Music Streaming Takes Dominant Role In Industry
3:56
The latest numbers from the Recording Industry Association of America show that streaming music brought in more money than digital downloads and physical releases for the first time last year.
March 26, 2016
To Help Newborns Dependent On Opioids, Hospitals Rethink Mom's Role
Carolyn Rossi, a registered nurse at the Hospital of Central Connecticut, says the opioid epidemic has required nurses who used to specialize in care for infants gain insights into caring for addicted mothers, as well. Rusty Kimball/Courtesy of Hartford HealthCare hide caption
toggle caption Rusty Kimball/Courtesy of Hartford HealthCare
Carolyn Rossi has been a registered nurse for 27 years, and she’s been fiercely protective of infants in her intensive care unit — babies born too soon, babies born with physical and cognitive abnormalities and, increasingly, babies born dependent on opioids.
As clinical manager of the nurseries at the Hospital of Central Connecticut, Rossi works in the neonatal intensive care unit. Like many hospitals across the country, the facility near Hartford has seen a dramatic rise in recent years in the number of babies born with neonatal abstinence syndrome. The National Institute of Drug Abuse reports that more than 21,000 infants born in the U.S. in 2012 (the most recent year for which data are available) experienced symptoms of opioid withdrawal. The hospital says each such baby in its care costs roughly $50,000 to treat.
These fragile and fitful newborns present new challenges for hospitals. Some research suggests the children do best when they can be held for hours at a time, preferably by their mothers, in quiet, private rooms, as they go through the process of being weaned off the drugs.
But delivering care that way requires changing the attitudes of many doctors and nurses about addiction.
Rossi, for example, says her initial training in the best ways to care for newborns in withdrawal was very different from what the research now suggests.
“You know, we looked at it like, ‘They are drug addicts and the baby is born a drug addict and we’re trying to protect the baby from the mother,’ ” Rossi says. “Like we were going to cure the baby, but not cure the mother and the family. So it was a lot about taking babies away from moms.”
That turns out not to be a useful strategy if you’re hoping to engage the help and support of a mother who already feels stigmatized by her drug habit, says Kate Sims, who directs women’s and children’s services at the hospital.
“She’s feeling guilt herself,” Sims says. “And then [she] comes in here and, unfortunately, as best as we are as providers and nurses, we’re also judgmental. And so it’s felt.”
A lack of trust between mother and a nurse makes treating the baby even harder, Sims says.
So the hospital is now trying to make sure everyone in patient care sees the addicted mother first as a mom. In some cases that means getting care providers to understand that addiction isn’t a moral failure, and that many people who are addicted come from a lifetime of trauma. Rossi says it’s been hard for nurses who have been trained to be baby specialists to become mom specialists, too.
“It’s a big culture change for me personally, and I know for the NICU nurses that are in here,” she says. “You really do believe you’re doing the right thing until something like this comes along.”
The hospital’s approach to caring for these infants is changing, in other ways, too. Dr. Annmarie Golioto, chief of pediatrics and the head of the hospital’s nursery, says a bright, loud and bustling intensive care unit is a hard environment for a baby going through withdrawal. So she’s gotten approval to use a few rooms just outside the intensive care unit as a quiet, monitored space for a baby and mother to stay for as long as the baby needs it.
“We’ve had to figure out: ‘How can we use our rooms differently?’ ” says Golioto. “How can we use our space differently? And how we can partner with mom differently to have that relationship with her, to say, ‘We expect you to stay here with your baby and take care of the baby after you’ve been discharged.’ “
Golioto hopes the new setting will shorten recovery times for the children and decrease the amount of morphine a baby needs to ease withdrawal. She’s also hopeful these moves will inspire some mothers to think differently about their newborns.
“The thinking was, ‘My baby is being taken care of. There are nurses there. There are doctors there. I don’t need to be here. They’re getting everything they need,’ ” says Golioto. “We’re trying to change the thinking — ‘no, they’re not getting everything they need if you’re not here. Because they need you.’ “
Rossi says she recognized the value in this new nursing approach the very first time she saw it in action. It was last December, she recalls. Rossi gave a mother a hospital room to stay in for more than a month while her baby went through withdrawal.
“She was just thrilled,” Rossi says. Though the mother couldn’t be at the hospital 24/7, “she was here as much as she could be,” the nurse says, “and just knowing that she had the flexibility helped me understand that she is a mom. She is a great mom. She wants to be a better mom.”
Nearly every aspect of the opioid epidemic worsened in 2014, according to the federal government’s latest figures. And even though the Hospital of Central Connecticut’s programs are just a few months old, health care workers there hope the changes they’ve made in their culture of care will, at the very least, give vulnerable moms and babies a better start.
This story is second in our four-part series Treating the Tiniest Opioid Patients, a collaboration produced by NPR’s National & Science Desks, local member stations and Kaiser Health News.
