quintuplet births

300g · Dec 4, 2008

For sextuplets and octuplets there was a team (minimum RT and RN) on call for each baby, and had every nurse we could recruit to agree to come in when they were born (just in case some of them couldn't actually come in at the time).

We kept as many admission beds set up as possible. Transfer any appropriate patients to LII, PICU or Peds to free up bed spaces.

The hospital that took the octuplets was large enough to absorb that kind of admission... with 4 Attending lead teams and 30-40 RNs staffed on a daily basis. I wasn't employed there yet at the time of delivery, but many of my coworkers were.

The hospital that took the sextuplets was much smaller, but still large enough for the six. Of course, the admissions were chaotic and staffing was difficult for awhile, but it all worked out in the end.

Hope that helps...?

UTVOL3 · Dec 5, 2008

The most glamorous birth we ever had happen in our smallish but high acuity level III was the birth of quads. It was honestly one of the best times I have ever had at work!

Basically you just have to have enough stuff, and bodies. Other than that, each baby is treated like it's own delivery. If it is something totally unheard of in your area the parents will need to decide how they feel about the media involvement too, but that's more of a management thing to deal with. You as a nurse just get to be on call and help admit those 5 beautiful babies!

I do remember that for some reason, everyone was very concerned about having the kids not get "mixed up" at delivery. We experimented around and tried everything in the world to color code cord clamps, clipboards, etc. I suppose it is an issue but a lot of twins wind up mislabeled anyway. I mean just have 1 nurse for each baby and slap that id band on them when their little butt touches the warmer. I don't know why we were all so bent outta shape about that.

I hope they do well!

littleneoRN · Dec 7, 2008

When we have higher order multiples, carts with resuscitation supplies are prepared and waiting in L & D so that whenever it occurs, there are absolutely going to be the appropriate supplies for all the babies. (Since we don't normally have that many beds/babies in our resuscitation room). Like others mentioned, there are also RN/RT/NNP teams for each baby on call. Our NICU can typically absorb that number of admissions unless things are already hopping. The last time, we were completely full, but they had pegged some kids for transfer to the peds stepdown and Level 2 area and warned their parents of the possibility. Good thing since it happened in the middle of the night.

lvnurs9 · Dec 7, 2008

The most we have done were quads, but everyone pretty much touched on the important parts. I know we had a sign up sheet for being called when the day came. You jsut had to make yourself available. Obviously everyone can't be 100%, but we had enough people willing to come in. That includes RT.

KatRNC · Dec 9, 2008

Thanks to the few of you who replied. Unfortunately, there are no team meetings. The staff has no idea about the plans. And the mom is now in house and 25 weeks gestation! I wish I knew what the delay was. I have tried to ask, but I've been shot down by management and accused of slander, etc.

Anyway, I guess it will be what it is, when it happens. I have done my best to make the care be excellent, but budgetary constraints prohibit that.

I'm very discouraged. After 22 years as a NICU nurse, this is the first time budget has ruled over outcome. I was told today that the chief neo must know enough about this to plan for supplies and staff. When did the neo docs become involved in that sort of thing?

:confused:

K