Parent turning down the FiO2 on ventilator

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The father of one of our premies turned down the FiO2 on the ventilator. He did it when the RN caring for the pt. was not looking, but another nurse saw it. When the RN tried to explain why this behavior was a problem, he would hear none of it. It went up the line to Charge Nurse, Manager, and Neonatologist. It seems this father knew more than anyone. The reason I bring this up is because my way of dealing with these situations is total avoidance. This was not my patient and fortunatly I work nights so it rarely comes up. But when I sense difficult parents I make sure I avoid those patients. If I sense a problem at all, I get the Charge Nurse or Manager to deal with it, then make sure I never get that patient again. How do you deal with these situations?

Specializes in NICU, Psych, Education.
final thought- imho- helping the parents deal with having a baby in the nicu is another aspect of our job that can be just as important as taking care of the baby

Along this line, it might help to think about how we can help such parents to make up for the loss of control they must feel.

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Specializes in NICU- now learning OR!.
A very similar concern is parents silencing alarms.

I was thinking the same thing....

I agree with above posters...DOCUMENT these actions! Have the Neos speak with the parents!

Ultimately, I wouldn't avoid difficult parents doing things like this - I would gently "remind" -repeatedly- that it is HANDS OFF because when it comes right down to it (in court) the RN is ultimately responsible and it is the RNs license in potential jeopardy if something should happen.....

Jenny

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I assume he was doing this to try to HELP the baby? and that it was not an attempt to HARM the baby?

You know what they say about the road to hell being paved with good intentions right? He may be trying to help, but that isn't the point. I'm all for involving parents in their babies' care as much as possible (cause it's their child, not mine). But, that doesn't include vent changes. That is outrageous. There is a good reason the people who fiddle with vents go through a lot of training.

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Specializes in NICU, Telephone Triage.
The father of one of our premies turned down the FiO2 on the ventilator. He did it when the RN caring for the pt. was not looking, but another nurse saw it. When the RN tried to explain why this behavior was a problem, he would hear none of it. It went up the line to Charge Nurse, Manager, and Neonatologist. It seems this father knew more than anyone. The reason I bring this up is because my way of dealing with these situations is total avoidance. This was not my patient and fortunatly I work nights so it rarely comes up. But when I sense difficult parents I make sure I avoid those patients. If I sense a problem at all, I get the Charge Nurse or Manager to deal with it, then make sure I never get that patient again. How do you deal with these situations?

I had this happen to me just the other day. The mom had just spoken to the Neo about how her son has a very rare condition...don't want to say too much...;)

She acted like she understood, but when I went to dinner, she not only weaned the oxygen on the vent, she took off his TCM and told the other nurse he didn't need it!

She's going through a lot and is very young...but WOW!

The nurse told her she couldn't do that.. we emailed the social worker and I charted specifically what happened in my "plan of care" charting at the end of my shift. I was very specific about what she did.

Parents need to keep their hands off of equipment...unless they are learning a Kanagaroo pump or something for d/c teaching...with supervision of course.:uhoh3:

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First point: No one but a hospital employee with the proper training should EVER touch a piece of equipment utilized in the patients care.

Second point: If a family member tells you they were encouraged to do so at "such and such" hospital, an incident report and investigation should immediately be launched.

Thirdpoint: wjfoo, you are doing yourself and your patients harm by practicing avoidance. You will not be able to avoid conflict during your career, so I suggest you start to research strategies for dealing with unpleasant situations NOW.

At the least, look on this forum for anecdotes from nurses who have been in similar situations, and the advice from their peers who have a myriad of solutions to adapt.

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Specializes in NICU.
She acted like she understood, but when I went to dinner, she not only weaned the oxygen on the vent, she took off his TCM and told the other nurse he didn't need it!

What's a TCM?

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Specializes in Maternal - Child Health.
What's a TCM?

Trans-cutaneous monitor. I thought (with the possible exception of term PPHN kids) that these things had gone the way of the dinosaur!

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A lot of places use TCMs. I prefer them to those worthless things that attach to the ET tube itself.

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wjfoo, you are doing yourself and your patients harm by practicing avoidance. You will not be able to avoid conflict during your career, so I suggest you start to research strategies for dealing with unpleasant situations NOW.

At the least, look on this forum for anecdotes from nurses who have been in similar situations, and the advice from their peers who have a myriad of solutions to adapt.

I agree that conflict will happen. And surly anyone would benefit to know conflict resoloution strategies. However my belief is that we all have strengths and weaknesses. My strength does not lie in dealing with these type situations. I do however deal well with terminal pt.'s with grieving family members. With that in mind if I am scheduled, and it looks as if a pt. may not make it through the shift, I will inevitably find myself assigned to that Pt. Other nurses I work with often ask me to switch assignments when these situations arise. Am I then doing them a disservice by agreeing to take an assignment they would rather avoid?

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Specializes in NICU, Telephone Triage.
What's a TCM?

Trans-cutaneous Monitor. This is a probe placed on the babies abdominal area to monitor Co2 and O2 so we don't have to stick them for gases very much. This is great for a baby like this one, or a very small preemie...it helps reduce blood loss as well.

Your unit doesn't use them? The RT's change them, we just monitor the read-outs.

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