Saturday, September 19, 2009

NICU Day 8 (yesterday)

You would think that I would have so much time. I mean, there are 24 hours in a day and if you think I visit with the kids for 5, pump/clean up for about 6, drive at least 4, and sleep for 8 (broken up in pieces, of course), that leaves me an hour to blog... Not to mention the 1/2 hour of the pumping sessions where I am hands free... But alas... That is not meant to be. I had a post for last night but by the time we came home it was after midnight.

The babies... Perfection. Sheer, heavenly perfection. I have no words. I am blessed beyond words. I feel so guilty because I wanted to hold them inside for so many more weeks (today would be 29 weeks...) but at the same time, I am so overwhelmed by their strength and health. They are increasing on their feedings. They are both making beautifully messy diapers. They trace with their eyes as we talk to them and, when they are frustrated and we talk to them, they calm. They hold us when we hold them. Their hearts sound great and their little lungs are functioning so well on their own. They are doing well with their temperature control. They may be moved into the next level down of isolettes. Maya is on her way to joining Bobby off the lights. I know the road is so long and I wait to go in and have bad news delivered, but it hasnt yet come. Will it come once I feel we are safe?

Yesterday morning was a lovely visit. We only really spend about 20 minutes with each baby during their care time. We take their temps, change diapers, hold feedings, and then get to cuddle feet and the tops of their heads through the doors of the isolette. Then, it is time to close it up and cover them with the blanket so they can go back to sleep. In between babies (Maya is done one hour, say 11am, then Bobby the following, noon), I go to the pumping room and do my half hour and clean up. Afterwards, we've been grabbing lunch and then heading home, where I pump again (an hour ride plus lunch... I usually get home around the 3 hour time frame). Then I take a nap. I am usually just so worn out (I think some of it is getting up to pump in the middle of the night but part of it was being awake with the babies inside during the night and being used to sleeping in patches of a few hours... I have to retrain my body...). After a few hours, I'm up to pump again, then it is time for dinner, and back to the hospital for our kangarooing.

And this, dear friends, is where our story picks up for last night (day 8).

For kangarooing, we are to arrive at 15 minutes before the scheduled care time (so that care can be completed and the baby's feeding schedule not thrown off). So, at 7:45 last night, I walked into the pod where Bobby and Maya are kept. Dropping off breastmilk, one of the nurses introduced herself as Bobby's nurse but said that he and Maya had been seperated for the night. (I dont like this, by the way; I prefer the same nurse for each of them. But, they have gotten some really sick babies, including their pod mate, and the nurses seem to be dividing the easy babies so that one gets an easy and a hard. As much as I dont love this arrangement, I do love that my babies are considered healthy enough to be easy. But the squeaky wheel gets the grease, too, and I worry that they arent going to get attention that they need... But let me get back to my story). I liked Bobby's nurse. She was very outgoing, talked to the babies, and was very involved. At this point, I still havent seen Maya's nurse. I make conversation, that, yes, we are kangarooing tonight. That we do Maya first and then Bobby, etc. Still waiting. By now, it is 8pm. The nice nurse offers to go find our nurse, who makes a brief appearance and says she's busy and will back to get us started. Long story short, her temp and diaper were done at around 8:10 and then the nurse was gone (given, she was helping another nurse get an IV in- very important but are you the only nurse on the floor???). 8:40 rolls around, Maya still hasnt eaten and is getting frustrated, even as we are holding her feet and head (which is uncommon, both babies usually relax when we touch them and talk to them). Finally, she comes back and takes Maya from her bed, to which her depositing of my sweet daughter on my chest could use some work. She didnt give her a hat. She laid one blanket over her. And then she was gone. I was wearing a thick open front sweater, which I wrapped around her head and body and she was warm against me. Peter fed her (thank goodness before she left, the nurse gave him the syringe of breastmilk) and we talked to her and loved her. She was wide awake, which was good and bad. We love to see her alert, but her sleep cycle usually has her asleep by 8:40. Not last night.

