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.
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.
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.
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.
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 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.
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!