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.

Patient notes are a factual patient record. People don't seem to understand the responsibility that sits with HCPs here.

How is rarely and quiet factual? Those are subjective.

Some of what is in a patients notes is factual - temperatures etc .And also the tick boxing re nappy changing described above .

Some of it is subjective and inevitably judgemental .And I understand what the motivation is and what the staff are trying to achieve .

But ...if longer notes to accompany the tick boxing are completed as described then they should contain comments that give an assesment either outlining why concerns persist or why they are dismissed .

*Some of it is subjective and inevitably judgemental .And I understand what the motivation is and what the staff are trying to achieve .

But ...if longer notes to accompany the tick boxing are completed as described then they should contain comments that give an assesment either outlining why concerns persist or why they are dismissed*

Exactly this.

The thing is I can remember every time I rang up being constantly asked what time I would be in and where my husband was, which as I would often get a lift in was difficult to answer as it wasn't just my decision. I can remember feeling like there was an agenda for asking and it made me anxious about ringing as I felt like I would be grilled by the Spanish inquisition. It was so bad I cried about it and one of my family members actually said to the staff "why do you keep asking her this? Is there some sort of issue? She feels like you're pressuring her and you know she doesn't drive." They told us that it was just so they could hold off doing a feed if we were close by.

Obviously my instincts were right...

I really don’t see how them asking that was wrong.

They like parents being able to do as much for the child as possible so if they can time things then great

It seems to a point you are looking for extra problems here rather than focusing on the main issue

Because I'm not a child and don't like feeling pressured or watched. I find it really uncomfortable actually. If I feel pressured it makes me feel anxious. Why do they need to know? If I'm there I'll do the feed and nappy if I'm not someone else will do it , either way DD will have her needs met and I will be there to see her, what time I get there shouldn't matter.

I don't understand the relevance of if I'm doing the 10am feed or 2pm one, basically.

We often ask which feed the parents want to do because then if they are running late by say half an hour we can leave it and wait a bit so they don't miss it. As part of family centred care we are supposed to hand the care back to the parents as some feel we take over which is supposed to affect bonding negatively.

@NicuProblem I think part of the issue here is this, correct me if I am wrong.

You feel failed by the hospital and it led to your DD being born very prematurely, you feel that put you in a terrible position? In terms of finance, emotions, stress, fear and upset to your DS? You then feel that NICU were unfair again when you were trying to deal with the fallout by the hospital failings? If they'd not failed you, you wouldn't have been there to be judged?

It's unfair and I understand why you're angry, you feel you are being held to account for doing your best in a situation you were not prepared for. You had it planned, you would get maternity leave, your husband would be in his "proper" job, your DS would've gone calmly to whoever while you were having DD. However you were let down and now you feel judged.

I totally get why you're feeling that way, but for YOU and YOUR family please do what you need to (de brief, complain etc) and then move on and lead the rest of your life happy.

Sorry if I've got all that wrong.

@TheNavigator
MrMakersFartyParty you are the sort that gives healthcare professionals a bad name. Wanting your wee gloat and pat on the back for how you and your husband behaved in NICU - because obviously how you did it is the correct way to do it, so OP's must be wrong. Your complete lack of empathy shines through your post, particularly in the light of the OP's last update
How bizarre, when did I describe my behaviour in the NICU? I mentioned what my husband did as it is the norm really, probably 90 percent of the dads we see working all week still visit even for 5 minutes. It's a fact and whether you like it or not it is something we are asked to monitor and if the sister in charge was concerned they may speak to the health visitor or safeguarding about it to check everything is OK.
@thecrunchymum he had days off... Paternity leave... But unfortunately as you know nicu stays tend to extend past 2 weeks. I don't think he will be going to an early grave, people who do 7 on tend to have a run of 2 or 3 days off after.

See I never felt the staff took over. I felt comfortable that her needs were met by professionals and actually felt intense pressure by staff to "perform" parenting tasks in a fishbowl which I found worse. I wonder if different families respond better to different techniques obviously no one will know who will prefer what.

Again I don't understand bonding really because I've loved my children from before they were born and always will.

A five minute visit is possible if you drive. Not if you rely on lifts and busses.

See to the staff it would have looked strange that doing things like that wasn’t important because to most parents in that postjon those little things are all they can do for the child so so important

Haven't read the 2nd half of the thread but just in relation to the feeds, they were asking because they would have held off from doing the feed or cares if you were close by so you could do it.

As I said upthread, since people - me included - feel very detached from their babies because they cant hold them (not often anyway) or care for them. That can be detrimental to long term bonding / mental health. Perhaps you didnt feel like that, or you simply didnt have the "luxury" of being there as much as you already had a child but from my own experience, if I had the opportunity to do cares/ feeds, I jumped at it. If I'd have arrived at hospital and they'd done cares/ a feed 5 mins before and there wasn't another opportunity for 3 hours, by which time I'd have left, I'd have been gutted. I think the staff want to offer that opportunity.

It really does sound that you're angry with the experience and you're then taking every question / conversation as spying/ checking up on you - when it's not intended that way. If you have your baby home, maybe look at getting some counselling to talk through your experience so you can move on and enjoy your family x

I don't see it like that. I see it as it's important to her that everything at home is ready, that her sibling is prepared, that our affairs are in order financially. I'm very much a planner and having a nicu baby was very much out of my control. Once we had passed the obvious danger it was important to me to sort of spring into action and prioritise our long term future.

