NICU staff being judgemental.

[NicuProblem]

I'm in tears. Requested my baby's medical notes after a prem birth. Found a part where apparently they started a visiting log as they felt we didn't stay on the ward long enough, that I wasn't talkative enough and that my husband "rarely visited".

I don't drive and have an older child with disabilities. My husband works and at that time was working night shifts. They KNEW this.

I feel distraught by this notion that at my most vulnerable when I was trying my best I was judged as somehow not good enough.

Thanks helena and Xmas. This case has really bugs me (even though it is much lower level than most of my case load). I subjectly admit my angst is to some extent from a personal level medical as nursing staff have been totally hostile towards me from day one- very professionally ganging up and not accepting of my professional judgement. I do accept this is their right. However this is a family with very simple support needs and they are totally open to working with us. For context one senior nurse helpfully made the comment that mum had started a new relationship with an old friend when she should be priortising baby then joked to a doctor she should be pinned down and have a contraceptive inplant inserted by him. Dad of baby has been long of the scene and there was significant DV and emotionally abusive behaviour but no kudos to mum for cutting ties at a time when it thought baby would not live (several weeks). Same professional responded to the fact that mum is still of an age which means her brain will not mature as an adult for 8 years so we need to tailor to this by helpfully ranting she had her first child at 17 without 'all this support' and she was sick of me making excuses for her. I am of senior CP professional with over 15 years experience and prior to that was a senior staff nurse. I am lucky that I usually work in a very 'patch' based setting and the health visitors, school nurses, family support workers and schools etc. It has been a long time since I have encountered these attitudes outside of the general public but when I do it has usually been from nursing or medical professionals.

Did not proof read but hopefully you get my gist! OP, of course this matters to you, your parenting is being called into question and all of us are defensive when this is the case. As professionals working with parents we have a duty to 'own' our concerns and be open with parents about why. The reality is there are very few times when the parents are less invested in their child's welfare than professionals and if they are struggling for whatever reason then we have a duty of care to òffer support and adapt this to the individual family's needs.

Parents are encouraged to take part in cares for their baby to help them to bond with the baby, and also to give the parent something to do/ give them ownership of their baby and a role in their recovery. It's a lot quicker for the nurses to get on and do a tube feed than talking a parent through it...so I highly doubt this is down to staffing levels.

You should contact the NICU and request a debrief where you can sit down with a senior member of the team and discuss any concerns that you have with the care you and your family received.

FWIW, in response to your original concern - I previously worked in paediatrics - and for every single child, on every single shift there would be a paragraph written regarding who visited/ for how long/ if they took part in cares/ if they raised any concerns or questions. It is a common policy to record these details and not a reflection on the parents. It's to have a paper trail should any queries or concerns arise... which for you they have.

Perhaps it isn't staffing but I did get the impression that when it's 4 babies to a nurse they try to reduce the workload.

I'm not sure what support they could have offered us anyway. Until she came home there wasn't anything that could be done. They couldn't magically speed up his start date

Wow @willstarttomorrow The misogyny there was rife.

If the staff had any concerns they should have spoken to the OP about whether she needed any support. I work in the maternity service and this does not happen, despite the terrifying rates of PND and trauma amongst nicu parents.

When my twins were in, there was no support whatsoever - plenty when I was pregnancy, evaporated once I’d had the babies and was having to deal with it all. One nurse was lovely and forced me to leave and go over the road to A&E when she realised I had the beginnings of cellulitis in my leg. I was a physical wreck but that was nothing compared to how I was mentally. They’re 2.5 now and I still can’t look at other people’s birth photos or nicu photos.

and if you think nicu is bad, try the general paeds ward! When one of mine was admitted to HDU (about 9 weeks old, 5lb, twin at home) you literally couldn’t leave the ward - they didn’t have the staff. Which wouldn’t be so bad on the main ward where every child has a single room and each parent has a bed, but I spent 11 nights in a plastic chair next to his cot. I was losing my mind.

Your all home now settled and well just enjoy your babies and let this pass over you it's gone done and finished.

Baby! You didn't have two did you OP?

And OP doesn't have to suck anything up. She is entitled to be upset about it. I agree that they have to log visitors etc but that doesn't change how the OP is feeling right now and it isn't like she is kicking off over it.

Like I said earlier, I know what it is like to feel judged by hospital staff, even when they are just doing their job. It's a horrible feeling to feel judged when you are doing the best you can, especially when it concerns our children.

What is the point of trying to make the OP feel worse than she already does? What enjoyment do people get out of that?

Absolutely NOBODY is saying that the dad should have risked his job, or quit his job. No one.

But what some of us are saying is that when he wasn't working, he could have made the effort, at least sometimes.

The Op is saying she'd have liked someone to have been able to cuddle her child when she wasn't there, but simultaneously, that there was no point her husband going there, even though he had opportunity, and could have provided the cuddling.

