NICU – JRM Nurse Consultants

April 04 2020

Religious Ethics in the NICU: Balancing Beliefs and Life-Saving Care

The ethical situation that comes to mind this week is religious ethics. This theory focuses on religion, often shaped by a parent’s upbringing and older family members. For example, Jehovah’s Witness parents do not allow blood transfusions. This becomes critical when a baby in the Neonatal Intensive Care Unit (NICU) needs a transfusion. In such cases, the treating neonatologist may need a court order to administer the transfusion. In extreme emergencies, if two doctors sign off that immediate action is necessary, the baby will receive the transfusion while the court order is pending.

As a parent of a premature baby myself, I could not imagine not doing everything possible to save my child. Yet religious ethics prioritize the parents’ beliefs, even when medical decisions are life-saving (Denisco & Barker, 2012).

The parents’ refusal can hinder care, but nurses must promote family-centered care, involving caregivers in decision-making whenever possible (Meadow, Feudtner, Matheny Antommaria, Sommer, & Lantos, 2010).

I recall my experience in a level 3 critical NICU, where many rooms were open due to the infants’ conditions. I watched a baby deteriorate rapidly, and the healthcare team discussed urgent transfusion needs openly. As a parent, it was heartbreaking. As a nurse, I wondered how I would handle such a situation, balancing professional responsibilities with compassion for the parents.

The nurse manager at the time criticized the parents, calling their decisions ignorant. While part of me understood her frustration, the compassionate nurse in me knew these parents faced an agonizing choice. I reminded the manager that, regardless of personal opinions, our role was to support the family, ensure the infant’s safety, and provide care—whether or not the parents agreed. By law and ethical standards, the baby would receive the transfusion if medically necessary, often by court order, but our empathy and guidance were essential for the parents during this crisis.

With religious ethics, we may not agree with the family, but as nurses, we must respect their customs and beliefs as long as the baby’s life is not in immediate danger. Compassion and empathy guide us in navigating these difficult situations.

References:
Denisco, S. M., & Barker, A. M. (2012). Advanced practice nursing: Evolving rules for the transformation of the profession (2nd ed., pp. 569-581). Retrieved from https://campus.capella.edu/web/library/home

Meadow, W., Feudtner, C., & Matheny-Antommaria, A. H. (2010, April 13). A premature infant with necrotizing enterocolitis. Special Articles – Ethics Rounds. http://dx.doi.org/10.1542/peds.2010-0079

January 01 2020

Compassion in the NICU: Balancing Expertise, Empathy, and Family-Centered Care

One of the clinical challenges I see in the Neonatal Intensive Care Unit (NICU) is staff complacency. When nursing becomes just a job, passion can be lost, and nurses may move through the motions. We may forget that what is routine for us is a first experience for the families we care for.

Approaching every patient and parent with kindness and empathy is critical. Body language, tone of voice, and facial expressions reveal our genuineness. Even when busy, we must prioritize compassion, putting ourselves in the parents’ shoes to determine the level of care they need.

A common issue in the NICU is assessing infant readiness for oral feeding in premature babies. Opinions vary among staff about the best approach. My experience as a mother allowed me to see both sides: as a parent and as a healthcare professional.

During my son’s NICU stay, he was fed initially via NG tube and later transitioned to bottle feedings. One weekend, I was feeding him multiple times while spending the day with him, but a nurse unfamiliar with us took over, claiming I was feeding him incorrectly and causing aspiration. I was only allowed to hold him. Despite prior arrangements with management for private-room feedings due to a hospital-acquired infection, the nurse acted abruptly.

I was devastated and cried for days. When I reported the incident to the head nurse, it was documented, and the weekend nurse later apologized. Ultimately, it was discovered that the baby’s aspiration was unrelated to how I fed him, and a Mickey G-tube was inserted to facilitate safe feeding and expedite discharge.

This experience highlights the importance of patient-centered care in the NICU. The Colorado model emphasizes including patients—and in this case, parents—in decision-making, respecting their preferences, religious or cultural considerations, and personal choices (Goode, Fink, Krugman, Oman, & Traditi, 2010). Nurses may excel technically, but if parents are excluded, care is incomplete. Compassion, communication, and inclusion are as essential as clinical expertise.

Reference:
Goode, C. J., Fink, R. M., Krugman, M., Oman, K. S., & Traditi, L. K. (2010, August 10). The Colorado patient-centered interprofessional evidence-based practice model: A framework for transformation. Worldviews on Evidence-Based Nursing, 96–105.

April 04 2019

What is a Nurse Consultant

Nurse consultants are a nurse who identifies problems and develop solutions to them. Once the problem is identified, then a workable solution can be developed. Patients and their families can be coached through these problems.

Nurse consultants offer medical education to patients, family, and healthcare professionals. The nurse consultant can create customized care plans for the patient in order to promote wellness.

