I need help processing something that happened in the NICU today. Very raw feelings. Update in new post

[Faith-manor]

Thanks everyone! I sure do appreciate the support and advice. I decided that since people may have an idea where this happened/location, it might be best to now delete the detailed, medical information just because Dd and baby do deserve some privacy. 

Everything wad resolved satisfactorily and the morning report for Baby T was very encouraging.

I just can't thank all of you enough! ❤❤❤

Edited January 29, 2023 by Faith-manor

[Harriet Vane]

I think your concern is valid. I'm so sorry for such a scary incident and for your poor, exhausted dd.

[Jean in Newcastle]

I would have her talk with the charge nurse. 

[Ann.without.an.e]

I’m so sorry, this sounds stressful. It doesn’t seem right and would make me nervous too. Our soon to come little grands may potentially be in NICU and this  sounds so scary. I’m pretty sure my dd would be panicking too.

[Tenaj]

I would be very concerned but I'm not sure what I would do.  My daughter had a premie three years ago and I know she would be completely upset if something like this had happened.  I would want to run screaming to file a complaint but on the other hand, if you get labeled as a problem patient does the baby end up getting worse care?  It is a mess. 

In my grandson's case a heart specialist prescribed a medication for him while he was in NICU.  It was given as prescribed and his condition deteriorated.  Came to find out the Dr. had the wrong file in front of him and prescribed a medication my grandson didn't need!  My dd was furious.  It delayed them leaving the hospital by almost a week be cause it set the baby back.  She never sued-considered it- but just wanted to move on.  She did transfer baby to a different cardiologist.

Edited January 29, 2023 by Tenaj
Typos

[Katy]

Well my first thought was that they generally know when another specialist is with them they would call a code rather than rely on monitors if it was a real emergency. I’ve seen this happen with one of my kids. His vitals dropped, he stopped breathing, and from down the hall a doctor came running and yelling a code for respiratory distress, and only then did the alarms start to go off. The doctor knew DS’s patterns and knew his breathing was about to crash from the monitors. They got set off a dozen times for coming detached and that never followed the same pattern. 

My second thought is when multiple cords get detached at once that is also rarely an emergency. 

My third thought is that if DD has a problem and wants a nurse, she should push the call light.  Assuming there is one in the area. Sometimes they look different in the NICU. With my kids one hospital had a normal button like for adult patients, another had a switch you pushed on the wall. 

My fourth thought is that even with remote monitoring and cameras, she should skip the charge nurse and call the hospital ombudsman and file a complaint. That baby should absolutely be rounded on a minimum of every two hours, even with family there. I don’t remember ever going more than an hour, even if it was just to remind me I could order a meal if I wanted. It’s fine if another nurse takes over for breaks, but that was way too long. 

[KSera]

Well, on the one hand, alarms go off constantly in the NICU and they don't all get treated like emergencies. It's common for alarms to be going off and for someone to just need to hit the reset when they walk by. On the other hand, for so long to go by with no one checking in seems pretty off to me, but I'm having trouble keeping track of how many hours you are saying went by with no one checking on the baby. Are there cameras all around that someone is watching from the nurse's station? It may be that they could tell he was attended to from that, if so. I'm glad to hear he is doing better.

[Grace Hopper]

Whoa. A friend of mine is peds cardiac step down and on her wing the nurses only have two patients each. 

[prairiewindmomma]

Talk to the charge nurse and go from there.

Stuff happens when the assigned nurse isn’t there, but the fact that zero nurses could be found is a problem. 

I would also want to know states staffing numbers. Dd was 1:1 early on, then 1:2, and finally 1:4 close to release but the most her unit allowed was 1:4, and then only on the grow/feeders. The NICU was set up in pods, I could pop my head up and see a couple of nurses at all times. Your dd shouldn’t have to assess whether something was a true emergency. She had a couple of instances of needing help and couldn’t access it. Even if they were following on cameras, someone needed to check in, iykwim. 

 

[Faith-manor]

From the time that Dd arrived and met the day nurse until she left, and he was not checked on by his assigned nurse during that time was top to bottom four hours total. They only have two patients per baby.

 

[Faith-manor]

Just now, prairiewindmomma said:

Talk to the charge nurse and go from there.

Stuff happens when the assigned nurse isn’t there, but the fact that zero nurses could be found is a problem. 

I would also want to know states staffing numbers. Dd was 1:1 early on, then 1:2, and finally 1:4 close to release but the most her unit allowed was 1:4, and then only on the grow/feeders. The NICU was set up in pods, I could pop my head up and see a couple of nurses at all times. Your dd shouldn’t have to assess whether something was a true emergency. She had a couple of instances of needing help and couldn’t access it. Even if they were following on cameras, someone needed to check in, iykwim. 

