NICU moms or dads, what did you prefer? When I am giving medical updates to parents of sick babies, I usually do the bedside update in person if possible or regular phone contact. If you got sit down updates away from the baby's bedside did you prefer this method of a complete information sharing? Was it to overwhelming or did you like getting a complete list of what the problems were and what treatments were being done? Just trying to get and idea. Sometimes parents are highly distracted when the baby is in view and I wonder if they are getting all the info I am giving, I will ask if they would like a sit down update and many refuse, so I am wondering what the parents viewpoint is.
Sit down conferences or bedside updates???
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I think it depends on the parents and the baby's condition.
We were as our nicu labeled us in the chart "pro active and involved parents" We made it a point from the first minute she was born that we wanted to know what was happening, why, and when. Sometimes we didnt like what was said but this is the nicu not a playground. Our normal ped was a former neo Dr in this nicu, so before the delivery, we made a call to her and she showed up immdtly. Turns out, she taught our NEo on that day and was her good friend. It immediatly set up line of communication that we wanted our Dr involved and also we wanted to be involvd.
We talked to our shift nurse at least once by phone every shift or twice if we didnt visit in that time. Our primary nurse worked doubles over night so she got to know us and when to call. We called her in the evening before bed and immediatly in the morning.
Our nicu is in a Catholic University setting and one of the largest in our city. They ran a very tight ship. The first few days while there, we had contact w/ the Director- Jonathon Maraskus everyday. As she got bigger and better, just her attending and he would pop in to talk if needed. Also the fellows and nurse practitioners were always available. We made it clear we wanted to talk to the Dr always. After a week or so, our attending would be right there at bedside when we visited to answer questions and give an update. Monthly they changed like most nicus. The second rotation, I asked the nurse to see my new Dr. She had a worried look on her face so I said immediatly, no I just want to put a name with a face.
We would set this up when expectation when needed to show they could come to us for anything and we expected the Dr to be avail for us. They were without fail like for all the nicu parents.
But, in our nicu all the Drs were always available 24 hours as well as the fellows. I have talked to many parents here and other places who say that is not the case in their nicu.
Bedside is fine for most things but if there are lots of details etc, a conference might be a good idea. I prefered bedside but its true I saw my share of parents who would have benefitted from a conference room setting.
We were as our nicu labeled us in the chart "pro active and involved parents" We made it a point from the first minute she was born that we wanted to know what was happening, why, and when. Sometimes we didnt like what was said but this is the nicu not a playground. Our normal ped was a former neo Dr in this nicu, so before the delivery, we made a call to her and she showed up immdtly. Turns out, she taught our NEo on that day and was her good friend. It immediatly set up line of communication that we wanted our Dr involved and also we wanted to be involvd.
We talked to our shift nurse at least once by phone every shift or twice if we didnt visit in that time. Our primary nurse worked doubles over night so she got to know us and when to call. We called her in the evening before bed and immediatly in the morning.
Our nicu is in a Catholic University setting and one of the largest in our city. They ran a very tight ship. The first few days while there, we had contact w/ the Director- Jonathon Maraskus everyday. As she got bigger and better, just her attending and he would pop in to talk if needed. Also the fellows and nurse practitioners were always available. We made it clear we wanted to talk to the Dr always. After a week or so, our attending would be right there at bedside when we visited to answer questions and give an update. Monthly they changed like most nicus. The second rotation, I asked the nurse to see my new Dr. She had a worried look on her face so I said immediatly, no I just want to put a name with a face.
We would set this up when expectation when needed to show they could come to us for anything and we expected the Dr to be avail for us. They were without fail like for all the nicu parents.
But, in our nicu all the Drs were always available 24 hours as well as the fellows. I have talked to many parents here and other places who say that is not the case in their nicu.
Bedside is fine for most things but if there are lots of details etc, a conference might be a good idea. I prefered bedside but its true I saw my share of parents who would have benefitted from a conference room setting.
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I liked getting bedside updates every time I came to visit her I enjoyed reading her bedside chart and having the nurse and/or doctor coming over and explaining things to me. I did want them to call me if anything major cropped up.
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We get daily updates from the nurses & respitory therapists while we are there... and anything they can't answer they are great about finding out for us. They do this at bedside.
Then we do care conferences every two weeks with the Dr, nurses, and whoever else we need. There's a specific nurse who's job is to make these meetings run smoothly, so that things don't get to techincal and go over our heads, or whatever, and she is awesome.
