Saturday, January 06, 2007

Wasted

The nurse drew my attention to the note on the front of the baby's chart. "The father of my baby, John Doe, is not to be allowed to visit him." I asked the nurse what the father had done to earn the mother's wrath. For one thing, he was badmouthing the mother in the NICU when she wasn't there, accusing her of having five kids by five different fathers, which is apparently true. Hmm....this may be a legitimate complaint, but if you're one of the five fathers - or maybe the sixth - I'm not sure you have any right to complain.

Also, while the father was visiting the previous evening, another mother of a two week old 27 weeker was also visiting her baby. The father took a shine to her, I guess, because he asked for her phone number. That is just plain bad form, trying to hit on a woman - who happens to be two weeks post delivery - who is not the mother of your baby while you are visiting your baby in the hospital. I've heard a lot of weird things, but this was a new one for me. I said to the nurses, "Does mother know he asked for the other mother's phone number" - no, she didn't - "or does she just know that he's a scumball from previous experience?" We all had a good laugh at that.

I might get some comments criticizing me for laughing at that, and the truth is, it is a pretty lousy situation to have the father of a baby acting like that, and it's certainly not funny to the mother. But please realize that we can't help but laugh at some of this stuff. It must be some sort of a mechanism we use to cope with these sad situations. It's not quite so bad that we're saying, "If I didn't laugh at it, I'd cry," but it's something like that.

The baby went home today after only a short stay in the NICU, so now it will be up to the mother to keep the father away. Unfortunately, it sounds like the kid doesn't have much of a chance of her parents getting along very well.

Meanwhile, in the NICU just one or two cribs away, a mother who was high on cocaine at the time of her delivery is still inappropriately silly seven hours later. As she leaves the NICU to go back to her room she turns to me and says, "Now, what room am I supposed to be in again?" Twenty years old and already wasted....

P.S. Please welcome Your Fellow Man to the blogosphere over at The Bulging Bag.

17 Comments:

Anonymous Anonymous said...

Very funny. You remind me of a story a lady once told me. Where we come from (small, close-knit community, strong families), many people are a bit sheltered as to what goes on in some places.

So, my friend gave birth in a very poor inner city hospital. TWO men showed up to visit her roommate in the next bed, and started to physically fight over which of them was the father! So what did my friend do? She immediately buzzed for her doctor and demanded another room - she refused to share a bathroom with that woman. (I don't blame her!)

It isn't a judgement of her roommate as a person, but a realization that she is "high risk" for diseases. But the situation was very amusing to me, picturing my friend in this predicament.

6:49 PM  
Blogger your fellow man said...

my wife and i delivered our first baby at an innter city hospital where i trained, and our roomate (a very nice woman actually) had been brought over from the local prison to deliver and was handcuffed to her bed. there was always a cop on duty outside of the room. it was very amusing to see my mother-in-law's reaction to this when she came to visit us!

also, thanks for ad

7:56 PM  
Blogger NeoNurseChic said...

Oh dear oh dear....sounds like my life at the NICU lately! We did have one scumbag father hit on nurses. That was pretty awful. We've had a LOT of inappropriateness lately. Security was up on our unit again tonight. And apparently last night, they were up on our unit - and some parents filed a police report against a nurse - and another set of parents the other day asked to be moved from the room - and so on and so on. The drama... I have received multiple phone calls and reports from mothers who don't want dad to be able to visit and then do want dad to be able to visit - and one chart has a note in it that says "Visitation Policy #412 :) " and that is truly kind of amusing! ;)

Our social worker and I keep joking that I attract social chaos. I think it might just be true. I'm starting to become good friends with the security guards. One of our charge nurses likes to joke that it wouldn't be a shift with her in charge if security isn't called for somebody!

And why must we have to put up with this? That's a rant for another day and since I'm really not anonymous, I'll never post it on the 'net!

The things we see...the things we must go through...

The other day, this mom (who is now one of my favorite people on the unit) told me that we should be treated like kings and queens and that we are angels for watching over her little one. I then muttered (sort of loudly enough for people to hear and laugh) that I would just like to be treated like a human. Isn't that a shame?

