NAS stands for Neonatal Abstinence Syndrome, a condition developed by babies if certain drugs or medications that can cross the placenta have been taken during pregnancy. Sometimes these are illicit, other times they’re medications that the mother cannot get through pregnancy without.
Squidge ran the risk of having NAS because I needed high dose antidepressants throughout pregnancy but the decision to continue was made by me, the Northern One, my GP and my midwife after lengthy discussion. I did attempt to reduce the dose shortly after I found out I was pregnant but I felt so ill it became a choice between putting Squidge at low risk of developing NAS or me not making it to the end of the pregnancy.
NAS is the result of the babies experiencing withdrawal symptoms from the substances they’ve been exposed to during the pregnancy. Essentially, they’ve had a steady supply of something for nine months and then the moment they’re born the supply stops. This can cause them to be irritable, jittery and difficult to settle, in the same way that an adult would be if they stopped taking a drug, legal or otherwise. These babies feed lots for the comfort aspect and usually become very attached to a dummy. They also tend to have quite a high pitched cry and usually only settle if they’re being fed or carried. They may also sneeze or hiccup frequently, develop a temperature and have minor breathing difficulties.
NAS is not a serious condition and is usually self limiting; even without treatment symptoms have disappeared within two weeks. Clearly it is uncomfortable and distressing for the baby but there is no evidence that NAS has any long term effects. The main issue with NAS, from a nursing perspective is that these babies require lot of attention as they need almost constant comforting and are don’t stay asleep for long if they’re put down.
NAS was a particular issue on one unit that I worked at and made some of the rooms very hard work because as soon as we put these babies down they started screaming. Although we’re pretty proficient at getting on with work while holding a baby there are some things you just can’t do one handed.
One of the senior nurses came up with the idea of purchasing a couple of slings for the unit. The plan was that we could carry the babies and give them comfort cuddles until they settled properly and then they’d sleep more deeply in their cots. We’d allocate a sling to each NAS baby and then wash them before the next patient used them and we’d wear aprons over our uniforms and then put the slings over the top. She found a company that made inexpensive, easily washable fabric slings that complied with our infection control standards. We would be able to use the slings to provide comfort holding for NAS babies and also have both hands free for getting on with other work.
We all thought this was a fantastic idea; the babies would settle far more easily and would be much less distressed, the nursery would be much quieter and relaxed which would benefit the other babies and we’d be able to give the NAS babies the attention they needed but not at the expense of the other babies.
We applied to the relevant management for funding to purchase a few of the slings for the unit but were refused.
Apparently having slings for these babies would make us lazy.
Instead of congratulating us for coming up an innovative, cost effective idea that efficiently solved a problem that we were having, that benefitted the unit, all the babies (not just those with NAS) and the parents they decided that we were simply trying to get out of having to work because clearly that’s what we spent most of our time doing.
The nurse who had the original idea invited them down to the unit to experience looking after an NAS baby but they declined.
This decision was made by people who have probably not set foot on the unit since it was opened unless they were showing off to dignitaries or celebrities; not that we had either visit particularly often. They had very little idea as to what working on the unit was actually like, what we needed and what would be of most benefit to us but rather than listening to us when we had suggestions they chose to use their own, very limited experience.
They’d never spent 12 hour shift trying to either do everything with one hand or with a constant background of high pitched screaming. Listening to these poor babies was awful but on some occasions, even if we didn’t have any breaks or go to the loo for the whole shift there were still some occasions where we had to put them down. Sometimes the parents were there but the majority of the time, for whatever reason they were elsewhere and two nurses looking after eight babies between them weren’t any sort of substitute.
I love my job but things like this make me really angry.
Fortunately I now work on a unit where any ideas we have are properly considered and if they’re rejected we at least get a proper reason why. Never once have we been accused of being lazy or workshy, instead we feel valued and treated like the healthcare professionals that we are.
On my current unit we only have NAS babies occasionally and so we don’t have the need for slings. You can still tell there’s a NAS baby on the unit though, the nurse looking after them is always the most harassed and tired looking so I make sure they’ve got a supply of chocolate.
The nurse that it, not the baby.