Changing her nappy doesn't actually impact her long term care and who does it isn't something she will remember. It doesn't affect her. But ensuring our home stays afloat does.

I posted about it from the staff side because I thought it would give a rationale as to why they monitor interactions. Even if a mum is in hospital herself we still note down that there's been no visitors but then there will be another part for the ongoing issues which will be on our handover sheet so everyone will know the situation.
If we don't note down that someone doesn't visit their baby and then it comes to going home and their parenting skills aren't ready then it's us that will be getting pulled into the office for not picking up on extra support being needed. If someone didn't visit and had too much going on at home and then 3 months later down the line something awful happened then it's our notes they will pull to pieces in court and they would ask why we didn't note down that the parent had only visited however many days.
As for saving feeds and cares for parents, I was screamed at 2 days ago because a mum walked in an hour late and I was tube feeding her asleep baby as she wanted to bottle feed her and I was "taking over" and put her in clothes she didn't like. We are supposed to hand it over to the parents as much as possible, even getting them to tube feed and give vitamins.
I thought it would be useful to have a rationale for some perspective, it's not personal, it's just there's so much responsibility lying with us. Probably a bit too much for the pitiful salary.
I think the notes are too much myself, but I still can't avoid writing the facts in them because I'd be in trouble.
I haven't read the updates, as is clear from my post I am responding to the OP.

I didn't feel upset if cares had been done and I'd have felt upset if they'd waited for me as I would have felt that they made DD stay in an uncomfortable nappy or go hungry on my account.

I never felt detached from her though so perhaps it's different.

I find it astonishing that a father prioritising earning money to keep a roof over his family's head (and looking after the other child(ren)) would be flagged as a safeguarding concern. Is this for real?

I was screamed at 2 days ago because a mum walked in an hour late and I was tube feeding her asleep baby as she wanted to bottle feed her and I was "taking over" and put her in clothes she didn't like

That's really nasty of her. She should be grateful you were providing the care her baby needed. I really don't understand parents who do that, because to me it seems like they're putting their ego above the baby.

But then people don't understand why we did it the way we did and think it seems heartless.

I don't think either way is right or wrong to be honest but there's no need to scream at someone.

@nicuproblem I agree with what you're saying, I felt pulled between 2 places when mine were in nicu.
Most nicus are bliss accredited and it means they are really into family centred care. This is a quote from bliss about it.

"When a baby is born premature or sick and needs to spend time in hospital, the care they receive is vital to determining their future health.

It is important parents are supported to provide hands-on care for their babies during their time in hospital, but many parents tell us they do not know how they can be involved when their baby is in incubator or has lots of tubes and wires.

Many say this makes them feel helpless, distressed and in some cases, prevents them bonding fully with their baby. This can also have a big impact on babies - but it doesn’t have to"

So it's really difficult because we have this sort of idea forced on us as being the way it has to be. When the evidence says it affects mums and babies and PND being so prevalent there's a big focus on it. Whether it's write or wrong I don't know.

Write! I meant right. Sorry I am post nights oops.
@havingtochangeusernameagain I wouldn't say flagged as a safeguarding concern, sometimes the HV just calls to see how things are or the safeguarding nurse might just double check the home situation rather than taking things at face value. It's usually behind the scenes checking.

I know lots of parents get upset if nurses tube feed the baby rather than it waiting to drink a bottle as often feeding is one of the things keeping you and every tube feed feels like a slap if you know they can take a bottle. Many see it as nurses being. More bothered about completing task A rather than getting baby to do everything to get them home.

However it is clearly NOT OK screaming at you, that shit. We'd never have survived - literally and figuratively, without our amazing nurses

MrMakers

I can see why some families would like that. I remember when my daughter was 1lb8 and I was asked if I wanted to change her nappy. It caught me off guard and I think I said something like "are you mad?! Her legs are skinnier than my fingers!" That bizarrely isn't documented and I thought from the replies here it would be! Once she was bigger I was perfectly fine with it but I hated doing it when she was small and I hated doing it when she had cannulas in.

I personally think a better approach would be tailoring it to each family. I reckon feeling pressured into things is as bad as feeling helpless. It's like with childbirth how some women get PND after a cesarean if they wanted natural and some women get if they couldn't access an elective cesarean. I don't think a one size fits all approach will ever work here.

I remember when my second was in NICU and I had said to them in the night (I was upstairs on the ward) that if baby cries call me and I'll come to baby - I was pumping etc or trying to get sleep in between and they promised that when she woke they would call me (she was in an incubator). No one had called me and I went in at 2am and the nurse said oh glad you're here your baby has been crying all night - I said why didn't you call me. My baby was so hot and distressed, her eyes were puffy from the hours she had cried. It was my second baby in NICU I had a Dural headache had been vomiting as a result of all the drugs from the section.

Anyway the nurse had just let her cry - as she had been fed and her nappy was done and they didn't know what was wrong. I did have words with the consultant and the communication improved. My DH had to often me at home to look after my eldest who was only 3 and my MIL could only help on certain days