I did have to smile on Thursday though because the mom I just mentioned gave me a hug and told me how glad she was that I was taking care of her baby. She has made several glowing remarks to me - which is always nice to hear. And then today, I was working with a different family - and after I had gotten them set up with the lactation consultant in the breast feeding room, the lactation consultant came to talk to me and said, "They are the nicest people! And they had the nicest things to say about you! They said you are so sweet and really reassuring..." Wow... I practically tear up hearing stuff like that - after being mudslinged all day long by the rest of them...

Take care!
Carrie :)

9:47 PM  
Anonymous Jenny-up the hill said...

After spending almost six months in the NICU with our son, my husband and I saw quite a few interesting things and met quite a few interesting people!! I should probably write some things down before I forget them. I can't even begin to tell you how many times we laughed ourselves silly there in the NICU! And then there was the Ronald McDonald House... sheesh...LOL!!

12:19 AM  
Anonymous Kath said...

Instead of using the word 'father' to describe these guys, just be honest and use the phrase 'sperm donor'...cause that's all that guys like this really are.

And to be fair, there might be more appropriate words than "mother' to describe the women.

2:32 AM  
Anonymous Helen Harrison said...

Similar "families" abound in the PICU, ICU, ER and hospital wards.

When our son was in Children's Hospital, Oakland, for one of his many shunt revisions, he had to share a room with a boy whose mother and raucous retinue were dealing "substances" from the hospital room.

Not exactly the best environment for our son who was in excruciating pain from intracranial pressure.

As we appear headed back to the hospital for yet another round of surgery, the memories come flooding back, along with fears for what lies ahead.

Yet I must also take this occasion to highlight the *great* interest (bordering, at times, on the prurient) that some medical caregivers pay to the social problems of their patients.

Substance abuse and dysfunctional behavior (of parents) are all gleefully examined at neonatal conferences, with sharing of lurid anecdotes such as we've seen here.
This seems to provide everyone with terrific entertainment.

I just wish the same degree of interest and energy could be focused on the truly atrocious outcomes of NICU care itself, little of which has been properly studied for safety and efficacy. and all of which has the potential to cause huge damage.

I have to ask you: how many conference lectures, how many press releases and news stories, public relations announcements, etc., have been devoted to "crack babies" and fetal alcohol syndrome and dysfucntional families in relation to prematurity?

By contrast, how many have been devoted to the devastation of so many preemies born in the 1990s who were exposed, quite recklessly, by neonatologists to post natal dexamethasone?

Some may wish to blame "irresponsible parenting" for poor outcomes, but current research by Terrie Inder and others strongly suggests that the damage is done in the NICU.

The phrase "physician, heal thyself" comes to mind.

1:11 PM  
Blogger Dream Mom said...

Very funny.

I think the worst I ever experienced though was a nurse who hit on my husband while I went home for a day to rest. I came back and we had enough formula in our room for an entire year, enough diapers for a year, etc. Although she had no time to help me with Dear Son that day, she opened up her entire schedule for my husband, and spent the entire time bathing, changing sheets and fully stocking our room with anything he needed. She brought him lunch and snacks to boot. To top it off, she wrote a glowing description in the nursing notes on what a doting father he was although he was only able to relieve me for a few hours after I had spent the last week there 24/7. We had a good laugh over it though. I told him that he'd have to come more often, so I could get keep the supplies stocked up. Don't get me wrong, he's a great father, then and now, but I think it's pretty low for a nurse to hit on a father when the child's in the hospital and is only ten weeks old. Thankfully, we never experienced anything like that again.

2:33 PM  
Anonymous Anonymous said...

It is called comic relief. It is a common emotion used by almost everyone to cover the true emotion of how much the reality could be painful to see.

If not for comic relief, the world would just crumble.

Keep up the good "comic relief," doc.

3:29 PM  
Blogger Judi said...

