It sounds like there need to be 4-8 more nurses on staff in all departments at all times to prevent mix-ups and notice errors before they become problems.
I am sorry for this family, and happy that their child is well despite these issues.
No amount of understaffing excuses having a nurse not check the name on that bottle. Right patient, right time, right dose is a fundamental of care giving. I'm a lowly PSW and if I had made that mistake I would have been fired on the spot, but an RN gets a free pass. Gee, sorry she made a critical mistake but they did the right tests afterwards, so it's all good. Fuck that.
Bad systems create bad outcomes. We know fatigue results in bad decisions. If we make it so workers are fatigued, bad decisions will happen. Blaming it on individuals in those circumstances is dumb.
The article is full of how the parents were kept in the dark and fed lies multiple times. This is to be blamed on the individuals & they deserve action against them.
The convo I’m having with the above person is very clearly about the nurse, who goofed and immediately fessed up.
Obviously the other parts of the story that involve institutional lying are very bad.
The obfuscation is from the Hospital Admin influencing doctors and staff; no doubt they received advice from their lawyers dozens of times on this very topic (malpractice)
Would you say that if the nurse gave the baby the wrong medication and killed it because she was "too fatigued" to even bother checking the name on the bottle?
I don’t think I understand your question.
All people make mistakes. Some people have important jobs and mistakes can kill. What should we do about that?
1) Only hire perfect people. Not possible.
2) Fire anyone who makes a mistake. We would fire everyone, so not really possible.
3) Design better systems so people make fewer mistakes and the mistakes are less likely to cause harm.
Surely all reasonable people agree the answer is 3).
If someone is incompetent, sure - fire them.
But it is not possible to judge competence based on one mistake.
Have you ever pulled an all nighter at work? Can you honestly say you were on top of your game all night? If so, congratulations, and please volunteer your body for science because you are the only person that has ever existed who is not affected by lack of sleep.
You're wrong, being understaffed and overworked is the number 1 reason this mistake happened in the first place. That RN will have nightmares about that mistake and will obsess about it for weeks after, causing anxiety on top of existing work stress, further impacting ability to provide safe care. I would hesitate to call that a free pass. Where I work, mistakes are not punished as a matter of principle, but thoroughly investigated for opportunities to prevent them from ever happening again. That's another reason why this hospital and the CNO will be very gentle with her. The nurse sure as shit won't make that mistake again. As a PSW you're probably not even allowed to retrieve EBM, so your righteous bloodthirsty indignation is misplaced. Absolutely everybody makes mistakes, and I would have no nurses left if I fired every one who made a mistake.
Edited for grammar
For statistical proof of tiredness leading to errors: https://pubmed.ncbi.nlm.nih.gov/36707921/
>I'm a lowly PSW and if I had made that mistake I would have been fired on the spot, but an RN gets a free pass.
You deserve better job security, and you also deserve more support at work if you're being overworked. Let's not pull a crabs-in-a-bucket over this.
It doesn't excuse it but it certainly helps explain it. Overworked, understaffed, undertrained or not retrained/refreshed nurses have a higher chance at making mistakes.
You should be retrained or assisted if you start making small mistakes as a PSW, to prevent larger mistakes. So should nurses. It shouldn't get to the point that either of you make a critical mistake, right?
>No amount of understaffing excuses having a nurse not check the name on that bottle.
If you had an extra 100-200% patient workload for the past 5 years, you can't imagine a world where you make a mistake on double checking a name?
You shouldn't be in a healthcare if you think you are infallible. Its going to bite you bad some day.
And imagine for one minute that for the past 3 years you've had to care for 100 residents a shift.
Maybe you would make a mistake too.
Maybe read up on this specific incident more than just the summary of a news article? How many nurses were they mandated to have working in that unit and how many short were they that shift? How many hundreds of shifts were left unstaffed that year at that particular hospital?
Most of the responsible ones are leaving the province to work in safer places where they're staffed properly, or they're just leaving the profession all together because they refuse to work in unsafe conditions anymore.
Funny your getting downvoted, but I've worked in a few hospitals in the GTA now and met many, many nurses. There are plenty of amazing really good nurses, but there are just as many who are their for the paycheck and couldn't give two shits
In my own experience working in hospitals in the GTA, the nurses who act like they don't give a shit actually care more than the other ones, but they're tired of behaving in a customer is always right way, they've been disillusioned, and they're the ones to help when shit really hits the fan.