Is March Losing Its Madness?
4:25
The Elite Eight of the NCAA men’s basketball tournament is set, and this year’s games have been as exciting as usual. But ESPN’s Howard Bryant tells NPR’s Scott Simon the meaning of the tournament may be changing.
Transcript
SCOTT SIMON, HOST:
You know what I missed when I was away for a few weeks? The chance to say time for sports.
(SOUNDBITE OF MUSIC)
SIMON: Actually, I said it a lot, but people on the subway just looked away. Listen, we’re deep into March Madness – and not just the presidential campaign. Last night in the men’s NCAA tournament, North Carolina, Notre Dame, Virginia and Syracuse advanced. Tonight, the round of eight begins. We’re joined now by Howard Bryant of ESPN.com and ESPN The Magazine. Howard, so good to hear your voice, my friend.
HOWARD BRYANT: Good morning, Scott. It’s been a while.
SIMON: Four big games last night, with Virginia and North Carolina winning. They join Kansas and Oregon in the Elite Eight. That means all four No. 1 seeds are still alive. We don’t see that a lot, do we?
BRYANT: Well, I think what we don’t see is a lot of the top, top seeds making it. We don’t see the 2s and the 3s getting there as well the way you had a 1 and a 2 play. And, like, the way you’re going to have a 1 and a 2 in Villanova and Kansas play today. But the top seeds seem to get there a little more often, which tells you about the gap between the very, very good teams and the – and the rest of the field.
But those – those 2 and 15 and 3 and 14 upsets seem to be coming more and more and more common. However, I am very much looking forward to when you see North Carolina last night beating Indiana by 15.
SIMON: Yeah.
BRYANT: They scored 100 points. And I think that Villanova and North Carolina are the best teams. But the top team in the country, Kansas, is playing Villanova today…
SIMON: Yes.
BRYANT: …A game that I’m really looking forward to.
SIMON: And of course, Oregon versus Oklahoma – what do you see there?
BRYANT: In Oregon-Oklahoma – Oregon is a great team, and they’re fun to watch. And they took out Duke, which is one of the great blue-chip – Oregon, you know, one of the great blue-chip programs. But a West Coast team taking on one of the big dogs like that is also something new. Let’s see if they can keep it going too. A lot of people like that team a lot. I didn’t think that they were national championship material. But they – they shoot the ball well enough, and they played a lot of good defense, and they’re big. And so it’ll be fun to see what they do as well.
SIMON: You mentioned Duke having one of the blue-chip programs. And I want to get you – I want to draw you out something. I’ll confess, you and I were chatting yesterday afternoon. There have been big moments and buzzer beaters in this tournament, but has the tournament lost a lot of its character?
BRYANT: Well, I’ve been thinking about this a lot lately and especially when I think about Ben Simmons, the purported No. 1 – the projected No. 1 coming out of LSU. He’s supposed to be the best player in the country. His team didn’t even make the tournament. It’s the first time in a quarter century that the projected number one player didn’t even play in the NCAA tournament. And it made me think more and more about the changing nature of this tournament. It’s that we remember – I remember, obviously, as do you, when the tournament wasn’t just about buzzer beaters. It was also about looking at the great, great players and how they were going to translate into the NBA – when you had Patrick Ewing and Hakeem Olajuwon playing for championships and the Fab Five Michigan teams and the Duke teams – that’s all gone now. Because now, the best players in the game – they’re gone after one year.
SIMON: Yeah.
BRYANT: You see that in Kentucky John Calipari encouraged his entire team to go pro. Every player that was eligible to go to the NBA – he said that they should go pro, so that changes everything. You’re not going to get those great two – three-year rivalries like you did with UNLV and Duke. It’s all different now. And so the tournament is sort of sensation. Is that enough for most fans? I think people filling out their brackets, it’s plenty. But for me, as someone who likes to watch the game as well as project some of these great players, it’s not the same as it used to be because these – these top, top players – you’re only going to see them one year. It’s not like you’re going to see Ralph Sampson and James Worthy play each other two or three years, that – those days are over.
SIMON: Well, that – and that’s why we can – we can take another 15 seconds. Great programs are a harder thing to achieve now because the personnel is gone within a year.
BRYANT: That’s right. And no – and then when you see that, you don’t have upsets anymore because the great teams aren’t as great as they used to be.
SIMON: Howard Bryant of ESPN.com and ESPN The Magazine – Howard, thanks. By the way, you know who writes our theme music?
BRYANT: (Laughter) Yes, we do.
SIMON: OK, go ahead. Say the name.
BRYANT: It’s BJ, isn’t it?
SIMON: BJ Leiderman.
BRYANT: That’s right.
SIMON: All right. You’re listening to WEEKEND EDITION from NPR News.
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