I spent 3 months in the NICU with my 26 weeker. He was born 1-9-06. He weighed 1 lb 12.5 oz. He came home free of equipment except an apnea monitor. He will be one year old Tuesday and he is so healthy you'd never know he was a micro-preemie. I am so glad to find your site. I love it! And I too witnessed some VERY interesting and sometimes inappropriate things in the NICU. It provides distraction from the stress of having a baby in there! :)

4:56 PM  
Anonymous Anonymous said...

Black humor, gallows humor.

Wasted is seen in bars every night of the week. No one thinks much of it 'cause everyone is doin' it.

"There but for the grace of God go I"---my son's birth mother gave birth precipitously due to a hit 5 hours before, with crack cocaine.
My son was born in the toilet and left there for someone else to find. I still say "There but for the grace of God go I." People in poverty and/or lower socio-economic groups are not only poor; they are desperate. They are angry. They lash out; they fight and bully and trash-talk anyone and everyone, even the mother or father of their baby---or the doc or nurse caring for the baby in the NICU. What are they supposed to do with a huge backlog (multi-generational) of anger and discrimination and poverty?
Chris and Vic

7:39 PM  
Anonymous Anonymous said...

chris and vic, what a terrible story! How is the baby today?

10:28 PM  
Anonymous Anonymous said...

when i come on duty and these situations come up,i call them 'springer stories' they are distracting me from caring for the infant and generally create a very tense atmosphere for everyone .i have made the observation that it is not about the infant for these drama people,but it's 'all about me'they care ONLY about themselves and it shows.why else would a person 'act the fool' in the nursery?

9:24 AM  
Anonymous Anonymous said...

Vic, known in our NICU as the toilet bowl baby, has his story in the new book by Ruth Levy Guyer, called Baby at Risk (published end of October, 2006). To condense: Vic was 860 grams, 1 lb. 6 oz. and cold when brought to the hospital where I work. The team resuscitated him aggressively---4 hits with epinephrine, for clinicians---to get his heart going, and then, of course, ventilator support. Intractable seizures the next day. Grade III-IV brain bleeds bilaterally---the equivalent of a stroke. Then hydrocephalus, as happens to about 15% of kids with Grade III-IV brain bleeds. Two shunt surgeries when he was 2# did not fix Vic, whose head was like a ripe melon. So they looked for a place to place Vic till he died. I was a medical treatment foster home and his nurse towards the end of his 3-month stay in the NICU. "Match-maker, match-maker, make me a match . . ."

Fast forward 11 years---the in-between is like a roller-coaster ride, including adoption troubles, 6 more shunt revisions in his first year of life, cortical blindness, not walking till he was 2 1/2 . . . Vic is now into precocious puberty---actually, he started at age 7---so he is deep-voiced with secondary sexual maturity, but only 69 lbs---half the mass of any other 11 1/2 year-old. He has cognitive disability, with an I.Q. of 40, but he reads. Like a first grader, not like a 6th grader. He has behavioral lability, but is often charming. He talks all the time----never stops talking! He is bouncy like an ADHD kiddo; with autistic features. He has visual spatial, small motor and gross motor and balance problems. He is not potty trained, cannot do buttons or snaps, nor tie his shoes. In fact, he cannot put on his socks nor other clothing without assistance.
We are in Tae Kwon Do together, but he cannot easily do/remember his forms, which have 20-30 movements per form----he cannot tell right form left. He walks around with a red dot on the top of his hand and foot (for his right side) and a black "L" on his left and hand foot. Just wanted you to have a visual. He will never live independently. He will never learn to cross the street---he just doesn't have the judgment nor the vision. But he gets holes-
-in-one on the mini golf course, and makes more than his fair share of free throws with the basketball. He is always ready and bright and "on." Yes, I insist, that even with an I.Q. in the moderatly retarded range, he is "bright." If you could see his shining eyes, and hear his excited voice going on and on about Garrison Keillor and Prairie Home Companion (he got 3 Prairie HC DVDs for Christmas from relatives!), you would get my drift. His latest stuffed dog is named Fred Newman (the sound-effects guy), for Keillor fans to appreciate.

