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?

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 Geriatrics, Dialysis.

Sadly she is not unique. It seems just about every summer there is a news story that breaks about somebody leaving their child in a car in the heat.

In some of those stories the adult is clearly at fault, leaving a child in the car while sitting in a bar or casino all day. However in most cases the adult was out of their normal routine and sadly just carried on with their normal routine somehow managing to completely forget about the kid in the backseat. How does that even happen?? Obviously it does, but wow. Going through the motions of your regular routine on such autopilot that you forget you have a child with you? Tragic, but it sure seems to me like such a thing should also be avoidable by just paying a little attention to what you are doing.

My heart goes out to the family and to the poor child. Although on one hand I wonder how one could do this.... I do know that we are all not perfect and could easily make a mistake that unintentionally injures another. No sentence will equal the pain that this family endures every day for the rest of their lives.

Specializes in ICU.
16 hours ago, JKL33 said:

Just a comment on this one aspect: Simple - - the car seat is always there and the child isn't. Their heads don't stick up over the back of the car seat, either. So if they're quiet, I assume it feels about the same as driving around with an empty car seat.

Thats right you don't switch the child seat forward until they are a little older.

On 4/17/2019 at 8:03 PM, cleback said:

I would eventually love corificeat technology that syncs with a car alarm, like the reminder alarm to fasten your seatbelt or take the keys out of the ignition.

Edit to add I used to be one of those moms that blamed the parent for unbelievable carelessness... that judgyness reassured me as a mom but it doesn't save the poor kids who die a horrible death. We can do better.

Thats an excellent idea. I wonder if there are prototypes available. This should catch on and make it to the "As Seen on TV" market

I feel bad for the mother, i really do. I am not judging her. However, don't say that this could happen to anyone because this certainly won't happen to me! And you know why? Because I don't rush, because I live in the moment, and I am organized. I don't need a reminder that my babies are in the car because i remember that they are in the car. When my children go to daycare , I talk to them during the drive. Most of the times they don't sleep because the ride is short...but regardless. I get out of the car, grab my purse, then go around to the backseat and put them both in their double stroller. When i get to work, i check my car again. It's quick. On the days they don't go to daycare ( staying with daddy at home) i still have a habit of going around my car, looking inside the windows to make sure ( even though i know they are at home), followed by opening the trunk to get my lunch from the car and then walking to the entrance. My husband does the same thing. When our routine changed sometimes, he would send me a picture the babies at daycare after he drops them off. It is really that simple. I also don't lose my phone, or my work id badge, and I have to-do lists. Type A personality, but it works for me.

My heart breaks for the family of little Remy and for that poor baby. I hope she rests in peace.

12 hours ago, tiffanyB12 said:

I feel bad for the mother, i really do. I am not judging her. However, don't say that this could happen to anyone because this certainly won't happen to me! And you know why? Because I don't rush, because I live in the moment, and I am organized. I don't need a reminder that my babies are in the car because i remember that they are in the car. When my children go to daycare , I talk to them during the drive. Most of the times they don't sleep because the ride is short...but regardless. I get out of the car, grab my purse, then go around to the backseat and put them both in their double stroller. When i get to work, i check my car again. It's quick. On the days they don't go to daycare ( staying with daddy at home) i still have a habit of going around my car, looking inside the windows to make sure ( even though i know they are at home), followed by opening the trunk to get my lunch from the car and then walking to the entrance. My husband does the same thing. When our routine changed sometimes, he would send me a picture the babies at daycare after he drops them off. It is really that simple. I also don't lose my phone, or my work id badge, and I have to-do lists. Type A personality, but it works for me.

My heart breaks for the family of little Remy and for that poor baby. I hope she rests in peace.

I agree wholeheartedly with this.

Specializes in Maternal-Infant.

This is a reminder of the humanity of all. As nurses, we are all human, not machines. We make mistakes. It could happen to any of us. It illustrates a valuable point as we move to a more "tech-savvy" healthcare system with bar codes and EMRs - we have added layers of complexity to an already complicated process (healthcare, healing, caring for others). Any nurse can tell you how things have changed and the increasing errors made. So many checks and balances and attempts to make healthcare safe and 100% error proof, and yet....

This is a salient reminder that no matter how hard we try, in the end, we are human, fallible. The essential differences between humans and technology is two-fold, IMHO:

1) The ability to learn intuitively from our mistakes.

2) To forgive.

As well, we have one inborn error that machines do not suffer from and that is our ability to become distracted by the most inane things. When we stop paying attention, we follow the group/herd down, often destructive, paths. Stay awake and pay attention to this moment. Mistakes, like feces, happens. ?

Specializes in corrections and LTC.

We are too damn busy. I long for the days without cell phones and e-mail and facebook. We are going all of the time, and if we have a few minutes to sit down we are on our damn phone or computer. Why? Do we really have to know what all of our friends and family are doing every day, and let them know everything about our lives? Why are we reading e-mails from work when we are at home?

We need to focus on the present, on the now. Instead of thinking about a patient or staffing on our way to work, focus on the child in the back and dropping them off at daycare. THEN we can focus on work.

I am not placing blame. I am lucky to have been a mom before all of this technology that overtook our lives. I wasn't so busy, did not have so many distractions. I certainly understand how this can happen and unfortunately it will happen again.

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
3 hours ago, ocean.baby said:

We are too damn busy. I long for the days without cell phones and e-mail and facebook.

THIS. I am tired of being so connected. I have gotten in the habit of putting my phone away during family time in the evenings. The people who are right in front of me are the most important to me.

Sorry, I cannot understand how anyone can not think of their baby during the time they have left them til they find them. When my kids were young I thought about them every other minute, what time is it, what they would be doing at that moment, feeding time, play, nap. I could not forget my babies no matter if I was overworked, stressed, or out of routine. They were part of my every minute routine no matter.But, I am not everyone and I do not know this person and feel she is in her own hell right now, which is sad for everyone involved.

I am so sorry for this tragic loss of a child and the heartbreak of a family. I think most of us can relate to being on a set routine; autopilot. Perhaps a check before one leaves the car whether it be a child or an animal . It's easy for people to blame, those people will always be there. I pray that your heart heals