a mom and a nurse!!!

[Mariam]

Dear netter,
We have a neonatal nurse who gave birth to a 23 weeks GA female baby on December, 2008. The nurse finished her maternity leave and joined back last month. She insisted to be assigned on her baby beside taking care of another baby as the ratio is 2:1. The baby now weighs 1680 gm, on full NGT feed, has ROP stage IV and brain US showed dilated ventricles. Otherwise, she is stable.
The question is, have you ever encountered such situation where the nurse taking care of the baby, is the mother?
Do you think its ethical to deny this mom the right to take care of her baby while she is on duty?
Would she be able to take care of the other assigned baby? Would she treat them equally?

and if you were in her place, what would you do?

Does anyone has any reference about this issue?

any input is appreciated

[Stefan Johansson]

Dear Mariam,
you raise several very thoughtful questions. We sometimes come across friends and relatives in the NICU and generally (if close friends & relatives) the staff involved decide not to be a care-giver. I have done that myself, refrain from being formally responsible (but yet involved in discussions etc) for the care of families I know privately. Thereby not saying that's a correct strategy. And, I have not experienced something similar.

I guess every case need to be individualized with a certain degree of consensus with those involved. Personally I would not consider your situation to be unethical, but it might be inappropriate. On the other hand, the choice (what-to-do) may partly be up to the parent involved. If this nurse and mother feels strongly that she can both take care of her own infant and another patient with the same professional approach, it may not be a conflict to be mother and staff. I would feel uncomfortable to formally forbid a parent to take care of its own child, if professionalism regarding the child and other patients can be ensured.

Being in the same situation... well, I would probably not feel like taking any medical responsibility if my own child would end up in the NICU, but leave this to my colleagues to take care of.

[manberbenitez]

Mariam:
we have a similar case not a nurse but a neonatologist (women) and we decide with her Mom to be treated for my colleagues. I think is better a "cool head" to take better medical decisions. Here in mexico we have a famous phrase " newborn or child with medical parents is a point of bad prognosis".