I love him dearly, a point that Clare was defending. AND he drives me crazy with his perseveration and constant chatter. There will be a day when I can no longer manage him. A wonderful neighbor who has become Vic's virtual dad and my S.O. moved in with us 2 years ago . . . but we are both getting on towards retirement age. This scares me silly. What will become of Vic?!

10:47 AM  
Anonymous Anonymous said...

Acting the fool in the nursery---and how!

Even though I may agree with anonymous about the selfishness, I still feel bound to those people, because they are the family of the baby I am caring for. And I know I must care for them, as well. I can accept their anger, and even understand it. I say to myself, "This is their 'style,' to be aggressive and defensive. They are no different here than on the street." Then I do what I do with Vic and my granddaughter and any child---I try to distract and eventually, by distracting, defuse.
The best distraction is the baby. Just focus on the baby, guys. Keep your anger away from him. Give him what you would want, as a helpless person---peace, protection, loving vibes. DO THE RIGHT THING by him/her.

Once there was a father visiting who had 2 children, by 2 different mothers, in the same area of the nursery. Once there was a Madam with 2 men arguing about paternity over the bedside---the Madam interpreting for a man who didn't speak/understand English. More than once, a baby was whisked off to foster care before a parent could arrive to protest. The birth mother slugged the charge nurse on one of those occasions. More than once, we locked down because of a threat to kill mother and baby by an angry father. Once a man accosted a mother leaving the hospital after her visit to her baby and the police asked more questions than we could answer, due to confidentiality. "Oh, the tangled webs we weave . . ."

I still maintain, "There but for the grace of God, go I."
CAK

11:09 AM  
Blogger Ex Utero said...

This is to Helen Harrison,

before you chunk that spear too far you need to read my literature string. I have been instrumental in decreasing early postnatal steroid use in modern neonatology. I won't say I was the only person who raised the red flag, but I was one of the earliest and have consistently been one of the strongest opponents of it's use. I also was the one that first demonstrated an association between postnatal steroids and spontaneous intestinal perforations (one of our worst acute morbidities in this patient population).

There are neonatology champions against postnatal steroids and we've been around for more than a decade. Mareen Hack's most recent paper in Pediatrics demonstrates that the we are seeing improvements in neurodevelopmental outcomes that correlate with decreased postnatal steroid use. You just have to know where to look.

Phillip V. Gordon MD PhD
(find my PubMed sting using Gordon P.V.)

12:57 PM  
Anonymous Helen Harrison said...

Dear Dr. Gordon (Ex-Utero),

Delighted to meet you! Yes, I am familiar with your research, and have been working on this issue myself for well over a decade.

In fact my files on the iatrogenicity of steroids extend back to the 1970s and earlier(eg,Taeusch HW. Glucocorticoid prophylaxis for respiratory distress syndrome: A review of potential toxicity" _J Pediatr_ 1975:87:617-623). I can only wish these warnings had been heeded in a more timely manner.

My own efforts to speak out on this issue are also well documented and include numerous letters to editors (see for example, The New York Times, October 24, 2002), online postings (check archives of preemie list or the website NAROF.ORG), as well as my article "Preemies on Steroids: A New Iatrogenic Disaster?" published in the journal _Birth_
March 2001, Vol 28, No. 1, pp.57-59. I have also spoken about the steroid - autism connection in Q&A at Hot Topics. In 2005, steroid abuse was central to my presentation "Tip of the Iceberg" at the National Perinatal Society annual meeting.

I thank you for service on behalf of preemies and their families!

Yours for evidence based medicine,

Helen Harrison

2:32 PM  
Blogger neonataldoc said...

Thanks for the comments and stories. Having a prisoner for a roommate would be interesting, to say the least. I guess as long as men and women exist, they will find inappropriate ways and times to "hit on" each other.

It's true that physicians seem to enjoy discussing the social problems of our patients. It's almost like we are competing to see who has the "worst" patient, in terms of societal problems. I'm not sure why. Maybe we think it makes us look tough.

7:17 PM  

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