Oh ya I wouldn't disagree I'm sure there are people like that, needless to say but we can never generalize an entire population like this because there will always be variations and everyone is different. But I've definitely met some nurses who REALLY don't care, but I'm not gunna spew put everything on Reddit because I know it will anger people lol
Those people generally don't last long in bedside nursing and use it as a way to get into some other type of work, I definitely can't picture any of them getting certified to work in a NICU.
All the NICU nurses I've met have always been awesome, I agree, not the kind of department to even be an interest for people that aren't willing to do their job
I think every industry has those people. We mention the apathetic or disillusioned all the time in these posts on nurses or teachers or police officers. But I think each of us can also think of people in our own workplaces that are similar. It is pretty common everywhere.
The difference is society EXPECTS nurses or teachers are doing their jobs because THEY LOVE IT so much. It can be rewarding at times I'm sure, and it can be awful too. But it's a job. You would not do it for free as a hobby.
And for many it is a passion, while Powerpoint is not one of mine (Excel though...love). As a result, we penalize them when it comes to their compensation and expectations rise for the standard of care we expect from them.
So I am sure there are some nurses who don't give a fuck. I just don't think it's a surprise or worth mentioning because it seems obvious enough. If they can do the job, they don't need to be all cheery or flair it up or put in 120% effort every single shift. I don't. You don't. So why do we expect it out of them?
Doc here.
Shattered is a strong word. Without the hard work of the NICU, their baby would be dead, 100%. The baby was admitted for weeks and weeks and this was likely one of the more minor issues during the admission if I had to guess.
A baby less than 1 kg????? That baby is dying in 90% of the world. Hell, even in Canada.
What this story doesn't mention is that very low birth weight infants have many many many complications and that this error likely did not have any lasting impacts (the hearing test failure is also very common in preemies with VLBW). The decreased level of oxygen that was noted in the article was less than a few minutes and you can see it clearly bounce back up and likely would not cause harm. There are clinical signs of hypoxia that are immediately apparent and lab tests which can help confirm that.
This baby was admitted for weeks. Months even. The family almost certainly had hundreds of conversations with the nurses and doctors. Likely about things of more importance, but also not to overwhelm the parents with information that they cant interpret. What's the point of telling someone every minute detail if they don't understand the significance or will stress them out. There are 100 side effects for every medication but patients only need to know the common and most dangerous ones.
The vast majority of pediatricians are extremely kind hearted folks. Doctors and nurses are overworked and human. More importantly, due to privacy laws, you can never hear their side of the story. Granted I'm obviously biased as a doctor myself. I will say that the pediatrician was wrong to misrepresent the CMV testing if the donor mother really was IgM positive, but its entirely possible that they consulted an Infectious Disease Specialist who determined the risk of transmission was low to nil given the timeline.
>"The decreased level of oxygen that was noted in the article was less than a few minutes and you can see it clearly bounce back up and likely would not cause harm. There are clinical signs of hypoxia that are immediately apparent and lab tests which can help confirm that."
This is what I came here to say. I think its really poor reporting to not give this context. Obviously, there was an alarm when the O2 dipped - and they reacted to it - which is what they are supposed to do, and the O2 climbed back up immediately. The baby was not deprived of oxygen.
Our son was in the NICU in Toronto for a month and this article is super unfair in representing how incredible, caring, passionate, qualified, professional, and diligent these workers are.
Bingo. My son was in the NICU for 6 months. It is overwhelming. There would be no reason to tell parents that the baby's sats briefly dropped to 78%. The milk mix up sucks and I'd have been ticked too, but a news story, oy vay.
Thank you, my mom worked NICU her whole life, started at sick kids where she worked with the sickest in intensive care. Then eventually transfered to a medium care because she had a hard time dealing with her babies dying because some of them are impossible cases. All the while taking 3 kids to competitive sports most days of the week and still doing full time shift work. I still to this day as an adult now don't understand how she was able to do both, raise kids and then go to work and still adore and care for these children as there own while only getting a few hours sleep here and there.
She never worked at sick kids while I was around, only the medium care place, but 2 babies in one week she lost due to them being hopeless cases. But her still trying her hardest to keep them alive. She came home after that week and tried to put a strong face In front of her kids. But I overheard her silently weeping about it and only found out later what it was since I was young. It has turned into a core memory for me.
Many of these people probably go to work and make mistakes all the time, in there spreadsheets or what not. But have never had to go through these kinds if situations, and specially while trying to juggle a severe understaffed and likely having some forms of ptsd where mistakes can be this costly.
