Help me make it stop!

[BugMacGee]

I'm really struggling with this issue at work. I'm in a level 3 NICU in a relatively low circ area. It seems lately we've had an upswing in our circ rates in our unit. In fact, I can pretty much guarantee that any "American" family will want their son circ'ed before discharge.

In the last week, two of them did not go smoothly. I have seen/ heard of so many that don't.

As a charge nurse, I have another issue with this in that any circ requires one of us to accompany the NICU baby off the unit to the nursery where the procedure is done. The nurse remains with the baby for the duration.
Anyone see the glaringly obvious problem with that?
We're a freakin' intensive care unit!!! We aren't staffed luxuriously enough to have a nurse off the unit for ANY amount of time!!! Especially not for an unnecessary, harmful procedure!

I've brought this up to our manager. She said it would likely get worse due to the changes occurring in our service line.

Many nurses who are on the fence about circ'ing have started complaining that we shouldn't be doing it. One nurse suggested the parents should have to arrange it with the pedi's out patient. ( which I totally agree with. The onus should be on the parents to get it done if they want, not us making it convenient for them). This nurse said that this suggestion was received as if she'd gone completely mad.

I love my job except for this. I need to make change happen. The whole thing just infuriates me.

[2lilsweetfoxes]

Originally Posted by BugMacGee

Many nurses who are on the fence about circ'ing have started complaining that we shouldn't be doing it. One nurse suggested the parents should have to arrange it with the pedi's out patient. ( which I totally agree with. The onus should be on the parents to get it done if they want, not us making it convenient for them). This nurse said that this suggestion was received as if she'd gone completely mad.

I love my job except for this. I need to make change happen. The whole thing just infuriates me.

I completely agree with everything you said. And of course you have to make it convenient for the parents: otherwise many would not even get around to having it done. It should be done, if the parents are absolutely insistent, after discharge for all babies (not just NICU), at a pediatric urologist, at an appointment not coinciding with another appointment. And both parents must be present (unless single mom and don't "know" who dad is) to consent.

Reminds me of a few years back when at a military hospital, the OBs and Pediatricians decided to refuse to perform infant circumcisions (whatever an adult man wants to do is up to him). Well, many of the parents complained to the Inspector General, Hospital Commander, Post Commander, Post Commanding General, and up and down the chain. Result: the doctors were ordered to perform the surgeries or face punishment under UCMJ for failure to follow an order.

[Quirky]

I'm not a medical professional so I don't know how these things work, but can you take it to your union if you're unionized? Can you take it to the hospital's ombudsman and/or ethical review board and/or quality control board?

It seems to me a no-brainer that the lawsuit that would result from a NICU baby crashing and possibly dying or getting irreparably damaged from the lack of available staff while NICU staff are attending a procedure that is optional and not necessary for baby's health would far, far outweigh the amount of money the hospital is making off circs.

[Fyrestorm]

Maybe you can contact Nurses for the Rights of the Child.

It's the organization that started the conscientious objector revolt at t. Vincents hospital.

http://www.nurses.cirp.org/

[Crunchy Frog]

What a horrible thing to have to deal with. In my opinion there should never, ever be a circ performed on a baby who is in the NICU, period! If a baby is unstable or unwell enough to be in intensive care, he is too unstable to undergo an unneccessary surgery.

On preemie boards elswhere (my twins were preemie) I have seen a number of accounts where the NICU stay was extended for several days due to some sort of problem with the circ. I recently read about a pair of 30 weeker twins who got circed right at 35 weeks during a two day "rooming in" period where it was being determined whether they were stable enough for release. One of the twins ended up staying an extra week because his vital signs just went haywire for a few days following the circ. I don't know whether it was caused by the circ or whether it was just because he was still inherently unstable, but it should never have happened.

All parents who want circs should have to arrange for it privately after discharge, but especially so for NICU babies.

I hope you are able to do something to get this ridiculous policy changed.