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 Practice educator.

I don't like the tagline 'this could happen to any of us' because that ain't happening to my kids. I don't really have a massive amount of sympathy for the mother only the child that died.

20 minutes ago, osceteacher said:

I don't like the tagline 'this could happen to any of us' because that ain't happening to my kids. I don't really have a massive amount of sympathy for the mother only the child that died.

Me too. I raised five children while working two jobs and trying to go to school...and involved in a bad marriage. I'm sorry I just don't get it and never will. Now we need safeguards to help parent? Call me judgemental all day, I'm ok with that.

Specializes in Dialysis.

I'm going to get flamed for this, but as another poster put out there, if this was anyone else (man at bar, 18 year old mom, etc) we'd be talking about horrible for the baby, but mom/dad needs punished. I agree. It doesn't matter, she was negligent to someone in her care and they died. I doubt anyone thinks she did it intentionally, but someone still died. Many of us have discussed another case on here where a nurse was negligent and someone suffered the ultimate consequence. If we are fair and unbiased, we must apply the same standard, although one was work related, the other was family/personal. Back in the day, I had 2 children, me and hub would often switch days on daycare drop off and pick up duties. Our kids were never forgotten or harmed. We were just as busy then as everyone is now. And in no way, shape or form am I saying electric chair, but she should be punished just like any other person out there. Being a nurse or NP or any other healthcare provider does not make us above any law!

One more other thing. So let’s say we have alarms for this sort of issue. What happens when it malfunctions? Who is to blame then? Relying on technology to parent is a bad idea. And as much as I can understand it as an extra check you know as well as I do that many will use it as the only check.

Specializes in Dialysis.
1 minute ago, kcochrane said:

So let’s say we have alarms for this sort of issue. What happens when it malfunctions?

Or when the parent becomes "alarm blind" after hearing it beep for the xth time

Specializes in NICU/Neonatal transport.

Which is the same argument for not having any safety measures for nursing. You have to have a reasonable system which won't replace thinking, but will help if there is a slip.

There are some safety mechanisms I would think are reasonable, but others that aren't.

Think of it this way: because of safety precautions, we make parents put their children in a hidden place in their car where they are not visible. And for some parents, that's even a change from when they might have had other kids or driven in a car with other children.

I don't think a single standard measure is out of line.

12 hours ago, wondern said:

Hopefully soon all car seats will be required by law to have an alarm built in at the factory. Maybe a wire or bluetooth attached somehow to the drivers door when it opens. Maybe have a little pulse type device built in that you can actually hear the beep beep beep beep of the childs pulse while you drive. Something already! I don't understand why the federal government hasn't demanded it by now. Parents need to demand this law of their congressmen and women. Now that there are more women in Congress than ever maybe we will see some action on this issue. Does anyone know of any laws being proposed for safer alarm built-in corificeats to help prevent this from happening? Certainly the technology is out there! So sad for all the parents this has happened to.

https://www.fatherly.com/gear/best-car-seat-alarms/

Specializes in ICU.

Did I turn off the oven before I left for work or Did I lock the door. you go back and the oven is off and the door was locked. You don’t recall doing it. Hell I put something in the oven yesterday and thought my significant other did it but I did. The difference between me and the NP I actually questioned myself and sought reaffirmation. There has been times when I didn’t always check the lock door and kept going. That didn’t involve human being or pet being ok. I don’t buy how you miss the baby when you look in rear view mirror

On 4/16/2019 at 1:05 PM, SmilingBluEyes said:

There is a lot of technology available to prevent this. Apps for phones; even vehicles equipped with programs to help people remember to take their kids out of the car.

I dunno, I never had this happen. I am so not perfect but--- I did not have to leave my purse or "something valuable and important" like my stupid cell phone--- in the back seat to remind me not to leave my kids to fry in the car. I was a nurse, worked night shifts, military wife, chronically sleep-deprived, you name it. I. never. did. this.

I think smart phones/technology have made us stupid.. we’ve become so reliant on technology for just about everything and I’m not sure if it’s for the better.

Specializes in Psych, Addictions, SOL (Student of Life).
8 hours ago, GSDlvrRN said:

Something was seriously wrong to cause her to have a lapse in judgement. She was exhausted or distracted and totally engrossed in job responsibilities for this to happen. I do not believe this was intentional.

Negligent homicide cases to not require malicious intent. The name implies the neglect was not necessarily intentional but a person still lost their life because of it. This is exactly what's wrong with society in general - Everybody is looking to make excuses instead of taking responsibility!

Hppy

17 minutes ago, hppygr8ful said:

Negligent homicide cases to not require malicious intent. The name implies the neglect was not necessarily intentional but a person still lost their life because of it. This is exactly what's wrong with society in general - Everybody is looking to make excuses instead of taking responsibility!

Hppy

People can take as much responsibility as they want but it doesn't make them less human. People will still get tired, distracted, go into auto pilot. The question is how to protect kids despite unintentionally imperfect parents?

Specializes in Psych, Addictions, SOL (Student of Life).
Just now, cleback said:

People can take as much responsibility as they want but it doesn't make them less human. People will still get tired, distracted, go into auto pilot. The question is how to protect kids despite unintentionally imperfect parents?

I mean really, we all wouldn't need seat belts if we all could just drive safely. C'mon folks.

You all know my opinion - I'll not take the bait of name calling etc.... My siblings all of whom worked full time jobs have managed to raise 21 children and none of them ever got left in the back seat of a car. From the time my son was born I have always had him in the back of my mind - always aware of where he is and how he's doing. Even when I was stressed and tired this would have never have happened to a child of mine.