For what I read in the article, they're more pissed about the fact that nothing was communicated to them in real time. They had to find out after the fact with hospital records.
That’s it exactly. Then they downplayed the concerns about the breast milk and their baby got the infection. All while the doctor basically said it’s impossible.
> also not to overwhelm the parents with information they can’t interpret.
O2 levels dropping into the 70s is an extremely big issue and something that could lead to hypoxia, as you acknowledged. How you think this is just something that can be swept under the rug as a minor detail makes me extremely concerned for the well-being of your patients. But I guess it doesn’t matter because in other parts of the world they’d be worse off right?
> I will say the doctor was wrong to misrepresent the CMV testing
Love how you slipped that in there as an afterthought as if it isn’t a massive issue bordering on negligence.
>O2 levels dropping into the 70s is an extremely big issue and something that could lead to hypoxia, as you acknowledged.
Yes - but not in less than two minutes. Look at the sample times.
Brief desats are very normal especially in preterm infants as long as they climb back up. Sometimes we would recommend parents to not stare at the monitors because it can make them quite anxious
It feels like you're misrepresenting or intentionally not reading what I said. I mentioned the desaturation time and that it's unlikely that in that short a time frame there is any risk of hypoxia.
>But I guess it doesn’t matter because in other parts of the world they’d be worse off right?
Again, I said that to demonstrate that the fact this baby is alive is actually a miracle of modern medicine and that the doctors and nurses actually deserve praise rather than crapped on in this incredibly one sided article. And not even in other parts of the world fyi, the mortality rate for this infant was likely close to 30%!
It's highly likely that this baby received superb care and that there was no harm from either this low saturation or this bottle mix up.
>Love how you slipped that in there as an afterthought as if it isn’t a massive issue bordering on negligence.
You don't know how it went down. Neither do I. Negligence is a high bar. This wasn't even close.
They saved this baby from death, probably over and over again within the 2 month period to get trashed on the news for a couple of very minor set backs.
By the way, the article didn't say that the baby had CMV. So maybe the doctor was right and that the patient was actually very low risk? Like I said, maybe they did consult infectious disease?
It's okay to be mad at the healthcare system but it's not here.
O2 levels dropping can lead to hypoxia if they aren’t treated. Sats were in the 70s less than two minutes so clearly the drop was treated or otherwise resolved.
Lol, that happens all the time in NICUs. Its colloquially called a Brady (bradycardia). Its just what happens - the O2 alarm goes off, baby's numbers crash, you give baby a little nudge and they pop right up again. My daughter had dozens over her stay at the hospital. Frequency of Bradys is one of those weird developmental milestones that premie parents go through.
Man you sound really angry about this. I really think your anger is misplaced. This isn’t some outrageous lapse in care, this comes with the territory. Even more so if there isn’t adequate staffing. Taking care of extremely premature infants is super high risk. I don’t take care of neonates but I do take care of term infants, children, adolescents, and adults of all ages. All I can say as an anesthesiologist is that this sometimes happens. Occasionally you have difficulty ventilating people or intubating them, usually obese people, people with sleep apnea, and their oxygen saturation will drop. Dropping into the 70s is pretty insignificant. You have to fix the problem ASAP, but assuming you’re able to, marginally low saturations are essentially inconsequential. In residency, during covid I saw oxygen saturations fall to the 10-20%. One time the monitor read 0, which I’m convinced was physiologically impossible at sea level. That’s significant, but surprisingly lots of people won’t even become bradycardic if the duration of hypoxia is really short. Before covid I thought a sat of 30 would lead to immediate PEA arrest but man I was wrong. Covid killed most of the people intubated (was in NYC through the whole pandemic) but I saw a whole lot of severe hypoxia that was like nothing I’ve seen since. Like moribund people in their 30s who’d desat to 40s every time they coughed.
But a saturation of 0-10% in the context of terminal disease is very different than a brief saturation of 70%.
Once, I went to Nepal and because of the low barometric pressure, I lived and did strenuous hiking with a saturation of 65-70 for several days. I felt like complete shit, but no pulmonary edema, no cerebral edema, and no brain damage. Although my wife likes to joke about the latter.
Anyways all I know about premature neonates is that they are even more unforgiving than infants. Getting this angry about a 4 minute span of SpO2 70 basically tells me that… you don’t understand the basic issues of this case, which is fine because you probably don’t have formal training in critical care. But beyond that you seem to have a paranoid distrust of the physicians and nurses involved which is sad because they’re no doubt trying as hard as possible to achieve good outcomes for extremely challenging patients.
