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

enfermeraSG · Sep 28, 2005

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"?

I think a good start would be to recruit interested staff to form a fetal demise committee, from there you can put guidelines and policies into place. At least you would be bringing this matter to the attention of the unit, and hopefully open their eyes to changing this manner of handling these little lives. I agree with previous posters, this is inexcusable to treat human beings with no more compassion than the placenta. SG

enfermeraSG · Sep 28, 2005

It is difficult to change our perspectives and consequently our practices. Just think though, only 30 years ago infants born in the 2-3lb range (1000g-1499g) had less than a 50% chance of surviving. Today those same babies have a 93% chance of surviving. As a matter of fact, we expect those babies to do well and are surprised when they don't (unless there are other underlying factors).

http://www.futureofchildren.org/information2850/information_show.htm?doc_id=257402

As hard as it is for me to imagine saving those early 20-some weekers, my 90yo great-grandmother/former nurse still can't believe my 3lb son survived (he's now 5yo). Longterm for these extremely premature infants? That is yet to be seen. SG

elizabells, BSN, RN · Sep 29, 2005

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"?

Aside from being utterly horrifying, I imagine this would open the hospital up to ... await magic word ... lawsuits. That might get through to mgmt.

prmenrs, RN · Sep 30, 2005

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"?

Sometimes, I think it's easy to NOT remember that these are HUMAN INFANTS, not a specimen. And as such, they deserve human contact, esp. if they are not going to live! Every human that comes into this world deserves a little love.

That is JMO.

One thing you can do is to break the habit. Bring the baby out of the utility room, diaper and swaddle and hold him/her. If anyone questions you, just say you wanted to do it. If you need to do some work, put the baby down, do what you need to do. You can chart w/babe in arms, too. If someone else feels so inclined, they can hold the baby, too. You could say you just think it's more humane.

The other thing is to get together w/the other interested nurses, and the UM, propose changing the "habit" of consigning a baby to the back room. If you are not alone, it will be more apparent to management that people desire a change.

If you have staff meetings, that's another setting to bring the topic up.

If you don't get anywhere w/the concept, you can still hold the baby yourself. Good luck, and kudos for wanting to do it better for the babies!

enfermeraSG · Sep 30, 2005

Sometimes, I think it's easy to NOT remember that these are HUMAN INFANTS, not a specimen. And as such, they deserve human contact, esp. if they are not going to live! Every human that comes into this world deserves a little love

:yeah: Well said. SG

BlueYYsRN · Oct 10, 2005

Actually was a press release from a D.C area hospital. Whether or not it is factually based it does bring up some issues.
It is documented and verifiable that 2% of 22 weekers survive, how will that impact your particular thoughts and practice?
Mike

Not in the least. If you have had to "care" for some of these "miracles" you may have a different perspective. :scrying:

DeeSki · Oct 10, 2005

{{{{{{{{{{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!

Thanks so much for the compassion. After so many years go by (10) nobody quite gets it, that the pain is never gone. I very rarely discuss it with people in person, online is so much easier.

Yes I am in school now, my first semester of clinical so probably next year I will get more exposure to these areas. One of the students in my program who graduated in May got her first job directly in the NICU so I'll definitely be asking her for input.

mari31666 · Oct 10, 2005

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.

i just want to let you know that where i work we don't have policies about such things. usaully the parents hold their baby past the point of death. the other night i was covering another nurses pt. the couple did not want to see the baby at all. 17 wks multiple genetic anomalies. baby was born alive with heart beating and it beat for several hours. the nurse asked me about paper work and i then learned that it was still alive and she placed it in the dirty utility room. i was horrified. her reply to me when i asked who was with it was "what do you want me to do? hold it?" i went back and saw it and held it and talked to it (sex undetermined) prayed something and i rested it back comfortably to check on my own two patients in triage. when i came back, the poor sould had passed. needless to say i was sickened and disgusted by this nurse, whom i never really had a great liking of to begin with. and she is senior and i'm only new nurse of 1 yr, and hear all the comments of how i will learn and change. everyone pray that i never lose this sensitivity. otherwise i will have to have someone tell me it's time to move on when i do.

SmilingBluEyes · Oct 10, 2005

Thanks so much for the compassion. After so many years go by (10) nobody quite gets it, that the pain is never gone. I very rarely discuss it with people in person, online is so much easier.
Yes I am in school now, my first semester of clinical so probably next year I will get more exposure to these areas. One of the students in my program who graduated in May got her first job directly in the NICU so I'll definitely be asking her for input.

I wish you the very best. You are always welcome to vent to me anytime. Good luck.

deb

SmilingBluEyes · Oct 10, 2005

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"?

this makes my blood boil.:angryfire

SmilingBluEyes · Oct 10, 2005

one more thought:

you can be a agent of change by MODELING it. Never allow anyone to warehouse a dying preemie in a dirty utility closet. Follow your heart in such situations and treat the dying preemie as you would any dying human being. Be there, touch and hold him/her and say goodbye, if you are inclined. Model the change. And definately have some discussions with the manager and at staff meetings about human dignity in dying.

Read my tagline: (dignity is not negotiable). I believe it. I think we all need to live it.

deb

jeepgirl, LPN, NP · Oct 10, 2005

i just want to let you know that where i work we don't have policies about such things. usaully the parents hold their baby past the point of death. the other night i was covering another nurses pt. the couple did not want to see the baby at all. 17 wks multiple genetic anomalies. baby was born alive with heart beating and it beat for several hours. the nurse asked me about paper work and i then learned that it was still alive and she placed it in the dirty utility room. i was horrified. her reply to me when i asked who was with it was "what do you want me to do? hold it?" i went back and saw it and held it and talked to it (sex undetermined) prayed something and i rested it back comfortably to check on my own two patients in triage. when i came back, the poor sould had passed. needless to say i was sickened and disgusted by this nurse, whom i never really had a great liking of to begin with. and she is senior and i'm only new nurse of 1 yr, and hear all the comments of how i will learn and change. everyone pray that i never lose this sensitivity. otherwise i will have to have someone tell me it's time to move on when i do.

This is very sad. It is a total disregard for human life. You would think that an OB / GYN nurse would "get it"... but this one obviously doesn't. I would go as far as to go to the higher ups on this one. It is a total lack of compassion to the dying child. Usually, we would swaddle it, give to the parents (if they wanted it) or we would put it someplace private and comfortable (warm and secluded - NOT a dirty utility closent) if staff was completely unable to stay with the baby. However, that would only be in extreme cases... most nurses would hold the baby and try to comfort it until it passed. I would even imagine that in our hospital (Catholic) that they may even call up a member of the clergy (one of the ministers, priests or nuns) to stay with the baby if staff is unable to sit with it until it passes and the parents are unable to do so.