This isn't about the precarious nature of zero hour contracts. This isn't about a dad who was abroad, or had 24 hour commitments far away (like a farmer). He could have seen his child without a risk to his job, if he visited on the days he didn't start until 3pm, or if he sacrificed the occasional hour of sleep. Its not that he couldn't go, the OP is of the view that it was pointless for him to go. A view which he must have shared. And because it was bourne out of choice, not necessity, I understand why it was noted in the notes.

OP I had twins at 27 weeks, thankfully they were my first babies so I could be with them. I dont think anyone can quite understand the stress of NICU unless you've been there - congratulations of getting your family home.

I think it's right that the unit makes notes about visiting / families, they're simply looking out for the welfare of the babies.

I did want to say that whilst I offer my full support of getting through the trauma of NICU, I would object to any criticism of the staff. The encouragement of parents to get involved is really to prevent parents (mums in particular) suffer after the birth - PND / guilt / lack of bonding (sonetimes due to fear of them not making it) with premature babies. Certainly when they're wired up to monitors, teeny tiny, parents can feel a distance, helplessness which is addressed by trying to get them involved in the cares / feeds. In my experience, it was nothing to do with workload.

But what some of us are saying is that when he wasn't working, he could have made the effort, at least sometimes.

And why exactly did you think that comment - unsolicited from the original post which was about hospital notes - was helpful, useful, or kind?

I'm sure if I looked at your life I could see lots of times when you could make more effort. Your posts on this thread certainly indicate you need to make more effort on empathy, kindness and decency.

There is a part of me that wonders whether staffing levels have anything to do with this and whether the pressure is on parents so the nurses do less per child.

I wonder this too. It is stressful to work short staffed, not able to give enough to those in your care.

My DD was not prem, but very poorly when born. She got rushed to a hospital 60 miles away. My DP could not go with her as he had my 11 year old DD1 to care for and I couldn't, because I was not well enough.

When I joined her the next day, it was an immense relief. DP was able to hand DD1 over to her Dad the next day and join us. Too far to travel regularly, so I was a patient and DP was in one of the parent houses.

I clearly remember talking to DD1 and her crying on the phone to me, wanting a cuddle and reassurance and to see her baby sister. I was crying too, telling her I had two beautiful girls and I couldn't cuddle either of them, her because she was so far away and DD2 because she was so poorly. Your DC1 is too young to have even this level of understanding really.

I remember the awful feeling of not being able to do anything 100% right for anybody, the absolute guilt and desperation.

DD2 is now 13, DD1, nearly 24, with children of her own, but I have been reminded of this so clearly, all these years later, just reading this thread.

I think you were just a mum in a desperate situation, doing her best, to be fair, dad was too. Try to put it behind you and not stop you enjoying your new baby. Congratulations and all the best for the future.

But if they are recording it is because your behaviour was out of the norm.

I completely disagree. They are recording these things because it is their job. They are recording these things for everyone. It’s standard.

As conveyed previously, one of mine was in a NICU for several months. I visited for 5hrs/day 4 days a week. This was recorded. DH visited one day a week. This was recorded. Toddler had brief 5min visit once a week every week. This was recorded. A grandparent would have a brief visit once every couple of weeks. This was recorded.

We were not singled out in any way, this stuff was recorded for everyone.

Over the months I lost my shit on a few occasions. That was recorded. It’s pretty obviously normal in that type of situation. There were days were I was upset. This was recorded. It’s obviously normal in that type of situation. There were days I was in good spirits. This was recorded. There were days my DH was tired on his visit and had trouble staying awake. This was recorded. There was the odd occasion toddler cracked it 2mins in to their visit and was taken out (tired, hungry, wanted to go back to play with their toys????). This was recorded.

Absolutely none of these things are judgements. They are just facts because people have to write shit on paper to fulfil their paperwork obligations. None of these things are personal insults that should be given a second thought or cause any upset.

If there were no conditions put on your care, if your child was not kept in for longer than necessary due to concerns about you caring for them or them being cared for at home, if child services are not involved then there were no adverse judgements/concerns as that’s what it leads to if people do have concerns.

On coming up to planned discharge a parent had to spend 24/48hrs (depending on medical needs) taking sole care of baby under the watch of staff, documented and signed off. This applied to everyone. It did not mean any individual was thought to be incompetent or there were concerns. It was not a slight against anyone. It was a duty of care and very sensible.

Perhaps it isn't staffing but I did get the impression that when it's 4 babies to a nurse they try to reduce the workload
Presumably at 4 to 1 baby was off the critical list, so at that point there's a view to home. Which means parents need to be able to do EVERYTHING and, alas, prove it.
When DS was critical, his nirses worked their precious backsides off to keep him alive (and yes, nirses not doctors). When he was stable enough to be out of the incubator we were encouraged to are for him as if he was ours, (because they don't totally feel really yours when you can only touched them with scrubbed hands on their heads and feet), safe in the knowledge that if I went off to express, eat, sleep or breathe real air they'd still do it all. Its really unfair to suggest NICU or SCBUnirses are just looking for way to do less work for their own sakes.

