Published Jul 19, 2004
The facility that I work at now turns a blind eye to postive drug screens, no matter what the substance of abuse is and no matter how spacy the mom is coming into the unit. A couple of weeks ago, we had a mom deliver and hers came back positive for benzo's, barbiturates, and cannibinoids. The doctor only asked her how recent her use was and that was it. She didn't get as much as a social service consult, and if that would have happened, absolutely nothing would have been done. My problem is this, shouldn't child protective services be involved in these cases? You know the baby is going home to an unsafe environment, the parents are not going to quit using and how are they going to care for an infant when they are high and using every dime they get their hands on for their next fix? The last facility that I worked at, social services was consulted, then dhs was in the home for an indefinate period of time until either the child was removed or the home was deemed safe for it to remain. How does your facility/state handle this situation?
And also, if a teenage mom delivers (13, 14, 15 y/o) do they get a ss consult? This is also something that gets completely ignored where I work, they are sent home just like they could actually care for the baby, not to mention the legal issues of how/why they got pregnant in the first place.
That is truly a disgrace. Although frankly, in some places I have worked a social service consult accomplished about the same as doing nothing! At my present job, we do social service consults for a lot of reasons - teen mom, financial problems, unstable home life - as well as the more serious ones like positive UDS or prior history of protective service involvement. I know that the SS workload makes them have to overlook a lot of things that we wish they didn't have to, but we do wind up with babies on protective service hold from time to time.
Mimi2RN, ASN, RN
The problem with lack of f/u on positive UDS's may be related to your state or county. We have noticed that over the last year or so babies have been sent home home when mom and baby have both been positive for methamphetamines. These are ones that have been turned in to CPS, following the social service consult. It doesn't make any sense to me!
I know high risk foster care is in short supply, but we do worry about some of these little ones. We have had our peds call CPS, when they have felt that something should be done. Sometimes the social workers believe every word the moms tell them.....you would be amazed how many moms go to parties around 35 weeks, and somebody must have put crank in their drink, they haven't used anything since they got pregnant.
Do you put in social service consults on your teenage moms? We do them on all moms under 17. Also our county looks into the relationship with the FOB, and they can and do press charges. If the mom needs support, she has to talk about the father, so that he can be billed. Of course, he has to be old enough to work, and to stay out of jail.
We had a barely 13y/o mom last week.......
It's up to us to make sure the SSC is ordered and done, it's part of our protocol. We can also get a uds on a baby if mom has a history of drug use, delivers at 35 wks or less, has a precip delivery, or is out of control. The L&D nurse usually tells us if we need to do one.
At our facility, if there is a history of drug use in the mother in the past 2 years, we ask for a UDS on mom. As for a UDS on baby--it is mandatory! We have very specific guidelines (no pre natal care before 20 weeks, etc). I have yet to see a baby go home with the parent when it tested positive for anything stronger than cannaboids. The baby is placed in "protective detention" and abstinence scores are done frequently and often the babies are placed on some sort of medication for their withdrawls. There is a zero tolerance for meth at our facility.
We don't deliver many "high-risk" social cases so we only have a positive UDS once every blue moon. Social services is consulted per protocol. Are we not required to make a report to CPS for a positive tox screen? I can't believe that your facility can so blatently ignore what I thought was the law. We place babies on CPS holds for positive screens. We also refer to SS for teen moms, NICU admissions, Moms with psychiatris histories, adoptions and surrogacies and any other reason we see. We have a LCSW assigned to Maternal Child Health and she generally knows about our patients' need before we do.
Moms with positive UDS get a chemical dependency consult and a SS consult. If baby pops up positive, it is referred to CPS. Where it goes from there depends. If mom has a history with CPS, they baby may go into protective custody, or be sent home with a relative (who the mom tends to live with it seems. )
And we do SS consults on our teen moms.
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