News From the Nursery Lab 2011-1

Wow. It's been almost a year since I posted anything about my work at Big Hospital Teaching School. It's been quite the ride, overall. I'll do what I can to give you an update or two.

I'm still working from 0400-1230 each day, but at least it's Monday through Friday with weekends off unless I'm on call. Even though we're short-staffed, we've still accumulated enough staffing that I'm only on call about every six weeks or so unless I fill in a vacancy. I have one weekend of full call, which means I'm on standby from 11 p.m. on Friday through 11 p.m. on Sunday night. I've got to be within 30 minutes of work, more or less. The following weekend I'm on "A.M. call" which means if the hospital census is high, I might get called in to assist for morning rounds from 0400-0800, or 0500-0900. At worst I get called in, at best I draw a bit of extra money for being on call.

The babies continue to get born, and sometimes it seems as though we have more being born and living in NICU than go home with Mom and Dad. Of course that's not so, but just seems so, for any child born without problems we don't see.

We've seen a definite increase in twin and triplet births. We're having more and more success with babies born at under 24 weeks, although their time in the NICU is long. I sometimes wonder if what we do is right, morally, even though I firmly believe that every soul deserves every chance it can get. But, then, I also wonder what kind of a life we are giving to those who have such tremendous health problems.
I wrestle with these problems in my mind often. It doesn't take long at all for a baby to become a "million dollar" baby, on the taxpayer's expense.

Because our facility is Big Hospital Teaching School, we get referrals and transfers for many things which are not commonly seen at community hospital level. We are one of the few places in the country with the ability to care for some of these babies. Many of the parents are without insurance - and because of that, many mothers have not had prenatal care, nor have the education and experience to know what to do to take care of themselves in spite of it.

Our team of doctors are wonderful; I'm madly in love with "God II". He's the nicest guy, bold and aggressive in his work, yet gentle as can be with these wee ones. I've gotten to know him enough to call him by name instead of Doctor. And, when he or "God I" call for labs, it tickles me to bits when he simply stands aside to let me do my work - he considers me part of the team, unlike some of the others who still think their offal does not stink! So, life is good in that part of my work world.

But, sometimes those of us in the NICU are not looked upon favorably by certain parents.

Currently, we are on lock down in the NICU. We are under a very real threat of violence from a parent. The child, the mother's fourth, was born normally, but with a few breathing problems, and a short NICU stay was necessary. After a few days, the child was transferred to its home hospital about two hours away.

Several days later, the child was returned to us, very very ill, with no one knowing exactly why.

Enter Dad, the father of this child, but not the others. He raised hell, stating to social workers, doctors, etc. that he was afraid that if the mother of his child was allowed to take the child home, the child would be dead before long. He ended up in jail for beating the shit out of her while she was staying at the local Ronald McDonald house. When he was released, he raised a ruckus in the NICU and was escorted out by the cops, because he said he was going to bring his gun back and kill any of us who had done anything to his baby.

So, we've been on lock down - the threat is very real, not just the ramblings of a crazed parent. We have plainclothes officers around at all times. Our entrances to NICU have all been locked and we are not allowed to enter any of the ones we use to ease our job. We can go out, but must wait to make sure the doors re-close and lock down. If we go into our one main entrance and there are non-staff calling to enter, we cannot simply badge in. We have to wait until they are identified and buzzed in. Only then can we follow.

Lock down has been for the last couple of months, and will, undoubtedly continue for a very long time. Last week, the baby passed away. Whatever happened with this child will never be completely known. The baby came back septic from the home hospital. It affected each body system in some way. The baby ended up on ECMO for awhile, dialysis for about three weeks, and many other things. Each system failure created more difficulties for life. It's sad to say, but the parents were not able to grasp the severity of the condition of the baby. Finally though, it was determined there was no brain function.

The baby was kept on life support and somehow the mother finally understood that the child she had carried for 40 weeks was not meant to live. She agreed it was time. Her child slipped quietly away within minutes of the machines being turned off.

I'm glad the baby is at peace. And I hope that someday soon the father will understand that we were not there to hurt, but to help, but Divine plan was something none of us could know.

But now we'll continue to look carefully as we go about our work. And we'll hope that craziness will not come to fruition in spite of what one man would like.