Saturday, September 20, 2008

Today's Rant!

There are times I am embarrassed to say I'm a nurse - not too often, but occasionally. We have noticed at IMC that the NICU night nurses can be especially difficult and there is a serious power/control aura there anyway. We have put up with the ridiculous rules, realizing this is temporary. Everything was great for Nat and the baby last night. At 6:00 AM the nurse charges into her room, abruptly waking her and announcing that they need to give the baby a bottle. Once she woke up enough to realize what was going on the nurse told her the baby's urine output wasn't enough. Nat replied that she would like to discuss it with the doctor (which is just a doctor they have covering for her regular pediatrician who doesn't come to this hospital). She explained her concerns and the nurse said, "In thirty years of nursing and ten years of day care I have never seen a case of nipple confusion." I don't doubt this - she's never had a baby she encouraged to breastfeed and NICU nurses don't follow the babies once they go home. I know how many mothers abandon their efforts to breastfeed because of this and because they lack confidence in their ability to do it. Is it any wonder with this kind of message?

So this nurse went for the charge nurse who came in and threatened Natalie with taking her baby back to the NICU, putting him back on IV fluids, losing the privilege of "rooming in" and incurring much more expense in NICU charges if she did not comply with this demand. There was no discussion, no involvement of the parent with problem-solving or alternative ideas. Natalie is able to pump plenty of milk now and the lactation consultant was confident things were going well. The baby is responding and making good progress. This staff was on a power trip. They deal with extremely premature babies and other nurses on the unit had even indicated that the regular nursery could do anything they were doing at this point. In fact the doctor had even supported the transfer but nurses had overridden it when it appeared Avery needed some more oxygen. However, in the NICU the alarms were going off as frequently for high levels of O2 as for low and could have been normal fluctuation that other newborns would also have if they were indeed monitored this way. There was no discussion of alternative methods to increase fluids - and there are alternative methods - they just take more time.

All Natalie wanted was a little time to absorb this new information and a chance to discuss the problem with the doctor and lactation consultant. I suspect this is a case of the nurse panicking at the end of a shift and trying to cover her rear. But, the baby is not in any imminent danger andt his was not a crisis for the baby. In fact he just finally had a good bowel movement now that he is actually getting something to eat as opposed to the previous NPO (nothing by mouth) status.

I can't tell you how angry it makes me that the staff would add to Natalie's stress this way and cause her to have to defend herself like this. Now (on Saturday) she has to try to locate the patient advocate, talk to the doctor and the day nurses (AFTER they have heard the night nurse's version of the story) and try to plead her case. I get so angry!!! This is a very unprofessional way for the staff to behave. Shame on Intermountain Medical Center's NICU! They are competent for reviving and caring for sick and premature babies but their patient PR is inconsistent at best.

1 comment:

  1. I agree from my experience having a baby in the NICU that they are a very "anti-breastfeeding" bunch -- and the lactation consultants have a very difficult time with them. I'm sorry for what Nat is going through on many levels. I think you should definitely launch a formal complaint on her behalf.


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