Unhappy 22 Weeker

[Rosepink]

undefined This past week I got the assignment from you know where. A s/p 22 weeker on DOL # 210. NO LUNGS or GUT, little vision or hearings. Blood pressures out of the roof, meds (3 pages ) like you would not belive. NPO because that morning he had had surgery #8, freshly extubated CO2 85 (Doc okay with it). This poor kid was unconsolable even with morphine, ativan and methadone. The only thing that helped was the swing and music. WHY DO WE DO THIS TO 22 WEEKERS! This kid has a misserable life! When I tried to talk to the Neo about what would happen to him he looked at me like I was nuts and said" Come on! you know hw is going to die" I still think these little kids are resus to keep the lawyers at bay. I cried all the way home. Does anybody else ever feel like this. I tried to help this kid but I failed.

[Gompers, BSN, RN]

Gompers, your unit sounds like a dream!

Everyone here is going to HATE me soon, if they don't already! I was just replying to a similar comment in the preemie nipple thread. :chuckle

Don't get me wrong, there is plenty to complain about on my unit - it's really old, too loud and open, beds and vents as old as time, etc. But the two things I can't complain about are scheduling/holidays (very flexible and fair) and the way we take care of the babies. Our unit has about 100 nurses, and I'd say 70 have worked there for 10+ years, and 10 for 20+ years! They've all been working together long enough that things have really come together over the years in areas like developmental care. If only we could get a new unit with more soundproofing and flexible lighting!!!

[fiestynurse]

FYI - I have a signed copy of Susan Ludington-Hoe's book on "Kangaroo Care" if anyone wants it. I heard her talk down in L.A. about 10 years ago. She is an incredible nurse researcher on preterm baby care. Very funny, too.

Just e-mail me if you are interested. It just sits on my shelf.

[Freeda]

I know this is kind of late and everything but I just joined. I am preparing for changing careers to nursing and had been waiting to start my prerequisites until after my baby was born. As fate would have it my baby was born at 28 weeks due to IUGR. He is still in the NICU but will be going home soon, and is doing great, other than having the infamous "wimpy white male baby syndrome" (not my words-this came from the doctors). I just had to look when I saw the posting about such an early baby. As a mom of premie, I was horrified to hear that parents had chosen to keep these babies alive to suffer and fill their own needs. So many times I have questioned the quality of life for my own baby, especially in the beginning when he could hardly stand to be touched. I constantly asked my perinatologist if it was worth "saving" my baby's life and was clear to explain that if my baby was not going to be viable that I wanted him to die in peace. I don't know what nursing ethics will allow for but I would hope that most parents would want you to make clear to them that the quality of life for the baby will not be a good one so they can make an informed decision. Thank you for all your hard work.

[Gompers, BSN, RN]

I don't know what nursing ethics will allow for but I would hope that most parents would want you to make clear to them that the quality of life for the baby will not be a good one so they can make an informed decision.

Sometimes no matter who talks to the parents, and what you say to them, it doesn't make a difference. To them, taking their baby off life support or "allowing them to die" as a DNR is the same as killing their baby. They feel religiously that they can't choose to end the baby's life, and somehow consider allowing the baby to suffer endlessly (in the hopes that they MIGHT end up okay) is a more moral decision for them. It's one of the hardest things about working in NICU. Other parents just can't let go, though you see this kind of situation all over the hospital with families and their sick relatives.

I'm so glad your baby is doing well! Yes, wimpy white boys can give us a run for our money, but at 28 weeks he'll be fine. Congratulations Mommy!!!

[BittyBabyGrower, MSN, RN]

We have several chronics on our unit that make one want to run and jump out the window. They are maxed out on pain meds, but I think there poor little neurons just jump and quiver so much that there isn't anything we can do. One will turn blue when you look at him and the other has steroid psychosis....I swear! :chuckle Neither of them have parents that come in and visit, but yet they still say oh, they'll be fine. How do you know, you're never here! Our OT PT take care of the whole peds section, so they can only devote so much time to them, and we can only hold them so long before we have other things to do. They are better off in the NICU because we can spend more time with them, the floors and or PICU won't accept them. So there they are. And as for ethics..once you have gone this far, most won't stop. The best we can do is hope that the family agrees to a DNR, but most won't.

Ugh...they are soooo hard to care for!

[Freeda]

what will be the outcome for a baby like this if the parents don't agree to a DNR? Are we talking human vegetable here?

[Gompers, BSN, RN]

what will be the outcome for a baby like this if the parents don't agree to a DNR? Are we talking human vegetable here?

No, just severe developmental delays and cerebral palsy. Many have lung, gut, brain, hearing, and vision problems as well. They are chronic preemies. Many are on steroids and yes, I believe they get steroid psychosis!!! The hardest ones to me are the ones who have shunts from bad head bleeds - the high-pitched neurological cry gives me shivers down my spine.

There are, of course, babies that are in a vegetative state whose parents keep them alive. Those kids usually have trachs, g-tubes, contractures, the whole thing. Most often these kids are the result of birth accidents (not necessarily the doctor's fault, more often knots in the umbilical cord and things like that) or strokes in utero.