And then the fun really began. Remember how I said that their pod mate needs a lot of attention? No sooner had Maya been wrapped in my arms, than the alarms sounded. And loud. And often. And he was screaming bloody murder because the nurse, who was interceding, was also in the midst of changing his bedding and feeding him, neither of which he was digging. It was the loudest night we've ever had. As Maya was dosing off, an alarm would sound and she would open her little eyes wide. I kept a hand over her exposed ear, which helped some I hope, but at some point, Peter and I were discussing limiting her holding and putting her back, just so it would be quiet. Of course, our nurse was gone, so that wasnt too much of an option! At 9pm, it was time to start Bobby's care, so Peter really got jipped on Maya-time (I was holding her but we sit together and spend time with the babies). So, he did our son's care and even postponed holding him for a few minutes, but we didnt want to screw up his schedule so we asked Bobby's nurse, amid the loudness, if she would put Maya back. It was the hardest thing. I'd only held her for 40 minutes and, in NICU life, that extra 20 minutes means the world. But more than anything, we wanted her comfortable and the loudness and the lights... She wasnt going to be able to really rest. Not to mention, her care would start again at 11pm, which would mean maybe 90 minutes of rest if I put her back early before she was bothered again instead of 75 minutes.

So... the nurse comes back, announces she doesnt know how to use the isolette to weigh the baby (REALLY???) so Bobby's nurse, who was kind enough to change Maya's bedding before saying that she'd be happy to put her back, says that she will do it. Peter has helped with this before (these beds weigh the baby by weighing the bed with the baby then you lift the baby and it weighs again and subtracts appropriately). Well, Maya's nurse looks upset when Bobby announces that Peter will be helping her weigh. I wanted to reach out and smack her. Handing my tiny daughter, who was reaching for me and crying back to the nurse I couldnt stand was horrible. She put her back in her bed just fine and Maya settled down and fell back to sleep quickly, but still... It was horrible. The only saving grace was that Bobby's nurse told us that Maya's nurse was only an 8 hour and was leaving at 11pm. Otherwise, I dont think we would have functioned leaving. As Peter said, we would have slept in shifts and just stayed all night. I dont think she was incompetent (although maybe) but she wasnt the caliber of nurse we have been used to in the NICU.

Peter went to do Bobby's holding and, because it was so late, I went to pump at the beginning rather than the end of his kangarooing. When I was finished and came back, we spent some time together before it was time for Bobby to go back into his isolette.

Both of us were quite verbal on the way home about the nurse we didnt care for. We'd never seen her before and are hoping she was just a per diem (which makes some sense since when we were there for the afternoon, I heard some of the nurses say that several nurses had called out for the evening). On our way out, we saw one of our favorite nurses coming in and told her we hoped she had Maya for the evening. She is sooo good with the babies. So good. Unfortunately, you cant choose the nurses for the babies. You can say you dont care for them but unless they are negligent, you cant say "I dont want X caring for my child." Thank goodness the other nurses step up and the nurse practitioners are always near by in the event of an emergency. All that being said, if either of the kids is assigned this nurse again, I plan on saying something to the nurse practitioner on duty, along the lines of I'm not comfortable with this particular nurse. Perhaps it was all the stress of last night. They seemed very harried with the babies who needed a lot of help and perhaps that set the mood, but it was a rough night.

Well, my pumping is over, which means it is time to close up. We leave for the hospital in 25 minutes. I am way behind on blog reading, but am doing it as I am pumping to try and catch up. I'm still here! It's just taking me a bit!


Donna said...

So sorry it was such a rough night for you and the little ones. I hope you don't have to see the nurse ever again. I hope you are having a better day today!

Debby@Just Breathe said...

Your time belongs to your sweet gifts from God. Perfection as you call them. What a beautiful word.
Thank you for posting and letting us know how they are. Sorry about the nurse, hopefully it was just a one time thing. Didn't you want to just shake her? Hugs to all of you.

Mother Knows Best Reviews said...

I think it's great that you are going to speak up if that nurse is assigned to either of the kids again. Honestly, though, I would probably say something to the department head now, too, while it's still fresh (that way they can't say, "Well, why didn't you say something earlier?"). Thank goodness Bobby's nurse was such an angel.

Anonymous said...

I am just reveling in how strong and healthy they both are.