Then we do care conferences every two weeks with the Dr, nurses, and whoever else we need. There's a specific nurse who's job is to make these meetings run smoothly, so that things don't get to techincal and go over our heads, or whatever, and she is awesome.
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I was always there for rounds in the morning. It was the best way I knew to get in on the ground floor discussions of ds's care and also to be considered part of the team and impact the decision-making right then. I know this doesn't answer your question, but that was always my best way to get information. That and reading the charts, of course.
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For me, bedside was fine, although my nurses didn't always do that even! I got the best info when I was there for the actual doctor checkup, but they came by at varying times, so I never knew when to be there for one. And there was one case where the doctor said "Oh, he's doing really well. He'll probably go home next week". DS was only a 1 week old, 30 weeks gestation! He was NOT going home the next week, and the nurse came by and corrected the doctor's information after he left (which I was questioning it anyway, since that just didn't sound right!). The doctors kept forgetting how young DS was because he was a big boy for his age.
Since my DS didn't have any major complications (just occasional increases in apnea that I needed to know about... that sort of thing - nothing life threatening or requiring surgery), I could have probably done fine with a daily bedside report and maybe a weekly sit-down report to go over what's going on in general and how he's doing overall and what we can expect in the next week, etc. If there had been any major complications, I'd want a sit-down right away to discuss all details of that, of course. And in the case of a baby with more drastic complications going on often, I'd say do sit-downs more often. So yeah... depends on baby's status (complications or just feeding & growing?), and also parents' wishes to be involved or not. I'm one that likes to know everything that's going on, but some parents don't really want to know!
Since my DS didn't have any major complications (just occasional increases in apnea that I needed to know about... that sort of thing - nothing life threatening or requiring surgery), I could have probably done fine with a daily bedside report and maybe a weekly sit-down report to go over what's going on in general and how he's doing overall and what we can expect in the next week, etc. If there had been any major complications, I'd want a sit-down right away to discuss all details of that, of course. And in the case of a baby with more drastic complications going on often, I'd say do sit-downs more often. So yeah... depends on baby's status (complications or just feeding & growing?), and also parents' wishes to be involved or not. I'm one that likes to know everything that's going on, but some parents don't really want to know!
We got bedside updates from the neo, and I also sat in on rounds every day during the discussion of Sam. I would wait outside the room for them to call me in, or they'd review Sam first and then I'd go get lunch while they finished up. The satellite nursery had two rooms separated by a central office/scrub room/daily bm storage room, so if they were doing rounds on another baby I could still be with Sam, which was good, since rounds could take anywhere from 1-2 hours if they had major stuff to discuss.
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In our nicu, the nicu was closed from 9:30-noon everyday for rounds. The only exception to the rule that I know of was if the baby was near fatel, a surgery was being performed (they did several right in the nicu like a pda surgery) or in our case- Maggie was being transferred to another hospital for feed and grow near us since she was doing better and they were at near capacity. And I felt like I was playing hookey or something while in there during that time!
Since there was no dividers and the 50 beds were all out, they had to close it to parents during rounds.
Originally Posted by jkpmomtoboys I was always there for rounds in the morning. It was the best way I knew to get in on the ground floor discussions of ds's care and also to be considered part of the team and impact the decision-making right then. I know this doesn't answer your question, but that was always my best way to get information. That and reading the charts, of course. |
Since there was no dividers and the 50 beds were all out, they had to close it to parents during rounds.
When we go in, we usually get bedside updates. Whenever the nurses see us they make it a point to catch us up on what is going on with ds from the last time we had contact with him.
I also call twice a day 1) when I wake up and 2) right before I go to bed. I find I'm able to concentrate better/have questions ready when I speak to his care providers on the phone than when we speak in person.
I also call twice a day 1) when I wake up and 2) right before I go to bed. I find I'm able to concentrate better/have questions ready when I speak to his care providers on the phone than when we speak in person.
I preferred the bedside updates. The more formal "team meetings" made me very anxious. I am grateful to the doctors that worked on my sons, but I got a bad case of white coat syndrome from our three months in the NICU. The way medicine is practiced now--from a defensive standpoint in deference to liability issues--make being a patient harder than ever.
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We were there for rounds every morning. We were almost always the only parents there for them, but being students and having the summer off, we didn't have to worry about going to work. In our hospital, having a sit down meeting meant that you were about to loose your baby. In fact, they had a special room dedicated to these kinds of conversations. We were able to converse with the doc and the residents during rounds and the nurses also sat in on these meetings, so if we were confused after talking to the doc, we could get clarification from the nurses.