I'd really consider talking to your GP about some sort of counselling to help you work through your feelings over this whole thing

OP. I think that you and your husband know in your heart of hearts that you did the best you could on the circumstances and that this was and is good enough. It really is.

You also need to know that the world is full of insensitive judgemental fuckers who couldn't properly imagine themselves in anyone elses position if you paid them a million pounds ( as is obvious from some this thread). They just don't have the ability to.see past their own prejudices and circumstances. This is as true of NHS staff as anyone else. They are just people like anyone else.
You and your us and did a great job on very difficult circumstances. Don't let anyone tell you otherwise.

"This isn't about the precarious nature of zero hour contracts"

Of course it bloody well is People on these are told to keep themselves available.

People have permanently lost hours for indefinate periods and been sanctioned into the bargain if they are on UC for going to visit relatives in hospital , attending funerals even attending jury service.

A lot of people keep voting for this shit but then whine when the reckoning is to be paid.

Which means parents need to be able to do EVERYTHING and, alas, prove it

I objected to this because I didn't see why I should have to have my parenting assessed and pass some sort of test when no one would do this for a term baby, especially as I already had one at home so clearly could change nappies and feed a baby.

I spoke to the consultants about it and they were fine with it and agreed it was unnecessary and my choice. The nurses gave me a load of grief for it though. Even though the consultant was happy!

sleepinsloth yiu missed a bit about op having another child with sn, presumably when op dh is not at work he is looking after his other child.

op tgat was unfair of them and uncalled for, reading on here It seems NICU nurses have a form for this! If they were worried about you or concerned they should have told you and offer support instead of making catty remRks in the notes. I think you should complain, so another family does not have the same experience. For your own piece of mind. I am shocked nurses were doing this for a fully cognis mentis adult patient. Infantilising the patient and treating them like a child.

OP what on Earth do you want from this thread some kind of validation that the nurses were wrong because they were not. They were doing their job in trying to both make your child well enough to go home and to make sure you were capable of looking after them.
For multiple children all the time

You yourself say your partner is still nervous and anxious because he didn’t have that experience

They won’t apologise and they won’t change the records. You made the decision you felt was right for your family and that’s ok it’s done you need to move on

Because and I think this is key you were not the patient your daughter was and it’s her best interests they need to have

especially as I already had one at home so clearly could change nappies and feed a baby well, no, if we look at general parents rather than YOU, having another child doesn't prove anything.
And regardless of your personal opinions, thry have a duty of care to make sure you know how to do feeds, cares etc (not sure if your DD came home in tube feeds too). Having a prem baby makes you a lot more at risk emotionally, especially if they have additional needs.

And if any parent had a child in hospital for an extended period they'd also be clocking how much parents are there, how much they do Re cares.

You and DH split yourselves the only way you could see how to, ensuring he didn't lose his job and thus your home. But from the outside can you really not see why one visit a week from Dad might raise a concern that he isn't supporting the mother, isn't bonding with the baby? Because regardless of how much your DP loves your child, the nurses can only go in what they hear and see. Thry made a few notes and that was it. No referral, no keeping you in longer than necessary. So ultimately their judgement was that there was no problem. So they were sneering and calling you a shot mum / person. Thry clearly believed you capable of looking after her.

If you think hospitals should fix kids and have no concerns about the home they go back to you're being naive at best

It seems NICU nurses have a form for this!... making catty remRks in the notes... a fully cognis mentis adult patient

NICU nurses DO have form for being concerned about the home environment and how parents are coping, yes. Would you rather they ignore any possible issues and just ship them home for someone else to deal with??
It isn't catty to note that Dad is rarely there, that Mum isn't there much and that she seems very quiet and isn't interacting much with baby. It's a warning sign. Which obviously after further observation came to nothing. If they'd made no notes, how would incoming nurses follow up in any concerns in order to raise support or a concern if OP actually wasn't coping?

If they were worried about you or concerned they should have told you and offer support but before they offer it they need to observe and make notes, to see if there IS an issue or not. It's in the notes so everyone Inc the parents have access to it, which is fair. They clearly decided there an issue hence no follow up.

Infantilising the patient and treating them like a child
The patient was 10 weeks old. Of course she was treated like a child.

Sleep

I don't understand why anyone would need to prove they can feed and change a nappy because it isn't a particularly hard task. When I had my eldest I remember thinking oh god how do I change a baby, my mum showed me, and that was that. It's not really something complicated. So unless there were different circumstances making it harder I don't understand.

Re dad visiting, I don't see that as problematic or concerning but maybe it's because of my own background. My dad worked long hours Monday to Friday to the extent he was back long after I was in bed and gone before I was awake. I saw him at the weekends. So a dad working long hours and seeing his children on his days off isn't something I see as a problem.

The notes are not off an adult patient they are of a newborn baby.

OP they clearly agreed with you there was no problem because nothing further was done but they need to check if you check in 10 cases and only 1 needs help that is better than checking 0 and missing the 1 that needed help

This isn’t about YOU stop thinking of it as if it does

Can you partner change a nappy yet or is he still anxious changing and dealing with a nicu baby isn’t the same as a full term newborn