Anonymous said...

I have had 'bad nurse' experiences too. It's too bad you can't choose the nurse. In L&D you can ask for another nurse if you want, at least in the hospital I was in.

It's great hearing how the babies are doing. It always makes my day to hear of their progress.

Kandi Ann said...

That was so painful to read. Taking time to send out Prayers now. Don't worry about reading until you can, just know there is a post waiting for you at my blog. Hugest hugs, love and Prayers for a better night tonight. xoxo, Kandi

quadmom said...

I am sorry you are having to deal with that nurse. I can't believe she is so clueless ... how frustrating. I hope Maya was able to get back sleep and have some peace after all that.

I can't believe they're already over a week old! Wow!

Reba said...

i can't believe a nurse like that would be in the nicu! i guess they must have been really strapped for help. i hope it doesn't happen again and i'm glad you and peter will say something if it does. i am so happy to hear the babies are doing great!

Michelle said...

So sorry it was a rough night for you. I am happy to hear tat they are doing so good. I hope they do not have that nurse ever again!

You take all the time you need. I don't think anyone is expecting you to keep up on all the blog reading.


Sophie said...

There is always a nurse or two that rubs you the wrong way. When I spent time in the expressing room at my hospital when Jordan was in nicu there was always bitching about particular nurses. If you have an expressing room, try it out... Good place to get goss. And validating too if you find out that others dislike the same nurse.

Personally I think you should be able to say to someone "I don't want her taking care of my child." But yeah, whether they do anything about it will be another thing. People have bad nights I guess.

Our nicu didn't have the staff to keep routines down pat with babies. Unfortunately nights like this will happen again. Bobby and Maya will cope with it, but it will drive you around the bend.

You are doing a wonderful job. One day this will all be over and you'll have those two home with you... :)

Carrie said...

Oh, I am so glad to hear they are both such little rock stars! Seriously, they are so strong, Michele. :)

Very sorry about the inept nurse. I too would speak up out of concern for yours and other babies- but it sounds like she is the exception to the rule at least.

Loving your updates. :)

A n T said...

Sorry to hear about the rough night with that nurse. So glad to hear how awesome both babies are doing!

Anonymous said...

I just wanted to leave a little note - I read your blog once in a while because I am a NICU nurse. I know it is hard to deal with nurses who seem busy with sicker kids, but I hope it helps to put it in perspective if say one of your kids was really sick. Not to stick up for her at all, she very well could have been a 'not up to par' nurse, but I've also been there where one baby really takes up a lot of time and you want to put in as much time for both as is possible, but when it gets crazy there's not much you can do! All I can think to say is that I know when I am in that situation, it's not that I'm not paying attention to the healthier baby, I am just confident that they are stable enough that they don't need to be messed with as much. This is probably all sounding wrong, but I mean well and just hope I could help to ease your mind a little.
I don't know if your NICU does this, but we have what they call primary nurses - they sign up for certain infants and then whenever those specific nurses are on, they automatically area assigned to those babies. It doesn't guarantee you'll always get the nurses you want, but you will more often! Typically they are assigned by parent request because there is a bond between them and the nurses, so maybe it wouldn't hurt to ask about it? Just a suggestion!
I am glad you're babies are doing well - it really sounds like they are. I'm sure you know the feeding thing is probably their biggest issue and all I can say is that even though you just want them home ASAP, it really is best to take it slow with feeding and GI stuff. And of course breast milk and kangaroo-ing is wonderful for that - for everything! I wish you guys and your twins the best!!

Michelle said...

I agree with the other Michelle, although us poor saps are addicted to your updates i think if you miss some here and there to have more quality time with your babies and recovering then we understand. everyone has a bad nurse story, it makes you appreciate your good nurses more. keep at it!! how much do they weigh now?

Christmas with Kasey said...

So glad they are doing well! You can say you don't want them working on your kids, they are YOURS after all! I had to do that when Kasey was in the hospital, yes they weren't very nice to me and told me I could, but I told them I was his mom and they will do what I say... That nurse was not allowed to be assigned to Kasey any more...I hope she isn't their nurse any more, but you do have rights-use them if you have to !!!((hugs))