A few shifts ago Leisl was caring for a newborn who had been passing small smears of meconium and had not yet passed a full stool as expected. Leisl was already well liked and appreciated by this newborn’s parents for her thorough care and explanations throughout the shift prior to the great catch and commitment to patient advocacy that she showed. This newborn and his mom were to be discharged at 9 pm that night by Leisl. She did her assessments and found that baby was still only having small smears of meconium. She knew that these small smears of meconium were not quite normal and assessed the newborn further to find that there was not a fully formed anal sphincter.

Leisl immediately called the pediatric resident without startling or frightening the parents. The resident examined the newborn then reached out to the NICU attending who determined that the newborn can be discharged and follow up with the pediatrician. Leisl insisted that the newborn cannot be discharged and then contacted the nursing supervisor as well as the NICU attending again with the support of her charge nurse. The NICU attending came to the floor and assessed the newborn further and found that the anal sphincter was not perforated and small amounts of meconium were being forced and squeezed through a tiny pinhead-sized opening. This baby was then transferred to NICU and immediately placed on NPO since the stool had no way to exit. We then found out that the baby will need surgery to form an opening at the anal sphincter.

Leisl saved this newborn’s life and saved the parents from the pain. Leisl stood her ground and said that the newborn cannot be discharged home and also requested that the NICU attending examine the newborn along with her and the pediatric resident. The NICU attending and the pediatric and NICU residents thanked and praised Leisl for a great catch. We also congratulated Leisl on a great catch having exceptional assessment skills and sticking to her gut feeling that the newborn would need further examination and interventions before being discharged home safely with his parents. Leisl continues to be an excellent role model for all staff on the mother-baby unit at NYP Brooklyn Methodist Hospital.