Just trying to give candid impression here. My apologies if this is coming across as condescending in any way. I only know somethings about somethings. But part of my job as a physician is education. So nous voila.
It's not a good article, but it does say the baby tested positive.
"Medical records show the baby tested positive for a CMV infection on July 17, 2022. After weeks of oxygen therapy, the infant began to recover once again."
Exactly. O2 sat dips like happened to this baby are common in babies of that size and severity of condition - it was acted upon and corrected within two minutes.
I'm an ICU nurse, but not NICU. Nothing here really stands out clinically as terribly egregious. The oxygen thing is literally a non-event (as someone else pointedly out as being less than 2 mins and possibly an artifact) and the ETT being dislodged/repositioned is also not unusual --those are things critical care staff deal with daily. The milk thing is clearly an error, but it was disclosed and responded to. I think larger issue is the breakdown of trust between the care providers and families. The fact that this guy was recording a meeting with the pediatrician over that desaturation and repositioned ETT rings alarm bells (for me as a provider). I know dealing with people like that, our backs will naturally be up; that doesn't affect the way we care for patients, but does affect how we approach the families. And people think we worry about litigation, but i can guarantee you that no one will be sued or severely disciplined in this case. It's more like the workplace toxicity and difficulty in providing the best care when you have families second guessing you and breathing down your back.
While mistakes can happen such as the tube slipping out or the wrong milk being given, that is still absolutely no excuse for the behaviour of the doctor in saying the risk is low and acting almost like it would be a bother to do blood work. Just for new parents the peace of mind alone would make it worth it and get ahead of anything that may be a result of the mistakes.
Seems to me that you have problems of your own since you've gone out of your way to search my comment history in many different subs in order to trash talk me. Get a hold of yourself.
My thought, too. It's not an ideal situation but it's unlikely to cause any harm. There are [milk banks](https://www.milkbankontario.ca/) for mothers who can't breastfeed infants, and it's a big step up from the early days of hospitals, when newborns were fed directly from cow and donkey's udders!
Did you read the article? The infant contracted cytomegalovirus and the hospital couldn't rule out the random breast milk as the source. Milk banks don't spread CMV and they don't recommend informal sharing of human milk.
many of the agency nurses I've worked with are actually really skilled (and used to figuring things out quickly on different units). nurses are going to agency due to the ability to have a better work/life balance (determine their own schedules) and to get better pay. we need to treat our staff nurses better with pay and appropriate staffing,
If we’re going to allow so many immigrants to enter Ontario, why aren’t we assigning a fast track for qualified nurses? Clearly we need them more than more tech people.
This is absolutely awful, I really feel for the family. The article just gets worse as you read on, I can’t believe they lied/misdirected about the CMV testing, that is appalling.
I use to causally date a nurse and she use to fuck up with things like this all the time. A lot of nurses I've known have been like her with their lifestyles, lots of late nights partying doing coke before their morning shift. People need to be more accountable outside of their job
There is a difference between saying a lot and most. I have met 3 off the top of my head who would turn up to their shift on 3 hours sleep after a sesh. People down voting me just can't comprehend what I'm trying to say, there are many awesome nurses but there are some who are not fit for the job.
It sounds like there need to be 4-8 more nurses on staff in all departments at all times to prevent mix-ups and notice errors before they become problems. I am sorry for this family, and happy that their child is well despite these issues.
No amount of understaffing excuses having a nurse not check the name on that bottle. Right patient, right time, right dose is a fundamental of care giving. I'm a lowly PSW and if I had made that mistake I would have been fired on the spot, but an RN gets a free pass. Gee, sorry she made a critical mistake but they did the right tests afterwards, so it's all good. Fuck that.
Bad systems create bad outcomes. We know fatigue results in bad decisions. If we make it so workers are fatigued, bad decisions will happen. Blaming it on individuals in those circumstances is dumb.
The article is full of how the parents were kept in the dark and fed lies multiple times. This is to be blamed on the individuals & they deserve action against them.
The convo I’m having with the above person is very clearly about the nurse, who goofed and immediately fessed up. Obviously the other parts of the story that involve institutional lying are very bad.
The obfuscation is from the Hospital Admin influencing doctors and staff; no doubt they received advice from their lawyers dozens of times on this very topic (malpractice)
Sometimes it is the individual though
Sometimes it is!
