Preemies
BLOG Q: What would you say to NICU nurses?
I know that a lot of nurses lurk both on the boards and on our blog, so let's put together a compilation of things we love(d)/dislike(d) about our experiences with them in NICU.
I'll be putting them together as c+p of your responses.
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Re: BLOG Q: What would you say to NICU nurses?
If you don't like working with babies, please find another job!
Please keep your personal opinions about our babies to yourself.. if a neurologist can not confirm that my baby will have CP or anything else wrong, please keep your opinions to yourself.
To the nurses who care about their babies & their parents.. THANK YOU!
Something I loved about one of our NICU nurses... we were working on bottle feeds with DS, he had not been able to drink a whole bottle despite our efforts. Probably the third day we tried his nurse sat down with me and politely said, "Can I show you how we feed the babies?" And waited for my answer before taking DS out of my arms. She showed me a technique I would have never thought of (I've fed babies before, usually in the crook of my arm cradling them, not sitting up with my hand on their chin, etc.) She then handed him back and helped me get positioned. Then it got even better, he took all 2 ounces! The nurse stood up and announced to all the nurses "B just drank his first whole bottle" and they all applauded, I melted. Talk about making a major moment for us. It really is the little things that count.
Making a parent feel like their child is the most important baby you are caring for (let's say if you are assigned to more then one) is the best thing you can do for a NICU parent. Remember the compassion and why you do what you do...We had one or two nurses who just didn't have time do care for our babies the way they should have been cared for, or so they acted. I actually had a nurse tell me via phone, "I tried bottle feeding him but he was pokey so I just didn't want to bother, I poured the rest down his tube."
This. Holy hell I hated when I called to ask her schedule or left for a little bit and they'd feed her early. Not because she was crying or hungry but because they had other babies to care for and needed to fit it all in.
Most parents know exactly how many minutes/hours/care times each day they spend in the NICU. Nurses telling me I spent too little time or too much time there was always hurtful.
Let the parents help as much as possible during care times. Dont assume we dont want to.
My daughter coded several times while in the NICU. The 2 times I remeber were the worst and the best handled by the nurses. One nurse totally ignored me and lost her cool in front of me. The other was really calm and communicated with me and talked to me while getting my daughter stable. Suprisingly the one who lost her cool was a seasoned nurse and calm and collected nurse's 1st code was my daughter.
Our NICU nurses were amazing for the most part. We were very happy with the care our daughter received. My worst experience with a nurse was this: I exclusively pumped because my daughter wouldn't breastfeed (at first she had a feeding tube and was too young, as she got older she just had no interest). I was also struggling with low production. I was pumping bedside one day when a nurse said to me "That's all your getting?". This comment was extremely hurtful as I already had major guilt at not being able to produce enough for all her feedings. When I recounted this episode to my husband, I burst into tears.
Besides this experience, I thought the nurses were amazing, although it annoyed me when a new nurse would speak to me as if it were my first day there, which I found condescending.
ETA: I'm new to this board but wish I had found it sooner!
Treat the parents like they are the expert on their baby, not you. Yes, you may have the medical expertise. But, you don't have the "mommy or daddy sense" that the parent does.
Also, be the person who stands in front of "the bus" and voices concerns to the neos and nnps that parents are to afraid to bring up. You will probably be talking to the parents more than anyone. If the neos or nnps are doing things you know are upsetting the parents, ask them to explain it better to the parents or speak up and see if there is another route that can be taken. Let the neos and nnps know the concerns the parents are having. It isn't always easy to 1) see the neos on rounds or 2) speak up.
We'll miss you sweet Debbie Girl (4.21.12) and sweet Cindy Girl (8.9.12)
All of this, but especially the bolded part. If Z was having a tough day, we would usually not kangaroo with him. We learned that he did worse when he was held if he was already in a touchy mood.
On the day of his first eye exam, he'd also just been moved back to the CPAP from the canula. He was having a tough day. The nurse offered to let me hold him, and, at first, I refused because I knew he needed rest. She pushed me a bit, and he had the worst apnea spell ever. He almost had to be bagged. It was terrifying. I still feel a bit of guilt about it - if I'd listened to my instincts, he wouldn't have had that spell. The nurse should have respected my opinion when I told her I didn't think it was a good idea.
We had one nurse that we loved in particular, and she always always always listened to what we thought needed to be done in terms of holding our son. If he was having a rough day, she always understood that we didn't necessarily want to make it worse by holding him. This same nurse also was willing to be the "bad guy" in a tough family situation we were having. That was awesome. Having the nurses stand up for you and your baby was much appreciated, even if it was outside of her normal duties.
I also agree with the thoughts about how important it is to have a caring nurse when it comes to feeding. I remember one nurse in particular who tried to rush my son through a bottle feed. The rule was that if he had 2 bradies during a feeeding, it went down his tube. Most of the nurses were very careful with the pacing to avoid a brady, but she just rushed through it. He bradied a couple of times very quickly, and it was like, "Well, that's the end of that! Down the tube." It broke my heart.
Great idea!
We loved the nurses who saw Henry as an individual and got to know him and us. ITA with pp that treating the parents like the experts they are is key, esp. in the feeder grower stage. I loved it when they asked me what he liked and how he did with certain things. I also liked it when they realized that chit chatting about random things helped me pass the time. Sometimes the silence was deafening!
