Rough Night in NICU

(((Navy)))

Scares the bejabbers out of me to read this post. I work postpartum and have been appalled at the way some of the patients take care (or rather, don't take care) of their babies. Just last week, I walked into a room and couldn't find the screaming newborn. Mom's in bed covered up to her neck. Crib is empty. No one else in the room. Finally, I trace the muffled crying to the bed. I ripped back the covers and there was the wee one half under the (large) mom.

Mom didn't awaken until I bumped her as I removed the crying child. Thank goodness, the baby had enough air to cry, but one false move by mom could have ended that.

Got everyone settled down (including my own racing pulse), strongly reiterated the importance of putting baby in crib, and left the room with mom feeding baby.

Came back later to find baby lying on bed next to mom with her talking on the phone. I moved the baby to the crib and didn't really care if mom was po'd.

At any rate, I am so sorry for everyone involved in this horrific tragedy. What a senseless loss. I'm glad the poor child had such compassionate care, and I'm really glad the parents had the ability to let the child go. I'm sure that was as heart-wrenching as it gets.

It sounds like you did what you could. As far as what you say to families, I think you just tell them that you're sorry for their loss and their pain and, if they care to talk, you'll be glad to listen. There really isn't anything else to say, especially in a case like this one where the mom is probably suffering tremendous guilt. I hope someone is going to help them get counseling.

Can you talk with the NICU nurses at your hospital? Seems like they would want to provide moral support for you, especially as it isn't your regular unit. Unfortunately, if you don't float back there for a while, there might not be an opportunity for you to receive this. Maybe you could stop in to talk and let your thoughts and questions be known.

I wish you the best. The family, too.

To Trama...thank you for your kind words!

To rn/writer....I added the feeding and phone call part of the story to give a background. I'm not blaming this mom (only 20) for anything or judging her! She is going to be dealing with a great deal of guilt for the rest of her life. Not only did she have to make the choice to withdraw care from her baby but she may feel like the whole situation was her fault. My heart just aches for her.

And I almost postive that I'm going to get floated up there when I work again tonight!

To Trama...thank you for your kind words!

To rn/writer....I added the feeding and phone call part of the story to give a background. I'm not blaming this mom (only 20) for anything or judging her! She is going to be dealing with a great deal of guilt for the rest of her life. Not only did she have to make the choice to withdraw care from her baby but she may feel like the whole situation was her fault. My heart just aches for her.

And I almost postive that I'm going to get floated up there when I work again tonight!

I didn't mean to imply that you blamed this poor mother. It just struck a chord with me because of my recent scare and because the mom I dealt with didn't seem to learn from her near miss.

You're right that she will probably struggle with guilt for the rest of her life. She never meant for anything bad to happen to her child. I hope this young couple's marriage can survive such a fierce blow.

If you get floated back to the NICU, please share your thoughts and let the regular staff give you some TLC.

Hugs to you.

I'm really sorry, but wow these parents were lucky to have you as their baby's nurse. What a painful thing to have to go through...

~J

I just wanted to update everyone on this little baby. She passed away on Tuesday nite.

This is the kind of sad situation which is very difficult for everyone to come to terms with; thankfully it doesn't happen very often.

It brings to my mind the wonderful organization www.nowilaymedowntosleep.org which this family would have been perfect candidtates. If you've never been to the web site, I very highly recommend it.

I remember a baby brought to our NICU coding from the mother-baby unit; he had simply "gone limp and turned blue" in Mom's arms. Turns out he had a heart defect which required his dutus arteriosus remain open; as soon as it closed (usually within the first 24-48 hours in normal term babies) the baby coded. We started prostaglandin infusion and the baby was successfully transferred to a larger hospital for cardiac surgery. It was many years ago, but if I remember correctly he did well. In his case the Mom was able to recognize the problem immediately so I'm sure this helped his case immensely.

Big Hug to you navynurse06 for taking such good care of this baby and family; it sounds like you truly did your best for them and to me that's one of the main purposes for being nurses...caring for the human condition.

:redbeathe

:icon_hug: After 15 yrs working with adults and in adult ICU I now work in PICU. It is different to lose a little one. Even though you know in your head that withdrawal is the best choice your heart still fights the idea. With an adult the end may be painful for the family and seeing that pain can be hard for the nurse but there can also be a sense of completion. A sense that the circle somehow has been closed and the life completed. With a little one you are dealing with not only the loss and pain of the family but also the sense of betrayal and loss of the future or potential of that little one. The heart believes that all little ones are supposed to be born health, and grow up happy. Reality is that not all do. On some level there is also the realization/fear that this could happen to me. That adds another layer to the grief/emotions of the moment.

You did the right things in staying with the assignment and supporting the parents through their personal hell. It may sound strange, but go back to the NICU. Talk with the staff. They know the story and are probably reeling as much as you. They are someone to talk with who you don't have to relive every detail with. They may also have special supports services in place for these types of incidents.

I am not meaning to stir up trouble but I am suprised at your being given such an assignment as a float. This is the type of assignment that only the experienced staff in my unit would take. I am not meaning to imply you don't posses the necessary skills but the emotional toll for both you and the family was excessive. You have never been in the situation of a baby leaving. It is very different and an emotional burden you were not prepared for. When you accpet a position in NICU or PICU you KNOW you will lose little ones. You begin to try and prepare yourself for that fact psychologically. Before I every considered this move a thought long and hard about how I would deal with and even I could deal with the loss of little ones. When you got ready for work that night I'm sure it wasn't with the idea of "I'll float to NICU tonight and learn what it's like to make a baby a DNR." For the parents making these discisions without the support of someone familiar with them caring for their child it is also difficult. You are a good nurse who did an admirable job but to have a familiar shoulder to lean on and cry on may have been easier for the parents.

All in all you had a night passing through the flames. You have every reason to grieve, and feel the pain of the burns. I wish I had some magic words to help.:icon_hug:

I'm sorry to hear this precious child's brief life has ended.

Will there be an autopsy to see if there was some kind of heart defect or other anomoly that caused the baby to arrest? Such a finding certainly won't take away the grief these young parents are facing, but it could relieve the mother of her guilt feelings.

Were you able to get some moral support and TLC from the NICU staff?

Many hugs,

I'm not sure about the autopsy part; I don't really want to ask. But I did get the parent's address, and I'm going to send them a card. I know that at this time in their life that words are futile, but I just want to let them know I'm thinking of them.

As far as moral support from the NICU staff....not happening. They just see me as another body up here. I'm in the military and at our hospital the NICU is the only area that is mostly civilian nurses, and I feel like the civilian nurses up here don't show the proper respect the the Navy or the military nurses. So I don't feel so welcomed when I'm up here. I don't have a choice about being in the NICU; I go where I'm told. Like I said in my OP the NICU have a lot of issue with staff and have someone call out about every day. So they use the Peds staff, PICU,and Mother/baby staff as the float pool for NICU.

And I just can't call out if I know I'm going to be floated up here; you actually have to be sick and get a chit saying so to be able to go home.

On the night that this happened I wasn't happy about getting floated up to the NICU in the 1st place then this happened. There's alot of other issues going on with management that I"m not pleased with, and just other issues. So to say the least this hasn't been a good week.