Wednesday, April 29, 2009

So what if I'm crazy?!

So it all started with a visit from Dr. Brown yesterday - well that's how the "crazy" topic came up anyhow. He stopped in (oh this is my primary OB who has been out of town since the day before I delivered) to see how I was doing. Of course I was pumping when he walked in and he sat down anyhow - totally un-phased. Not that I really cared anyhow - I'm exhausted. He eventually asked me if I thought I had the"baby blues". I stared at him for a minute contemplating whether or not to go on a tangent about how I'm in my own personal hell and instead started giggling and said, "I don't think I'm expressing any feelings that are unwarranted." He smiled and said he was glad I was on Zoloft for the time being - I thought I'm glad this hospital doesn't have a psych ward because I think I'd have a line of people waiting to sign me over to it.

So today was a good day - until I went for my regular afternoon NICU visit and ran into the babies' neonatologist. Now, this man is known for his uhem sparkling personality if you will - but is also known for being the best neonatologist around which is why we (or I) chose him. Anyhow, he was sitting next to Mary Louise. I was happily going from bed to bed. He suddenly said - we've started Mary Louise on antibiotics - you know she has an infection - I told you they would get infections. I said no that I was not aware an infection was even considered at this point (the blood cultures had been drawn yesterday and I was uninformed). Then I asked why the nurses and students - and lab techs for that matter didn't wear gloves. He stated that the latest research showed that gloving did not reduce risk for infection - that simple handwashing was the only universal precaution. I said that he assumed the handwashing was effective and that it didn't make sense that wearing gloves would not thereby reduce exposure to bacteria. So what ultimately happened was that I walked away, he followed, confronted me again and we got in a sort of yelling match about bacteria and handwashing in the middle of the nicu. Then I said that I didn't want students working on my babies and that everyone working with them should use gloves unless he planned on guaranteeing proper handwashing. He said fine - and now I'm crazy nurse mom.

What was really bothering me? Mary Louise had a student assigned to her this week. The student had long nails, wore rings and smelled of smoke - and didn't wear gloves. Who ended up with an infection? MARY LOUISE! I did make that point during our little tiff but was told that I just needed to expect infection and that IF the babies survive, they will have infections. What a schmuck.

So Brent and I went back later this evening and tried to get some photos of Mary Louise's eyes and David's face. Some got a little blurred but I'll post them anyhow. Oh - and the NICU started to make all visitors wear gowns and masks because of swine flu - in case you're wondering about the get up.

mary's eyes and david's face

10 comments:

  1. I'm rooting for "crazy nurse mom's" team!!! GOOOooooo GLOVES! Stupid student :(

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  2. Nothing crazy about motherly caring. Not caring--that's crazy. Looked at the pictures over and over. Love those legs, eyes, and sweet faces.

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  3. Okay, that is just crazy! Not you...your doctor! When both of our girls were in the NICU, we all had to scrub in AND wear protective gear. No gloves, but coats for sure and a mask if you had any sign of being sick. This way WAY before this crazy swine flu going around.

    I am so sorry Mary Louise has an infection. I think of you daily and pray for you all often. I love the blog and the updates!

    Hang in there Mama - this won't be your last fight for what is best for your babies! ;-)

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  4. Hey Heather - Christine and I are reading this blog thinking how LUDICROUS that sounds! To actually think that a NEONATOLOGIST, of all people, would assume that all nurses and students would use appropriate handwashing techniques every time!! That's just crazy! You go, Mama! You tell 'em like it is - crack that whip!!! :)

    Hannah

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  5. Go momma bear! Whether they like it or not you have to stand up for your babies. By the way I totally agree they should be wearing gloves especially around premature babies. What morons, doctors can be such morons! Not everyone washes their hands while singing the ABC's. Cute pics!, Thanks for sending them. Sending hugs, kisses and prayers.