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Well, what everyone who reads this should know is that a parent can ALWAYS be in the room for their baby's rounds. You can ask to be notified when it's your baby's turn or ask to go first and then leave the room for the others' rounds. That's what I did and that's what any hospital would let you do. I'm sorry they didn't tell you that...
Originally Posted by Amys1st In our nicu, the nicu was closed from 9:30-noon everyday for rounds. The only exception to the rule that I know of was if the baby was near fatel, a surgery was being performed (they did several right in the nicu like a pda surgery) or in our case- Maggie was being transferred to another hospital for feed and grow near us since she was doing better and they were at near capacity. And I felt like I was playing hookey or something while in there during that time! Since there was no dividers and the 50 beds were all out, they had to close it to parents during rounds. |
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It was posted at our NICU that they were closed during rounds from 10am to 1pm due to patient confidentiality reasons. Parents also had to leave when there were new admits, nursing shift changes or a baby critical being worked on.
It was aweful and hard but I do understand why it was the policy.
Originally Posted by jkpmomtoboys Well, what everyone who reads this should know is that a parent can ALWAYS be in the room for their baby's rounds. You can ask to be notified when it's your baby's turn or ask to go first and then leave the room for the others' rounds. That's what I did and that's what any hospital would let you do. I'm sorry they didn't tell you that... |
It was aweful and hard but I do understand why it was the policy.
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Well, see, that doesn't make any sense to me. It would be as if you were a patient in a hospital and they told you to cover your ears during your own rounds. There's no patient confidentiality issues if you pop in and out during your own child's rounds, for which you have every right to be there...
If anyone has these rules, I would question them and ask to be there during your child's rounds and then of course you would leave. Being there during rounds was invaluable to me...
Originally Posted by Liba613 It was posted at our NICU that they were closed during rounds from 10am to 1pm due to patient confidentiality reasons. |
If anyone has these rules, I would question them and ask to be there during your child's rounds and then of course you would leave. Being there during rounds was invaluable to me...
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jkpmomtoboys said:
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munkeesmama said:
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My NICU wasn't closed for rounds. One of the doctors would go around each baby at some random time during the day, and they didn't care if parents were in the room or not. The feeder/grower NICU was always open except 1 hour during shift change (morning and evening) and 2 hours in the afternoon for "quiet time", when they turned off many of the lights and noise making objects and tried to keep the room quiet (except for emergency beeping, of course).
And since they've opened a new NICU area since I was there (they opened it while DS was there, but he had been moved to PICU as an "overflow baby" the last week and a half of his stay), it'd be really hard to hear about another parent's baby during rounds. It's really spread out now! They have a "home" for each baby with cabinets on 2 sides forming an 'L' shape, and rocking chair and curtain and such. It was really nice. So babies are pretty far apart now. The old NICU had been typical crowded NICU. And the part where babies first went into the NICU and/or critical babies stayed felt literally like a closet. You couldn't fit 2 people between beds in there. And you couldn't pass someone down the aisle. You had to move between two beds to let someone by. It was really really squished!
And since they've opened a new NICU area since I was there (they opened it while DS was there, but he had been moved to PICU as an "overflow baby" the last week and a half of his stay), it'd be really hard to hear about another parent's baby during rounds. It's really spread out now! They have a "home" for each baby with cabinets on 2 sides forming an 'L' shape, and rocking chair and curtain and such. It was really nice. So babies are pretty far apart now. The old NICU had been typical crowded NICU. And the part where babies first went into the NICU and/or critical babies stayed felt literally like a closet. You couldn't fit 2 people between beds in there. And you couldn't pass someone down the aisle. You had to move between two beds to let someone by. It was really really squished!
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I preferred bedside updates. I always made sure to be there when the doctors were making their rounds so I could talk about everything with them then. If there were times when it was taking long, some kind of delay and I had to go eat and missed them, then I'd have the nurse taking care of my baby go over everything with me and if I wasn't satisfied, I'd ask to speak with the doctor. I'm sure I was a big pain to them..
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I never had anything besides bedside- I really didn't want to be away from my baby at all, between going back and forth from home to there several times a day, I wanted to be with her every second I could, even if she was sleeping I wanted to stand there to watch her sleep, and I think if I'd been asked to leave her to go into another room I would be anxious to get back. I also really wanted phone calls for anything important, which did happen once and I was very grateful to the nurse for taking the time to call me.
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