What happened that day — when James was about 4 months old, still on high oxygen support and frequently yo-yoing — seems like a textbook case study in alarm fatigue, compounded by a confluence of other factors. It was around shift change and it was a holiday weekend, which meant a double-whammy of far fewer staff, and none of his usual nurses working. When the alarm went off signaling James was dipping, my husband and I watched his numbers fall — slowly at first, then precipitously — as we looked around for a nurse to respond.
But there wasn’t a nurse (or doctor) anywhere in sight. James’ oxygen saturation continued to plunge as his alarm flashed red, red, red. We pushed the emergency call button but nobody came. As our son started to turn blue before our eyes, my husband and I tore through the NICU to flag someone down. Not seeing anyone, I ran out to the receptionist so she could call for help. A nurse appeared and called for a crash cart. When the crash cart came, it came agonisingly slowly and by then, James was grey-blue and motionless. It took several more excruciating minutes to revive him.
Inevitably, that event changed the dynamic between our family and James’ care team, and a great amount of trust was lost.
Even if heart-stopping close calls don’t happen, I think alarm fatigue can still negatively impact family members’ relationships with the healthcare team and cause them to lose faith in the hospital as a whole. Nurses know better than anyone that 99 out of 100 alarms may not require immediate attention. But what they might not know is how parents can interpret delayed reactions to alarms as complacency and unreliable alarms as indicative of untrustworthy equipment.
For example, as a mother, I knew that a cumulative lack of oxygen could affect my baby’s nascent brain development, so every desaturation ignited deep reactions of helplessness and fear.
Sometimes I felt that nurses silenced alarms as a reflex, and I noticed that every nurse had vastly different reaction times and levels of concern when it came to his alarming. Some nurses set his parameters differently, being personally comfortable with a wider margin. And a few even gave us permission to push the silence button ourselves if we determined it to be a bad read. While it was nice to be able to quiet the squalling alarms on our own without waiting for a nurse, having that responsibility — under a nudge-nudge, wink-wink jurisdiction — didn’t instill confidence that there were consistent policies in place to keep James safe.
But I stifled my frustration. How could I expect busy nurses to stop what they were doing and constantly come over? I didn’t want to be a nuisance mum, compounding the annoyance of my baby’s nuisance alarm, and risk alienating the people who held his life in their hands.
...what other mothers experience when they hear their baby cry... My. Baby. Needs. Me."