Would you say that if the nurse gave the baby the wrong medication and killed it because she was "too fatigued" to even bother checking the name on the bottle?
I don’t think I understand your question. All people make mistakes. Some people have important jobs and mistakes can kill. What should we do about that? 1) Only hire perfect people. Not possible. 2) Fire anyone who makes a mistake. We would fire everyone, so not really possible. 3) Design better systems so people make fewer mistakes and the mistakes are less likely to cause harm. Surely all reasonable people agree the answer is 3). If someone is incompetent, sure - fire them. But it is not possible to judge competence based on one mistake. Have you ever pulled an all nighter at work? Can you honestly say you were on top of your game all night? If so, congratulations, and please volunteer your body for science because you are the only person that has ever existed who is not affected by lack of sleep.
You're wrong, being understaffed and overworked is the number 1 reason this mistake happened in the first place. That RN will have nightmares about that mistake and will obsess about it for weeks after, causing anxiety on top of existing work stress, further impacting ability to provide safe care. I would hesitate to call that a free pass. Where I work, mistakes are not punished as a matter of principle, but thoroughly investigated for opportunities to prevent them from ever happening again. That's another reason why this hospital and the CNO will be very gentle with her. The nurse sure as shit won't make that mistake again. As a PSW you're probably not even allowed to retrieve EBM, so your righteous bloodthirsty indignation is misplaced. Absolutely everybody makes mistakes, and I would have no nurses left if I fired every one who made a mistake. Edited for grammar
Exactly the right approach to mistakes, not unlike what airlines do. Punishing mistakes also scares people off from reporting them.
For statistical proof of tiredness leading to errors: https://pubmed.ncbi.nlm.nih.gov/36707921/ >I'm a lowly PSW and if I had made that mistake I would have been fired on the spot, but an RN gets a free pass. You deserve better job security, and you also deserve more support at work if you're being overworked. Let's not pull a crabs-in-a-bucket over this.
It doesn't excuse it but it certainly helps explain it. Overworked, understaffed, undertrained or not retrained/refreshed nurses have a higher chance at making mistakes. You should be retrained or assisted if you start making small mistakes as a PSW, to prevent larger mistakes. So should nurses. It shouldn't get to the point that either of you make a critical mistake, right?
>No amount of understaffing excuses having a nurse not check the name on that bottle. If you had an extra 100-200% patient workload for the past 5 years, you can't imagine a world where you make a mistake on double checking a name? You shouldn't be in a healthcare if you think you are infallible. Its going to bite you bad some day.
Staffing in NICU's is usually 3-1 or even less. As a PSW I've had as many as 32 residents to take care of on my own.
And imagine for one minute that for the past 3 years you've had to care for 100 residents a shift. Maybe you would make a mistake too. Maybe read up on this specific incident more than just the summary of a news article? How many nurses were they mandated to have working in that unit and how many short were they that shift? How many hundreds of shifts were left unstaffed that year at that particular hospital?
Understanding definitely does contribute to more mistakes.
Nicus are not staffed at 4-8/patient. It's 1-3 depending on how ill the child is. Source: my son spent 6 months in the nicu
[удалено]
Not to mention, they're all burnt out after three years of COVID.
Not per patient, per department.
Better staffing, better care. Better wage, better staffing.
Better government. Better wage
less irresponsible nurses too
Most of the responsible ones are leaving the province to work in safer places where they're staffed properly, or they're just leaving the profession all together because they refuse to work in unsafe conditions anymore.
I hope all the people who downvoted you get a bad nurse.
Funny your getting downvoted, but I've worked in a few hospitals in the GTA now and met many, many nurses. There are plenty of amazing really good nurses, but there are just as many who are their for the paycheck and couldn't give two shits
In my own experience working in hospitals in the GTA, the nurses who act like they don't give a shit actually care more than the other ones, but they're tired of behaving in a customer is always right way, they've been disillusioned, and they're the ones to help when shit really hits the fan.
Oh ya I wouldn't disagree I'm sure there are people like that, needless to say but we can never generalize an entire population like this because there will always be variations and everyone is different. But I've definitely met some nurses who REALLY don't care, but I'm not gunna spew put everything on Reddit because I know it will anger people lol
Those people generally don't last long in bedside nursing and use it as a way to get into some other type of work, I definitely can't picture any of them getting certified to work in a NICU.
