What about Nursing Dx's for abandoned babies?

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I'm doing peds clinical right now, and am caring for a very young infant who was placed for adoption after birth by drug-addicted mom (CPS involvement). I'm in a county hospital this quarter, and they see more than their fair share of these sorts of situations. So, I'm looking for nursing diagnoses to add to my problem list dealing with a baby who has no mother and father to bond with at this time while the involved agency locates adoptive parents. Risk for/Ineffective infant bonding? Nope. Risk for/Ineffective parental attachment? Nope. Nothing of the sort. Nothing remotely like this. What gives?

My heart breaks to think of all the babies who are abandoned, or who are given up for adoption at birth (with no prenatal planning or setting up for adoption), or who are taken from parents at birth (and perhaps even bounced around in foster care for a while) by protective services, and have no visitors, no family, no parents to bond with while all the paperwork gets sorted out at that mind-numbing government pace (grin).

Perhaps I missed something? Perhaps you have ideas? Is this an old issue, and if so, what's the word on what's being done to have NANDA adopt appropriate diagnoses for these sorts of situations? Even for birth parents, attachment and bonding can be real issues, especially when baby is in NICU for a long time, or has birth defects, etc. Surely this delayed bonding has negative effects on infants, and there are things nurses can do about it? Surely this is already a hot topic somewhere and I've just been out of the pediatric loop ;-)

Anyway, back to care planning for me. Joy.

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Specializes in NICU.

http://en.wikipedia.org/wiki/List_of_nursing_diagnoses

Here is a list of some nursing diagnoses, there are quite a few in the social section. Maybe "Social isolation r/t adoption process" or something like that? "Interrupted family process r/t adoption process" maybe? Just something where you can have your interventions be that the baby is interacted with when awake and held when appropriate. Outcome could be that the baby was held for ___ minutes and that there was a decrease in crying time/increase in uninterrupted sleeping time...

If it's a drug addicted baby, then that is a lot easier. They have so many problems with feeding, sleeping, skin breakdown, irritability, etc. when they are withdrawing.

My heart breaks to think of all the babies who are abandoned, or who are given up for adoption at birth (with no prenatal planning or setting up for adoption), or who are taken from parents at birth (and perhaps even bounced around in foster care for a while) by protective services, and have no visitors, no family, no parents to bond with while all the paperwork gets sorted out at that mind-numbing government pace (grin).

Of course we initially feel bad that these babies have no visitors...but when you've worked with newborns in the nursery or NICU, you often realize that those babies will probably have a better life than if those parents had kept them. I've seen way too many drug-addicted moms manipulate the system to make it look like they're in rehab so they can take the baby home, even though they are not in recovery at all. Or moms that really didn't want the baby to begin with, doesn't bond with the baby, and doesn't have the emotional or financial resources available to rasie the baby - but feels she still has to keep the baby. You will see families take home babies where you fear for their lives and curse the "system" for whatever loophole allowed that baby to be placed in their custody.

We just try to spend as much time with these babies as we can can hope that they will be adopted soon into a loving family. But even if they end up in foster care...it might not be that bad. Of course there are bad foster situations, but most likely, those babies will end up having better lives than if the mother had kept them - if someone wants to give up a baby or is forced to, there's generally a really good reason for that.

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I know this is upsetting, but these kids are a lot better off this way than staying with a parent who can't care for them. I was placed for adoption as an infant. My birth mother had planned it and picked my parents, but at the time (1970s) the adoptive parents couldn't pick their child up until the adoption was final. That meant I spent 18 days in the nursery without any parents to bond with. Despite that, I've turned into a normal, healthy adult and don't have any bonding problems that I know of:) I'm still very close with my parents too.

I just wanted to reassure you that you don't need to be broken hearted. You're sweet for caring so much:)

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