When Linda West-Conforti, RN, first saw Sammy in the neonatal ICU at Loma Linda University Medical Center in Loma Linda, Calif., hospital staff warned her not to get too attached. He was born four months early when his mother’s placenta burst due to her methamphetamine addiction, and his chances of survival seemed slim.
Sammy had seizures as he withdrew from the drugs. He suffered from complications of necrotizing enterocolitis, and half of his intestines had to be removed. Thousands of hemangiomas had formed on the inside and outside of his body. He had coded four times, and the NICU staff was concerned his brain would be severely compromised.
After overcoming numerous hurdles, Sammy was stable enough at 16 months to be discharged. He was slated to move to a nursing institution for medically fragile foster children. West-Conforti knew his odds of thriving there were low because he would not receive the medical and emotional attention he needed.
As a nurse with more than two decades of experience, West-Conforti had noticed more medically fragile babies being discharged into foster care due to birth mothers’ methamphetamine addictions. Determined to find nurturing families for these children, she started making phone calls. After six months, she found what she was looking for.
Angels in Waiting Is BornSammy at 4 1/2
West-Conforti, a NICU nurse at Kaiser Permanente in Riverside, Calif., discovered a program through Medi-Cal called In Home Operations, in which nurses could become independent providers for medically fragile babies in the foster care system. These nurses could care for up to two infants at a time in their own homes and bill the hours to Medi-Cal.
Eager to spread the word, she founded a nonprofit organization in Lake Arrowhead, Calif., in 2005 called Angels in Waiting to connect medically fragile babies with nurses who wanted to take them into their homes.
When I heard about this program from Linda, I knew I could really change the life of a child, says Natasha Ching, RN, a NICU nurse at Kaiser Permanente in Riverside who has taken in five medically fragile babies in the past three years. I knew that if we could put these babies in loving homes where they could have emotional attachment with one person, it could affect the child’s entire life outcome.
To qualify as a foster parent for these babies, a nurse must complete training and screening. For West-Conforti, this included a 40-hour class, fingerprinting, and a criminal background check. Medi-Cal’s nursing requirements include nursing liability insurance and two years of acute care experience in the last five years. Medically fragile babies’ conditions can include neurological issues, difficulty feeding, and prenatal drug exposure with medical complications.
Now Angels in Waiting is in contact with 20 Southern California nurses who are caring for medically fragile babies in their homes. Most of the nurses work part time in a hospital NICU or pediatric ICU and then clock in at home to care for a baby.
Although the care depends on the baby’s medical condition, typical tasks include giving TPN, doing dressing changes, and installing feeding tubes. To cover when the nurse is away, spouses or other caregivers can be trained to perform certain routine tasks.
Babies may stay with one nurse for a few months or as long as a couple years, depending on the baby’s medical situation and how quickly an adoptive family is found. In some cases, nurses choose to adopt the baby into their own family.
When Sammy first came home with West-Conforti, he had a Broviac catheter, colostomy, and feeding tubes and required 14 different medications every day. West-Conforti would start his day by unhooking his feeding tube, providing a breathing treatment, and then giving him his first round of medications. Sammy also suffered from oral aversion because he had grown accustomed to feeding tubes for his nourishment. To help him learn to accept food through the mouth, West-Conforti started by dipping his pacifier in different flavors. She also incorporated physical and occupational therapy exercises into his play time to help him catch up developmentally.
Additionally, West-Conforti had to assess whether Sammy suffered from bonding aversion. When an infant is in the NICU for five months with no parent around, they associate being picked up with being fed or poked, so they just shut down emotionally, she says.
Although West-Conforti admits she initially felt nervous about juggling Sammy’s myriad medical needs, the fruits of the risk she took to care for him are clear. Sammy is now 5, does not show any signs of developmental delay, and started mainstream kindergarten in the fall. The only signs of his medical past are a few remaining hemangiomas and visual impairment.
He is a miracle baby, says West-Conforti, who adopted Sammy in 2007. This venue of nursing truly enables the nurturing souls of nurses to make the biggest impact in a sick child’s life. It makes my heart sing to do this.
Anyone interested in learning more about becoming an independent nurse provider and foster parent for medically fragile babies can call Linda West-Conforti at 1-800-974-4274 or visit her Web site at www.angelsinwaitingusa.org.When Linda West-Conforti, RN, first saw Sammy in the neonatal ICU, he suffered from complications of necrotizing enterocolitis.