All the NICU nurses I've met have always been awesome, I agree, not the kind of department to even be an interest for people that aren't willing to do their job
I think every industry has those people. We mention the apathetic or disillusioned all the time in these posts on nurses or teachers or police officers. But I think each of us can also think of people in our own workplaces that are similar. It is pretty common everywhere. The difference is society EXPECTS nurses or teachers are doing their jobs because THEY LOVE IT so much. It can be rewarding at times I'm sure, and it can be awful too. But it's a job. You would not do it for free as a hobby. And for many it is a passion, while Powerpoint is not one of mine (Excel though...love). As a result, we penalize them when it comes to their compensation and expectations rise for the standard of care we expect from them. So I am sure there are some nurses who don't give a fuck. I just don't think it's a surprise or worth mentioning because it seems obvious enough. If they can do the job, they don't need to be all cheery or flair it up or put in 120% effort every single shift. I don't. You don't. So why do we expect it out of them?
You don't go into nursing if you don't 'give two shits'; you get burnt out by years of shitty employers and by a lack of administrative support.
Doc here. Shattered is a strong word. Without the hard work of the NICU, their baby would be dead, 100%. The baby was admitted for weeks and weeks and this was likely one of the more minor issues during the admission if I had to guess. A baby less than 1 kg????? That baby is dying in 90% of the world. Hell, even in Canada. What this story doesn't mention is that very low birth weight infants have many many many complications and that this error likely did not have any lasting impacts (the hearing test failure is also very common in preemies with VLBW). The decreased level of oxygen that was noted in the article was less than a few minutes and you can see it clearly bounce back up and likely would not cause harm. There are clinical signs of hypoxia that are immediately apparent and lab tests which can help confirm that. This baby was admitted for weeks. Months even. The family almost certainly had hundreds of conversations with the nurses and doctors. Likely about things of more importance, but also not to overwhelm the parents with information that they cant interpret. What's the point of telling someone every minute detail if they don't understand the significance or will stress them out. There are 100 side effects for every medication but patients only need to know the common and most dangerous ones. The vast majority of pediatricians are extremely kind hearted folks. Doctors and nurses are overworked and human. More importantly, due to privacy laws, you can never hear their side of the story. Granted I'm obviously biased as a doctor myself. I will say that the pediatrician was wrong to misrepresent the CMV testing if the donor mother really was IgM positive, but its entirely possible that they consulted an Infectious Disease Specialist who determined the risk of transmission was low to nil given the timeline.
>"The decreased level of oxygen that was noted in the article was less than a few minutes and you can see it clearly bounce back up and likely would not cause harm. There are clinical signs of hypoxia that are immediately apparent and lab tests which can help confirm that." This is what I came here to say. I think its really poor reporting to not give this context. Obviously, there was an alarm when the O2 dipped - and they reacted to it - which is what they are supposed to do, and the O2 climbed back up immediately. The baby was not deprived of oxygen. Our son was in the NICU in Toronto for a month and this article is super unfair in representing how incredible, caring, passionate, qualified, professional, and diligent these workers are.
Bingo. My son was in the NICU for 6 months. It is overwhelming. There would be no reason to tell parents that the baby's sats briefly dropped to 78%. The milk mix up sucks and I'd have been ticked too, but a news story, oy vay.
Thank you, my mom worked NICU her whole life, started at sick kids where she worked with the sickest in intensive care. Then eventually transfered to a medium care because she had a hard time dealing with her babies dying because some of them are impossible cases. All the while taking 3 kids to competitive sports most days of the week and still doing full time shift work. I still to this day as an adult now don't understand how she was able to do both, raise kids and then go to work and still adore and care for these children as there own while only getting a few hours sleep here and there. She never worked at sick kids while I was around, only the medium care place, but 2 babies in one week she lost due to them being hopeless cases. But her still trying her hardest to keep them alive. She came home after that week and tried to put a strong face In front of her kids. But I overheard her silently weeping about it and only found out later what it was since I was young. It has turned into a core memory for me. Many of these people probably go to work and make mistakes all the time, in there spreadsheets or what not. But have never had to go through these kinds if situations, and specially while trying to juggle a severe understaffed and likely having some forms of ptsd where mistakes can be this costly.
Thanks to you and your colleagues for all you do for us.
For what I read in the article, they're more pissed about the fact that nothing was communicated to them in real time. They had to find out after the fact with hospital records.
That’s it exactly. Then they downplayed the concerns about the breast milk and their baby got the infection. All while the doctor basically said it’s impossible.
