The neonatal nursing mirrors the most vulnerable population it serves, and individuals choose neonatal nursing as career and remain in the profession because of opportunities for personal and professional growth, supportive work environments and compensation commensurate with roles and responsibilities'. (Buus-Frank et al., 1996)
Neonatal nursing has for long been the area of much research, concern and legal and ethical considerations. There exist various organizations, separate strategies and solutions for the issues which are related to the neonatal nursing practice and its aspects. However, in the situations, when the life of the newly born child is decided, the solution may be supposed to be correct from the ethical point of view, but absolutely wrong from the legal or political aspect. Thus, this work will be devoted to the discussion of the situation, which took place in reality and on which it is high time to deliberate and discuss it.
The situation concerns the premature baby born at 31+6 weeks who was remarkably grunting with subcostal and intercostal recession has had poor blood gas results, needing endotracheal intubation, ETT was fixed @9cm at the lips. Following this procedure a Chest X'ray was required to confirm ETT position. Chest X'ray revealed ETT in Right main bronchus it needs to be pulled back by 1.5cm.Junior doctor not available to see Chest X'ray
prior to pulling back ETT.
The feelings and experience of the situation described were various. On the one hand, the life of the child depended on the fact that the tube had to be pulled back 1.5 cm, to provide it with the necessary amount of breathing, and to stop the damage which could be made in case the tube were not pulled back. The analysis of the chest X-ray clearly identified the need to pull back the tube; however, without the confirmation of the Junior doctor it was not legally possible.
Another feeling was that the legal implications of the case could both hurt the participant and the life of the infant. There was the feeling that the case had to be more related to its ethical and moral issue, than to its legal side. It was also understood, that despite the active development of the enhanced neonatal nursing care knowledge between the workers, who are not traditionally directly connected with this nursing, does not give them the right to involve with the emergency situations, and does not guarantee the high level of this knowledge. On the other hand, it was clear that the situation needed urgent reaction, and that the skill of pulling back the tube didn't need much knowledge, being mostly a mechanical action.
The feelings were mixed - one feeling was absolutely definite; it was definite that something had to be done, but there was no time for looking for the junior doctor, or the related staff. Another feeling of supreme responsibility for the life of the infant was accompanying the actions. Simultaneously, this responsibility was even increased with the fact that the actions to be performed had to be illegal, and thus left no space for risk. When such emergency situations occur in neonatal nursing practice, it becomes evident, that actually feelings themselves should be left behind, while