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  6. I am 300% behind you on the gloves. This is why we don't do tissue culture without gloves - although if he's got a way that we don't know of, tell him to come on down! (Lucky I'm not up there starting some kind of street brawl)

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  7. :) Glad no post partum blues

    OMG! I'm sorry about Mary's infection! I hope it's minor and doesn't spread to her gut!

    Not to be ugly, but why are there nursing students in the NICU? And why are they allowed to touch the babies? Are there 2 NICU levels at your hospital? Students should only be allowed in the level II nursery. A NICU nurse is not a entry level position and i assume nursing school is similar training like we get as RDs, only for entry level positions... if anything, they can be in there but should be touching the babies...

    I can't believe she has long nails and isn't required to wear gloves! GROSS Even ladies in the kitchen aren't allowed such unclean hands! No long nails, no finger polish, no jewelry unless it's a plain wedding band.

    No gloves is outrageous! Especially when they're that small. I mean, the doctors in the NICU here scrubbed up before touching a baby without gloves and no jackets or long sleeves allowed, but I think the nurses wore gloves for any baby in a box...

    And the doctor saying that crap, someone needs to slap him. If he expects babies to have infections, then he runs a pretty dirty NICU. JACHO would not accept that as an acceptable answer for nosocomial infections. NICU infections are something you strive to avoid not expect. We had a baby come down with a rare strep bug and all babies in the same area (5 total) were cohorted and are being followed to determine where the infection exposure occurred...

    That makes me so angry that they are being like that. I mean they are supposed to be the advocates for your babies when you are not there and I am glad you stood up for your babies rights to clean environment! YOU GO GIRL!

    I hope she gets better! They always say with premies and in the NICU, it's one step forward, two steps back...

    Talk with the babies primary nurse and let them know that you're just fighting for your babies lives and if they are parents, they will know the feeling that you have, that you will do anything for them! Praying for quick recovery and smoothed over feelings with you and the staff.

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  8. Hi Heather~
    I have been following your blog. I am sorry about your recent loss and for all that you have been through. I am so happy to hear of all the small, yet sooo BIG, positive strides for Mary Louise and David. You have EVERY right to be a crazy nurse mom! I have been praying and hoping that you and Brent have the grace to remain strong and hopeful for yourselves and your other sweet peas. I will continue to pray for healing and strength to sustain all of you for what lies ahead.
    ~Teri Rau~

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  9. You go girl! I pray for the little ones every day and can't wait for you to get to August 5th. I love your posts...so truthful and you guys are doing such a great job! Keep up the positivity and good work!

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  10. Total agreement that the parents have the right to advocate for their children and families. The nurse should empower the parents and advocate for the patient as well. Listening to the parents concerns is very important and so is educating. The situation definetly could have been handled better. Everyone involved, parents, family, and those professionals caring for these type of patients are under a great deal of stress. The team needs to be understanding and supportive.

    Personally, when I care for NICU patients, I wash, glove, then use the alcohol based solution on the gloves. Evidenced based practice and research has shown that gloves protect the staff more than the patient (due to gloves being in an open container unless they are sterile gloves) Proper handwashing protects the patients. Gowning has not been shown to improve outcomes or prevent infections.
    Babies have an inexperienced immune system. They have not had time to build up their own antibodies to fight infection. Preemie babies get fewer antibodies from their mothers since most antibodies go across the placenta to the baby in the last few months of pregnancy.
    Preemie babies often have intravenous catheters. These may serve as routes of entry for bacteria.
    Preemie babies frequently are given antibiotics for infections. These kill the bacteria most likely to cause infection, but enable other less common germs to grow more easily. -from Meriter Health Services. Recommend this site for parents, family, friends, and other professionals.
    http://www.meriter.com/living/preemie/index.htm

    Normally the only students I know of that participate in patient care are those precepting (those in their last semester, graduating; serves as an internship). I agree that this preceptee needs to wear a gown (due to being a smoker), cut her nails, and glove prior to every patient contact. Talk to the person precepting her about your concerns.

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