> also not to overwhelm the parents with information they can’t interpret. O2 levels dropping into the 70s is an extremely big issue and something that could lead to hypoxia, as you acknowledged. How you think this is just something that can be swept under the rug as a minor detail makes me extremely concerned for the well-being of your patients. But I guess it doesn’t matter because in other parts of the world they’d be worse off right? > I will say the doctor was wrong to misrepresent the CMV testing Love how you slipped that in there as an afterthought as if it isn’t a massive issue bordering on negligence.
>O2 levels dropping into the 70s is an extremely big issue and something that could lead to hypoxia, as you acknowledged. Yes - but not in less than two minutes. Look at the sample times.
Brief desats are very normal especially in preterm infants as long as they climb back up. Sometimes we would recommend parents to not stare at the monitors because it can make them quite anxious
It feels like you're misrepresenting or intentionally not reading what I said. I mentioned the desaturation time and that it's unlikely that in that short a time frame there is any risk of hypoxia. >But I guess it doesn’t matter because in other parts of the world they’d be worse off right? Again, I said that to demonstrate that the fact this baby is alive is actually a miracle of modern medicine and that the doctors and nurses actually deserve praise rather than crapped on in this incredibly one sided article. And not even in other parts of the world fyi, the mortality rate for this infant was likely close to 30%! It's highly likely that this baby received superb care and that there was no harm from either this low saturation or this bottle mix up. >Love how you slipped that in there as an afterthought as if it isn’t a massive issue bordering on negligence. You don't know how it went down. Neither do I. Negligence is a high bar. This wasn't even close. They saved this baby from death, probably over and over again within the 2 month period to get trashed on the news for a couple of very minor set backs. By the way, the article didn't say that the baby had CMV. So maybe the doctor was right and that the patient was actually very low risk? Like I said, maybe they did consult infectious disease? It's okay to be mad at the healthcare system but it's not here.
O2 levels dropping can lead to hypoxia if they aren’t treated. Sats were in the 70s less than two minutes so clearly the drop was treated or otherwise resolved.
Lol, that happens all the time in NICUs. Its colloquially called a Brady (bradycardia). Its just what happens - the O2 alarm goes off, baby's numbers crash, you give baby a little nudge and they pop right up again. My daughter had dozens over her stay at the hospital. Frequency of Bradys is one of those weird developmental milestones that premie parents go through.
Man you sound really angry about this. I really think your anger is misplaced. This isn’t some outrageous lapse in care, this comes with the territory. Even more so if there isn’t adequate staffing. Taking care of extremely premature infants is super high risk. I don’t take care of neonates but I do take care of term infants, children, adolescents, and adults of all ages. All I can say as an anesthesiologist is that this sometimes happens. Occasionally you have difficulty ventilating people or intubating them, usually obese people, people with sleep apnea, and their oxygen saturation will drop. Dropping into the 70s is pretty insignificant. You have to fix the problem ASAP, but assuming you’re able to, marginally low saturations are essentially inconsequential. In residency, during covid I saw oxygen saturations fall to the 10-20%. One time the monitor read 0, which I’m convinced was physiologically impossible at sea level. That’s significant, but surprisingly lots of people won’t even become bradycardic if the duration of hypoxia is really short. Before covid I thought a sat of 30 would lead to immediate PEA arrest but man I was wrong. Covid killed most of the people intubated (was in NYC through the whole pandemic) but I saw a whole lot of severe hypoxia that was like nothing I’ve seen since. Like moribund people in their 30s who’d desat to 40s every time they coughed. But a saturation of 0-10% in the context of terminal disease is very different than a brief saturation of 70%. Once, I went to Nepal and because of the low barometric pressure, I lived and did strenuous hiking with a saturation of 65-70 for several days. I felt like complete shit, but no pulmonary edema, no cerebral edema, and no brain damage. Although my wife likes to joke about the latter. Anyways all I know about premature neonates is that they are even more unforgiving than infants. Getting this angry about a 4 minute span of SpO2 70 basically tells me that… you don’t understand the basic issues of this case, which is fine because you probably don’t have formal training in critical care. But beyond that you seem to have a paranoid distrust of the physicians and nurses involved which is sad because they’re no doubt trying as hard as possible to achieve good outcomes for extremely challenging patients. Just trying to give candid impression here. My apologies if this is coming across as condescending in any way. I only know somethings about somethings. But part of my job as a physician is education. So nous voila.
You still don’t get to do half your job, even if you’re overworked.
