge to try and do it (work and have children).She was trying her best but sometimes the balls in the air drop on the ground. Even if you stay at home it is a challenge but morso when you work.

1 hour ago, dumbnurse said:

Unfortunately this points to a larger problem...we are all trying to do too much. Whether it's a sour relationship, stress on the job, multiple responsibilities, we all need to take a step back and remember to be mindful of ourselves and those close to us. Pay attention to what we are doing each and every moment of the day. Have a plan when there are too many things going on to just separate yourself from the extraneous. Too many sad stories such as this.

Basically.....

Specializes in CMSRN, hospice.
1 hour ago, Wlaurie said:

More than likely an unpopular opinion here but I think her husband or her should have worked pt or not at all till the baby's in school. Rushing around with a demanding career and a toddler would wear anyone out. If you waited so long to have a child then raise them yourself. It wont put you on the fast track at work but its worth the sacrafice. I work to live, not live to work. BTW I do have sympathy for her, there is nothing more devastating than loosing a child, especially under these circumstances.

I think a lot more people would do this if it was financially feasible. It sounds like it wasn't exactly their choice to wait as long as they did, and regardless of whether you're working or not, sometimes you simply lose track of things or forget. I'm not saying it's not beneficial for young children to have one parent at home full-time, but unfortunately it's not realistic for many families.

26 minutes ago, NightNerd said:

I think a lot more people would do this if it was financially feasible. It sounds like it wasn't exactly their choice to wait as long as they did, and regardless of whether you're working or not, sometimes you simply lose track of things or forget. I'm not saying it's not beneficial for young children to have one parent at home full-time, but unfortunately it's not realistic for many families.

I understand all this. My niece is having a baby after waiting 10 years due to medical issues. Infertility is a problem with some couples. Yes, you lose track of things, but it's more likely to occur with a busy hectic lifestyle. Also, I think more couples can afford to have one of them not work for awhile or do part time. However, it does involve sacrifices. Smaller house, not as new a car, eating out less often, you name it. I know because I've done it. I'm not saying that everyone has to make the same choices I've made but the choices we make definitely affect our life and the lives around us. I don't want to put down the woman who lost her child but I would like to throw out the idea that we can do more than we think we can and get by with less than we think we can.

Specializes in CMSRN, hospice.
8 minutes ago, Wlaurie said:

I understand all this. My niece is having a baby after waiting 10 years due to medical issues. Infertility is a problem with some couples. Yes, you lose track of things, but it's more likely to occur with a busy hectic lifestyle. Also, I think more couples can afford to have one of them not work for awhile or do part time. However, it does involve sacrifices. Smaller house, not as new a car, eating out less often, you name it. I know because I've done it. I'm not saying that everyone has to make the same choices I've made but the choices we make definitely affect our life and the lives around us. I don't want to put down the woman who lost her child but I would like to throw out the idea that we can do more than we think we can and get by with less than we think we can.

We can agree on that. It's hard to have everything you want in life, but we can always work toward what's most important to us. As nurses we're fortunate to have careers that tend to allow a bit more flexibility with work schedules, decent hourly pay for full-or part-time, etc. I know I would have an easier time making do with less work hours compared to friends with other careers, so it's definitely still a case by case thing. But it really is important to know what you care about most and learn to let the other stuff go for a while.

35 minutes ago, Wlaurie said:

I understand all this. My niece is having a baby after waiting 10 years due to medical issues. Infertility is a problem with some couples. Yes, you lose track of things, but it's more likely to occur with a busy hectic lifestyle. Also, I think more couples can afford to have one of them not work for awhile or do part time. However, it does involve sacrifices. Smaller house, not as new a car, eating out less often, you name it. I know because I've done it. I'm not saying that everyone has to make the same choices I've made but the choices we make definitely affect our life and the lives around us. I don't want to put down the woman who lost her child but I would like to throw out the idea that we can do more than we think we can and get by with less than we think we can.

I disagree with you so much. Being a stay at home mom was not for me. I’ve done it. It’s not about sacrificing for a smaller house. I have no credit card bills, no car payments. My husband makes twice what I do. I like working.

My heart breaks for this NP. I cannot fathom it happening. My DH normally takes my youngest to daycare. Sometimes, I do. But that changes my whole morning routine. So, I personally would not be on autopilot as I leave 30 minutes earlier. Plus, the daycare is in the complete opposite direction.

Im sure this woman is living a complete nightmare every day and will for the rest of her life. But it does boggle my mind.