 

This was my thought. And it wasn't just a nervous nellie mother. The feeding specialist who is a former NICU nurse did not like the lack of response to stimuli from T and wanted his nurse, was yelling for help, no one came, and when she went looking for his nurse after T stabilized could not find her. But, I wanted to make sure we are not overreacting. So yes, he came around under the care of the nurse specialist and his mother who had medical training, however, I feel like it shouldn't have fallen on the two of them to make sure he was okay and did eventually respond to stimulation. It occurred to me though that never having been through this before maybe hospitals really do put this level of medical burden on parents due to the staffing crisis. Things have been wonky to say the least since the pandemic began.  Dd is at the hospital now and is going to talk to the night nurse because she is worried about the possibility that he aspirated spit up. The only thing I could think of is that multiples of much less stable.babies than T were coding at once, and it was a kind of all hands on deck thing, just an unfortunate set of too many bad things happening at once. Yet, even if that is what happened, four hours of not rounding to see him is too long. Progressive status or not, he is in the NICU for a reason. I don't think babies in the regular nursery on the maternity floor would go four hours without being checked. Shoot, I couldn't manage a four hour nap after my kids were born without someone poking and prodding me or banging about in the room. 

 

[easypeasy]

Forever ago, when my dd was in the NICU, this couldn't have happened. We had nurses breathing down our necks. I couldn't make a move with that baby without someone telling me a better way of holding/feeding/burping her or ensuring that we weren't over-stimulating the baby.

I imagine it's a Covid-effect carryover, unfortunately. 😞 But, I hope she gets positive actions/results when she brings it up to another/lead nurse, because four hours in the NICU without a nurse getting a physical eyeball on the baby just isn't okay. 😞

[Ausmumof3]

Dh was in for something recently and a similar thing happened minus the alarms. I wasn’t stressed because I knew it was the leads coming off but I also felt that if it had been an issue no one would have responded. Hospitals are a mess.

[popmom]

2 hours ago, easypeasy said:

Forever ago, when my dd was in the NICU, this couldn't have happened. We had nurses breathing down our necks. I couldn't make a move with that baby without someone telling me a better way of holding/feeding/burping her or ensuring that we weren't over-stimulating the baby.

I imagine it's a Covid-effect carryover, unfortunately. 😞 But, I hope she gets positive actions/results when she brings it up to another/lead nurse, because four hours in the NICU without a nurse getting a physical eyeball on the baby just isn't okay. 😞

yep. 3 out of my four did stints in NICU. This was my experience. including stopping me from breastfeeding too long! Because they were burning more calories nursing than they were taking in after the first several minutes. 

Edited January 29, 2023 by popmom

[popmom]

@Faith-manor is there any indication that they are short staffed? Is NICU over capacity? 

I know that when one of my twins was in the step down nursery there was a definite difference in the care level, but not to the extent that you are describing. 

[Faith-manor]

Dd is sleeping right now so I have not been able to discuss the outcome of her discussion with his night nurse or find out if she discussed this with the nurse manager.

[Insertcreativenamehere]

My youngest was in the NICU for 11 weeks. He is now 10 years old. I would be extremely concerned at the lack of response. My kiddo crashed while in the NICU, with oxygen levels going into the 30s (I witnessed this) and he only survived because of quick response from a doctor and a nurse. 

We had a terrible experience with a nurse, one of his regulars, who completely lost it while my son was being prepped for a tracheostomy. He was crying inconsolably and since he was not stable, I was not holding him. She started yelling at him to stop crying! My husband, mom and I were all so shocked that we froze. Later, I went to the patient care representative and demanded she be removed from his case. Another nurse tried to convince me otherwise, saying that the yelling nurse was one of the most experienced in trach care, but I would not give in. We were assigned other primary nurses who were wonderful! 

[pinball]

Yeah, this doesn’t make sense.

What is the ratio? Most NICUs are 2:1, sometimes 1:1…maaaaaybe 3:1 if the 3 are all feeders/growers and the nurse is very experienced/unit head. Heck, adult critical ICUs aren’t more than 3:1

it’s in the name INTENSIVE CARE…

How is the unit set up? One big room or pods?

Literally, WHERE was the NURSE? Where were other nurses? Other caregivers?

Why didn’t the specialist go FIND THE NURSE once the baby was stable?

[Faith-manor]

Dd just got up and gave me the update. She talked with the night nurse and night nurse manager. It was a very good, productive talk. Things have been resolved favorably, and the night nurse report was very encouraging.

I am now deleting the rest since I did give a lot of information and some folks know the location. I want to be respectful of dd's privacy.

I sure do appreciate the support and advice! You all came through at a time when I REALLY needed it!

Edited January 29, 2023 by Faith-manor

[kbutton]

4 hours ago, Faith-manor said:

Dd just got up and gave me the update. She talked with the night nurse and night nurse manager. It was a very good, productive talk. Things have been resolved favorably, and the night nurse report was very

I didn’t see the original post, but it’s ideal for things to be handled as close to the situation as possible.

Some hospitals have a Family Relations department, just in case that information becomes helpful later or for someone else listening in.

 

[Jaybee]

Glad to hear baby had an encouraging report this morning!