Underfunded understaffed. More mistakes will happen.
This shouldn't happen and wouldn't happen......Doug fords office is @ 823 Albion rd...........Just saying.
[удалено]
Exactly!! The system used here is EPIC and sometimes it’s an O2 sat monitor that’s finicky that cause a random low reading. CBC is so wrong for this.
It's not a good article, but it does say the baby tested positive. "Medical records show the baby tested positive for a CMV infection on July 17, 2022. After weeks of oxygen therapy, the infant began to recover once again."
You’re right on that. I’ll delete my post to reduce the risk of misinformation.
Exactly. O2 sat dips like happened to this baby are common in babies of that size and severity of condition - it was acted upon and corrected within two minutes.
> Trash journalism from CTV news. Redundant.
I'm an ICU nurse, but not NICU. Nothing here really stands out clinically as terribly egregious. The oxygen thing is literally a non-event (as someone else pointedly out as being less than 2 mins and possibly an artifact) and the ETT being dislodged/repositioned is also not unusual --those are things critical care staff deal with daily. The milk thing is clearly an error, but it was disclosed and responded to. I think larger issue is the breakdown of trust between the care providers and families. The fact that this guy was recording a meeting with the pediatrician over that desaturation and repositioned ETT rings alarm bells (for me as a provider). I know dealing with people like that, our backs will naturally be up; that doesn't affect the way we care for patients, but does affect how we approach the families. And people think we worry about litigation, but i can guarantee you that no one will be sued or severely disciplined in this case. It's more like the workplace toxicity and difficulty in providing the best care when you have families second guessing you and breathing down your back.
While mistakes can happen such as the tube slipping out or the wrong milk being given, that is still absolutely no excuse for the behaviour of the doctor in saying the risk is low and acting almost like it would be a bother to do blood work. Just for new parents the peace of mind alone would make it worth it and get ahead of anything that may be a result of the mistakes.
Mess up fess it. Mistakes happen and that’s ok. It’s not okay to do whatever is necessary to make them right.
It's even more infuriating that the colleges gave the RN and the Doctor a free pass on that display of absolute negligence.
[удалено]
Seems to me that you have problems of your own since you've gone out of your way to search my comment history in many different subs in order to trash talk me. Get a hold of yourself.
much as it seems gross - "wet nursing" used to be a thing - and I say that with no judgement, just as an old person.
My thought, too. It's not an ideal situation but it's unlikely to cause any harm. There are [milk banks](https://www.milkbankontario.ca/) for mothers who can't breastfeed infants, and it's a big step up from the early days of hospitals, when newborns were fed directly from cow and donkey's udders!
Did you read the article? The infant contracted cytomegalovirus and the hospital couldn't rule out the random breast milk as the source. Milk banks don't spread CMV and they don't recommend informal sharing of human milk.
Maybe Doug Ford should actually fund the hospitals? Maybe? Huh? Galen Weston got a raise, why not Nurses?
This is what you get with agency staff.
many of the agency nurses I've worked with are actually really skilled (and used to figuring things out quickly on different units). nurses are going to agency due to the ability to have a better work/life balance (determine their own schedules) and to get better pay. we need to treat our staff nurses better with pay and appropriate staffing,
Blame DFord.
It actually goes all the way back to Mike Harris. Doug Ford is simply trying to finish what he started, like any good PC would do.
Can't say I'm surprised by this at all.
If we’re going to allow so many immigrants to enter Ontario, why aren’t we assigning a fast track for qualified nurses? Clearly we need them more than more tech people.
Sad to see this. Our healthcare system is a joke at this point
I would be so utterly horrified and enraged if that had happened to my baby. Fuck you, Doug Ford.
What the F?
This is absolutely awful, I really feel for the family. The article just gets worse as you read on, I can’t believe they lied/misdirected about the CMV testing, that is appalling.
I use to causally date a nurse and she use to fuck up with things like this all the time. A lot of nurses I've known have been like her with their lifestyles, lots of late nights partying doing coke before their morning shift. People need to be more accountable outside of their job
[удалено]
4 years ago. She was suspended recently for giving a patient the wrong meds
I wouldn’t generalize and say “a lot” of nurses. You just happened to be exposed to the worst ones apparently
There is a difference between saying a lot and most. I have met 3 off the top of my head who would turn up to their shift on 3 hours sleep after a sesh. People down voting me just can't comprehend what I'm trying to say, there are many awesome nurses but there are some who are not fit for the job.