Some "pointers": When parents call for updates remember that they are unnaturally separated from their LOs and every details DOES matter ( I hated it when I called at 2am and all they could say was "nothing much happening, you should be sleeping!"). My favorite nurses told me the funny positions he was in and the cute facial expressions he was making.
Remember that parents notice everything going on around them. If you handle another baby a little too roughly, let it cry too long, or complain about another set of parents, we assume you'll be doing the same thing when we leave our LO.
Esp. early on, every chance we get to touch our LOs and care for them is monumentous. Don't rush to "get things done" before we get there- save that dirty diaper, temp, or repositioning for us to do! Also I loved it when the nurses asked us to do these things and made it a given that we wanted to/were going to hold our LO as much as possible without us having to ask!
Finally talk to the parents of your primaries about their preferences for painful procedures. I liked to be there because I could offer some comfort by hand cradling or giving sweet ease. It would burn me up when he seemed to get stuck every time I left for a minute to grab food or go to the bathroom. It felt like they didn't want me to watch- like they weren't good at it or it made them nervous.
BFP#2 3/16/11, beta 138; 4/12 Baby/HB DS born 9/10/11 at 29w4d due to partial abruption and PTL
BFP#3 8/19/13 Another boy! 17P, modified bedrest and Nifedipine helped us have a termie! DS2 born 4/19/14 at 38w5d.
I pretty much agree with everything the PP have said.
I liked the nurses who took initiative to go beyond their job. eg. (1) calling us when he did something cute, finished two whole bottles in a row etc. (2) asked me which of his clothes were my favourite so that if they had to change him when I wasn't there they would put him in something cute. (3) one morning I came in and the night nurse cleaned out his whole cupboard and organzied and folded all of clothes instead of reading a magazine when she wasn't busy.
BPF May 12, 2013 :: EDD Janaury 22, 2013 :: MC Began On July 14, 2013 at 12W4D
Born at 34w2d:
Know that I'm the mom and while I respect that this is your job, it's my CHILD. Please help me and let me parent her. I have had issues with some nurses doing things without me ahead of her schedules times and while it may just be a diaper change to you, it is one of the few things I can do for my baby.
Explain things! I consider myself a reasonably smart person, and I'd have to play context clues to figure out the jargon. I appreciate it so much when nurses answer my questions. I ask for updates and specific questions every time I call and visit. I shouldn't find out that she's coming off a med 5 days after you started it.
Whew, lol that sounded quite vent-like. Overall, we've had a great experience with our NICU drs and nurses, but these are the things that irk me.
It makes me feel absolutely wonderful when I hear that a nurse called when she was off to check on Layla. It helps to know that people care.
This is tough for me, because I have half a preemie/NICU mom brain and half a nurse brain
The biggest thing to me is when they include us. Including us in rounds, daily care, feeding, ANYTHING, means so much to us. When my daughter was first born, I was on a Mag drip and couldn't see her for two days. When she had been in the NICU about 3 hours and had been stabilized and intubated, my husband got to see her. He was obviously very upset and terrified and our nurse, who we LOVE and is one of our primaries and is having surgery tomorrow and won't be back before we go *sob*, let him take her temperature. Such a small, menial task in a normal world, but my husband said he will NEVER forget her for being so kind and patient with him in such a scary situation. Makes me tear up just typing it!
I also love that her primaries text & call each other to update each other on her. I All three of them were in a training class last week and one said, "uhh who's taking care of our baby?" LOL I know some parents don't like when the nurses refer to the babies as "my baby", but to me, as a nurse, that just means that I am taking ownership of what happens during my 12 hours. When I'm working, I am 100% invested in my patients!
There is so much but I can't think of it all right now. So I will contribute a DO and a DON'T DO:
1. Please DON'T hesitate when I ask to hold my child (when he is stable enough to be held of course). I had a few nurses hesitate in the beginning, like they didn't want the extra work. Most nurses are great with this though bc they see the importance of bonding.
2. DO take the time to teach parents. There is one nurse who always calls us for bathtime and the first time or two she really guided us and explained how she does things (of course saying that we can choose to do it her way or find our own way). She gave us wonderful suggestions that really made bath time easier. And most importantly she took the time with us to teach. She didn't rush us or seem impatient.
Ditto this. And approach the baby gently and with a quiet voice. Don't be rough with her, respect her space and tell her what's happening next, even if it seems like the baby doesn't understand. Don't speak loudly around the incubator and laugh with your friends. Especially for tiny babies, keep the lights dim when possible.
For me... something that was especially important was for the nurse to remember that although this is her 1 billionth blood transfusion/PICC line/Desat/Brady/Apnea/Choking episode/Intubation/CPAP/Cannula etc. etc. etc. It is most likely our first (of maybe many) and it is OUR baby that it is happening to. So don't be so non-chalant about it. Tell us what is happening and why. Explain that this is good for the baby because it is what they need right now. Hug us if we want or let us cry if we want.
Also, as PP said, there was nothing I liked more than to call or arrive to see that my son was being held/carried/cared for by a nurse and not just during a diaper change/temp check/feeding. One day I showed up and my son wasn't in his crib and I couldn't see him in the room, until a nurse turned around and she was holding him at the table as she did her notes. Another time I called and the nurse on the line was like "he is doing great, so-and-so is dancing around the room with him and singing" I said, in a panic, "if he is off the monitors, how do you know he is ok?" But the nurse assured me that they "know" him and he was fine... and he was! (He was much older at this point tho!).
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