Nurse consultants provide and develop new ways to ensure that a patient’s well being and safety are met. They also provide an insider’s view on medical issues to legal professionals.

If you would like more information on having a nurse consultant for an evaluation of your needs, please contact:

Rosie Moore 407-760-1662 info@windermerebabyand family.com

Rosie Moore, RN, DNP

Visit my Website to learn more www.rosiemoore27.com
Follow me on Facebook https://www.facebook.com/rosiesnursecorner

March 03 2019

A Theory for Post Partum Moms

Betty Neuman’s theory will work well with visiting post-partum moms in their homes after they have had their babies. One of the things that I have seen while working in labor and delivery, is that the mothers come in with preconceived ideas on what breastfeeding is or is not, based on what their mothers and grandmothers know. The family will say that back in the day, there was not any teaching on breastfeeding, you just did it. This can cause stress with the newly delivered mother and the family. However, I most recently read an article and it spoke about a 17-year-old girl that came in with a complicated pregnancy and she delivered early sending her baby to the Neonatal Intensive Care Unit. She was from Mexico but spoke a language called Mixtec. This would make explaining about breastfeeding difficult and frustrating to the family and the nurse (Peterson-Iyer, 2008).

However through Betty Neuman’s model, if the nurse takes out a book that talks about breastfeeding, even if it is not in her language, she can point to the pictures and demonstrate what she needs to do. Initially, this mother will be pumping her milk, since the baby may be too sick to drink at the breast, however, once the discharge is planned, she will need assistance breastfeeding and bonding with the baby. It is through home visiting nurses, that these cases of mothers that are learning and have language barriers can have support for proper breastfeeding.

Betty Neuman believes that nursing should be approached from a holistic standpoint; physical, psychological, mental, social, cultural, developmental, and spiritual well-being. As a person, Neuman’s theory considers the patient as an individual family member, community or society. The environment that the patient lives in can be external or internal. Stressors that Jean Watson speaks of in her theory, produces tension in a person’s life (Alligood, 2013).

References

Alligood, M. (2013). Systems model. In Nursing theorists and their work (8th ed., pp. 281-301). [Vital Source Bookshelf]. Retrieved from https://campus.capella.edu/web/library/home

Peterson-Iyer, K. (2008). A difficult birth: Language and cultural differences. Retrieved from http://www.scu.edu/ethics/practicing/focusareas/medical/culturally-competent-care/difficult-birth.html

October 10 2016

Stress Levels Among Parents of Premature Babies in the NICU

For parents of premature babies, every moment in the NICU brings a mix of hope, fear, and overwhelming stress. Various studies have been conducted on the stress levels that parents of premature babies experience while their infants are in the Neonatal Intensive Care Unit (NICU). A qualitative study was conducted to explore this subpopulation, using semi-structured interviews with two mothers who experienced preterm labor. The mothers reported feelings of separation anxiety after delivering prematurely. They described a sense of a shattered dream, as their ideal scenario of an uncomplicated birth and taking their newborn home immediately was disrupted (Da Costa Krieger et al., 2014).

Numerous studies confirm that parents of premature babies experience high stress, making this a valuable population for ongoing research to identify supportive interventions. Using Spradley’s domain analysis, the study highlighted that mothers were stressed not only because their baby was in the NICU, but also because nurses sometimes made parents feel like visitors rather than primary caregivers (Heerman, Wilson, & Wilhelm, 2005).

These findings emphasize that, regardless of sample size, the common denominator remains: parents of premature babies endure significant stress. This stress is compounded at home due to family obligations, financial concerns, complex schedules, hospital visits, and caring for other children. The NICU itself adds another layer of anxiety, as parents worry about the survival and well-being of their infant.

Conclusion:
While the NICU journey can be overwhelming, parents are not alone. With compassionate healthcare teams, proper guidance, and ongoing support, families can gain confidence and find strength in caring for their premature babies. Every step, no matter how small, is a milestone worth celebrating, and creating a nurturing environment at home helps both parents and infants thrive.

References
Da Costa Krieger, D., Valeria de Oliveira, J., Bittencourt, V., Garcia Parker, A., Ambrosina de Oliveira Vargas, M., Regina de Luz, K., & Marin, S. (2014, August). Perception of Prematurity: A Case Study Aimed at Approaching Mothers. Journal of Nursing, 2754-2761.

Heerman, J. A., Wilson, M. E., & Wilhelm, P. A. (2005, May/June). Mothers in the NICU: Outsider to Partner. Pediatric Nursing, 31(3), 176-200.

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Tag Archives: NICU

Religious Ethics in the NICU: Balancing Beliefs and Life-Saving Care

Compassion in the NICU: Balancing Expertise, Empathy, and Family-Centered Care

What is a Nurse Consultant

A Theory for Post Partum Moms

Stress Levels Among Parents of Premature Babies in the NICU