My name is Emma. And I am a Neonatal Nurse.
I have been a nurse for nearly 13 years now and spent nearly 8 of them in the NICU (Neonatal Intensive Care Unit) and SCN (Special Care Nursery).
I started my career as a post surgical nurse before returning to university to do midwifery, which is where my love of babies and caring for them and their families developed.
However, after working in a private hospital where little education was available, I wanted to focus on vulnerable babies and expand my career. So with a few nerves I applied to the four Level 6 hospitals in Victoria that had a NICU unit and was lucky enough to be offered a position at Mercy Hospital for women in their SCN (Special Care Nursery). After 18 months in the SCN I headed back to university again to complete my postgraduate certificate in NICU.
As a general rule of NICUs in Victoria, currently any pregnancy that gets to 23 weeks in gestation is considered viable and is given a chance at life. At 23 weeks babies have roughly a 50% chance of survival. The realities of having a baby at 23 weeks will be devastating difficult. No 23 weeker will have an easy ride. If they can survive the first 48 hours their odds increase but there are a million things waiting in the wings to challenge you…IVH (Intraventricular hemorrhage), NEC (Necrotizing enterocolitis), CLD (Chronic Lung Disease), Sepsis. The list goes on.
But the satisfaction, relief and joy of helping these babies make it to ‘the fat farm’ (the back wall where they will leave to go home) is incredible and when these little miracles come to visit after gradating home... makes every bad day worth it.
A standard day in NICU is never standard. That’s what makes it challenging, fun, an adrenaline rush, boring and heartbreaking all at once. Generally, if you are looking after a NICU baby on life support you will have just the one patient for your shift… their life is literally in your hands.
Between the team of doctors and you, we are responsible for them entirely. From making sure their ventilator settings are high enough to oxygenate them and clear their carbon dioxide yet low enough not to cause lung scaring from barrow trauma. We need to feed them enough to meet their nutritional needs yet not enough that we cause feed intolerance. We give them inotropes to support their blood pressure and circulation. We are constantly adjusting numbers and adding and subtracting medications.
We are also here to support our patient’s families and encourage them to be as involved as possible with their child’s needs. We teach them to change tiny nappies through port holes, to take temperatures and change oxygen saturation monitors, to be there at doctor’s rounds and be their child’s advocates. So much control is taken away from these parents. They have lost so much already. But they can do so much for their baby. Parents tell me all the time that they feel they can’t do anything for their baby yet just by being there, touching, reading, providing vital breast milk does more for their baby than all the medical interventions we are providing.
The hardest part of my job is the obvious. Sick and premature babies die. Despite our best efforts and desperately trying everything we can think, of not all babies survive.
The first time I worked with a family whose baby died I had just finished my NICU course. I was still green and nervous about doing or saying the wrong thing. I had looked after their baby from day 2. He was born at 25 weeks and his mum had a maternal fetal haemorrhage so he lost nearly his entire blood volume. On day 3 we did a head scan to find he had a devastatingly bad brain bleed. He would never breath for himself. To make things worse this beautiful family had lost their daughter 18 months ago at 36 weeks who was born sleeping. Life just isn’t fair sometimes.
On day 4 of this babies life his parents made the heart breaking decision to let him go. Despite only working with this family for 3 days I felt incredibly connected to them. I was sharing one of the most heartbreaking moments of their life with them and as I sat in the butterfly room with this family, I have to remove his breathing tube, this babies lifeline, while his parents cuddled him for the very last time.
These are the moments that stay with you as a neonatal nurse. There is no greater privilege than sharing this moment with a family and doing anything you can to make it as positive an experience as possible.
To my delight, nearly 2 years later I walked out of the NICU unit to find this family sitting out front. They had had another baby girl who was perfect. She spent 2 days in the Special Care Nursery for low blood sugars and was about to head home.
Seeing the relief and delight on their faces as they introduced me to their daughter gave me goose bumps. It was one of my best memories as a neonatal nurse. They went on to have another boy who also needed a brief visit to NICU for some CPAP (Continuous Positive Airway Pressure).
As the father walked past me, just as the baby was brought up from the operating theatre, it felt like fate... that I was once again on duty when he arrived, and I could see this families full circle.
The two children they lost will forever be longed for, but their two live children have completed their family.
Those are the days that make it the best job I’ve ever had.
Today (17th November 2018) is World Prematurity Day
Today we raise awareness of preterm birth and the concerns of preterm babies and their families worldwide.
Approximately 15 million babies are born preterm each year, accounting for about one in 10 of all babies born worldwide – more than 25,000 each year in Australia alone.
Premature birth is the leading cause of death in children under the age of five worldwide (more than one million of these babies).
Babies born too early may have more health issues than babies born on time, and may face long-term health problems that affect the brain, the lungs, hearing or vision.
Preterm birth is a problem that can happen to every one of us, irrespective of the country we live in, our culture or socioeconomic status.
Giving birth to a child is one of the paramount, most positive experiences in life. Having a baby born too early can be a significant trauma for families.
Raising awareness of preterm birth is the first step to defeating it: Preterm birth rates could be significantly reduced and lowered through overall information and improved treatment and care.
#givethemtomorrow #worldprematurityday
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