3rd Trimester

NICU Baby...can anyone here tell me my options please

I am really unhappy with the care my son is getting in the nicu @ the hospital where I delivered.  There is one doc in charge of all the nicu babies and nurses.  I am unhappy with this doc plan for my son and the attitude of two nurses in partucular.  Do I talk to my OBGYN? Do I try to get him xfered to another hospital?  Is private care an option?  Any advice pls! 

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Re: NICU Baby...can anyone here tell me my options please

  • 11kacey11kacey member
    I would talk to your OB. What, in particular, do you not like about the plan for Lamar? If you feel like you need a second opinion, you should definitely ask your ob for another doctor to take a look at your son.
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  • awisernawisern member

    Your ob won't be able to help you in this situation.  You need to talk with the neonatologist yourself about the care of your infant/the manager of the nicu.  There should be a clinical manager that is over the nurses, not the neonatologist.

    If you transfer your baby to another hospital you will more than likely have to pay for the ambulance (about $1500 typically) because your insurance won't cover it if it's not medically indicated.

     Sorry you are having issues with the nicu where your baby is.  Maybe talk to the neonatologist and reevaluate things in a day or two.  What gestation is your baby?  Maybe he won't be there for very long.

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  • vigurlvigurl member

    I am trying to be to the point since I am typing this from my ph.  LO was born 5/22 4.64lbs @ 36w5d.  He currently has a feeding tube preventing him frm going home.  That is his only issue. He was feeding well when i left his bed side fridazy night after 9.  on sunday morning when i returned he had a feeding tube.  the day nurse said he was not feeding well. it was her first shift caring for my son.  today is her last shift. the doc said during roulds Lo does not cry when his diaperis being changed or wake up for feeding and until he does so the tube stays in.  my disagreement is in the fact he has never done those things.  before the tube was put in he never did those things and was actually eating the same amount and more than he is being given  in the tube 

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  • Hi, I was a NICU RN in the Houston area.  Start with the nurse manager regarding what you are not liking about the two nurses.  You can also ask that your baby have a primary nurse care for him (someone that you like and trust) and not have the two nurses that you aren't comfortable take care of him.  That should solve that issue.

    As far as the doctor goes, usually there is a head neonatologist on staff, try speaking with him.  If he is the one you have an issue with, ask for the case manager and see if you can have a family meeting scheduled.  This will likely have the head neo doc, the nurse manager, and a case manager and you can address your concerns.

     You can try to get your baby transferred if you want, but it is a huge hassle and can be costly.   We have had babies transferred out, parents thinking they would get better care elsewhere, who ended up coming back because they were even more unhappy with the new hospital.  Many times there is a protocol that is followed, especially with babies that are following a fairly normal NICU course.  May I ask what issue you are having with them?  I don't really think private care is an option unless you have medical equipment in your home.

    Again, I'm not sure what/how serious the issues are, but I would also keep in mind that having your baby in the NICU is a very, very emotional thing and sometimes that can get the best of all of us.  If you're baby is getting good care, I would just spend as much time as possible there so that you can express to your docs/nurses what is upsetting to you.  I can assure you that we want our families to have the best experience as possible and most of us will go out of our way to try to make that happen for you.

  • They may be watching him thinking that he might be getting sick, babies who are getting sick tend to be lethargic and not taking feeds well, and it can happen very, very quickly.  Is it possible for you to be there for the feeds and attempt to bottle feed him or watch the nurses attempt to bottle feed him?   I would think they should at least be attempting to bottle feed and then tubing the rest if he won't take it.  If they are not even attempting, ask them why.

     Ah, I just saw your other post...he's IUGR with a suck and swallow reflex issue.  Is he having any apnea or drop in heart rate while he eats?  That could be one reason that they are keeping him.  It's also possible that he is tiring out before he finishes eating.  Is he losing or gaining weight?

  • from what you are telling us here it sounds like they are doing their job. They have to acess your baby moment to moment. one moment your baby could have been eating well and the next it can change quickly which can show signs of other issues. if your baby is not responding to the temp change while changing a diaper that can show that your baby may be lethargic and other issues can be the cause. the feeding thru the tube may be due to your little one just cannot process the formula/breastmilk by bottle feeding. did you ask why they think he is not getting enough? he may have been spitting it up therefore none was getting to him.

    what were the nurses doing that you were upset about? if it is because they acessed that your baby needed to be on a feeding tube that is not a reason to be unhappy with them cause you want to take him home or that you want him out of the NICU. Try to relax as others have said having a baby in the NICU must be stressful but your baby when he is strong enough will be out of there but that is when he decides that it is time. it should not be rushed.

    It is up to you and your dh to ask why the set back. ask them why they do what they do and maybe by having someone break it down for you it may answer your questions. I find it hard to believe they are just holding him back if they did not think it was the best for your baby at this time.

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  • vigurlvigurl member
    imageKelliO924:

    They may be watching him thinking that he might be getting sick, babies who are getting sick tend to be lethargic and not taking feeds well, and it can happen very, very quickly.  Is it possible for you to be there for the feeds and attempt to bottle feed him or watch the nurses attempt to bottle feed him?   I would think they should at least be attempting to bottle feed and then tubing the rest if he won't take it.  If they are not even attempting, ask them why.

     Ah, I just saw your other post...he's IUGR with a suck and swallow reflex issue.  Is he having any apnea or drop in heart rate while he eats?  That could be one reason that they are keeping him.  It's also possible that he is tiring out before he finishes eating.  Is he losing or gaining weight?

    exactly!  igur w/suck & swallow issues.  no apnea past or present.  no drop in heart rt.  exceedes his birth weight as of yesterday.  any advice?

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  • I have been lurking a bit on the Preemies board for the last week or so (close friends' son was born at 32 weeks 2 week ago and he's in the NICU), and the ladies there might have some experience or suggestions for you.  GL!
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  • I know that you feel that his feeding tube is "all that is keeping him there" but that is a big deal. He needs to consistently be taking his feeds orally. They rarely send a baby home with an NG tube unless it is an extenuating circumstance, and you are passed your edd. 

    Our NICU needed babies to be taking feeds orally for two days straight, and gaining weight each night to be able to be discharged, no matter what weight they were at. You can always ask for the patient advocate from the hospital and talk to them about your concerns. Our LO was 4lbs 10 oz when she was born, and in NICU for close to 3 weeks for eating issues alone. If you take him home and he backslides with his eating, he will have to be readmitted, and then into a PICU, and not a NICU, which has much more one on one care.  

  • vigurlvigurl member

    I wasnt trying to imply his feeding tube isnt a big deal.  I feel like the one particular nurse is lazy and I have NEVER seen her offer him a bottle in tje 8-12 hrs I am here daily.  Her excuse is that he dose not "root" enough for it.  The night shift nurse never has a problem and neither does the day shift nurse who had him before the 3 days she was on.

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