Poor woman!

"A couple of things, she was a classic case of rusty pipe syndrome,
had all the factors listed in lawrence as typical, etc. however, the
nurse proclaimed she had "never seen this before and it's bad!" and
called the ob/gyn who said the same thing, and told the mother to dry up
immediately so she could get worked up for cancer. "i've never seen this
before ever!" was the direct quote."

This would be a great opportunity to invite the OB and the nursing staff
to, when they see something they know nothing about, to call in  a
specialist, just like they would if they were confronted with any other
out of the ordinary medical condition. hint, hint

"one of the other lovely aspects of this was that the father was
bottlefeeding the baby formula while we had this talk, and the nurse
came in and said, well! she's not taking it fast enough, here, let me,
and proceeded to shove the bottle in the baby's mouth, rotate the
bottle, rub the nipple on the roof of the baby's mouth, etc., etc., all
those ugly things we discuss with the idea "oral rape." if you saw it,
you would believe it. imagine the level of restraint i had to employ to
remain calm and professional! i didn't say a word.

In this case, I would encourage you to consider trying what I have done
many times in the past.  Excuse me, will you please come back in a few
minutes, we are going over some things now. The nurse would never have
butted in that way if you were the doctor!  After scooting her out, you
then have the opportunity to include a brief discussion on oral
defensiveness and how to avoid it.  The parents will likely resist the
nurse's brutality if she ever bothers to come back.

Also, perhaps you could arrange for an OT or PT who works in the NICU do
an inservice for the staff about oral defensiveness.  I admit, that I
worked in an admission nursery for years and never heard of this and had
no idea that suctioning out a "mucousy" baby, I could be doing anything
lasting except removing the mucous.

I have a hard time remembering my own advice, but I try to look at these
situations as good teaching opportunities rather than just frustrating
examples of ignorance and poor care.

Denny Rice, RN, IBCLC
Dallas, Texas, where it is still getting into the 90's some days!

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