5 Years of Rewarding Work
Being a NICU nurse is the most rewarding work I can think of. The last 5 years have gone by in what seems like a flash. As a ripe new grad nurse, I was so fortunate to be hired into a highly intense nursing specialty. The NICU is dimly lit with a slight blue glow from infant phototherapy. There is a low humming noise from ventilators and loud alarming of monitors and machines. Babies are in isolettes (incubators) or open cribs, some are crying and some are asleep. The smallest premature babies are sometimes hard to find. Covered by their breathing machines and IV pumps, they are snuggled away firmly in their gel mattresses in a warm humidified isolette. The success stories I have seen by far outweigh all of the sad moments. To play an active role in a baby’s first fragile days of life is humbling, and to see them grow big and healthy and be discharged from the hospital is the ultimate feeling of success.
Shocking Facts about Preemies & the NICU
Babies can survive as early as 23 weeks' gestation
Actually, now it’s being pushed to 22 weeks, and we have seen success stories!
Love is the best medicine
Babies who cuddle with their parents and do “skin to skin” have the best outcomes. This is the most therapeutic activity for both the baby and the mother. The basis of this, love, is really the best medicine. It provides a feeling of comfort, safety and security for the baby. Love is felt as deep bonding and a sense of belonging.
Maternal drug use is on the rise - especially with Fentanyl
More and more babies are being born addicted to drugs and experience mild-severe withdrawals in the NICU. This is often coupled with a mother who does not visit her baby and therefore never holds or provides a feeling of love for her baby. These babies require morphine around the clock to manage their withdrawal symptoms.
Preemies are administered Caffeine
This is to help reduce the amount of times they randomly stop breathing (caffeine is a stimulant)! When babies do stop breathing, sometimes it takes a gentle, or vigorous, nudge to get them to start breathing again. Nurses to the rescue!
IVs are placed in tiny string-like veins. They are also placed in the umbilical cord.
As I have begun IVs on premature babies I have often thought to myself, “will this catheter even fit in their vein?!” Their little veins are extremely thin and fragile, but it IS possible to fit an IV in them. The umbilical cord has three blood vessels which are used quite often for IV access. This can only be done in the first week of life before the cord dries up and falls off.
Babies can’t stay warm on their own until they are about 4 pounds
Babies under 4 pounds don’t have enough fat to keep themselves warm. Babies can burn too many calories trying to keep themselves warm so we put them in a crib only when they are completely ready!
There are about 8 million machine alarms
Eight million might be a slight exaggeration, but it’s close. All of the NICU machinery with alarms include: IV pumps, feeding pumps, monitors, ventilators, oxygen humidifiers, beds, and more! Not to mention, phones ring often nonstop. Alarm fatigue is very real. Sometimes I still hear the alarms beeping when I go home. . . sometimes I need to drive home in complete silence. . . and sometimes the dinging, alarming, and chaos in the NICU is so overstimulating I need to step outside to reset.
Babies are the toughest and most resilient human beings
Fragile? Yes, kind of, mostly - but not really. Babies born at 23 weeks and weighing just one pound can undergo extreme stress, pain, discomfort and stimulation. Babies sometimes have the toughest course with setback after setback - procedures, exams, poking, etc. BUT they power through, they do survive, and they go home.
All NICU babies get physical therapy, occupational therapy and speech therapy
This helps them to stay developmentally on track so they can reach their milestones, learn to self soothe, stretch their muscles and learn how to bottle feed!
Other facts about the day-to-day
- The smallest baby I’ve seen survive weighed just 14 ounces, less than one pound.
- Sometimes, families don’t visit or call
- Adoptions sometimes fall through, leaving adoptive parents devastated
- Infant deaths in the NICU can be a combination of scary, gut-wrenching, relieving, beautiful and “for the best.”
- NICU Nurses have to be one step ahead of the doctor and check their work.
- NICU nurses take care of the whole family, not just the baby.
- The NICU would crumble without sufficient teamwork. Everything is teamwork.
- Babies can’t speak, of course, so nursing assessments and critical thinking skills have to be thorough
Q: Do you keep in touch with families and babies after they leave the NICU?
A: Yes! We receive updates from families all the time and get pictures of their babies growing up! It’s the best!
Q: What’s your favorite part about your day to day?
A: I really enjoy hands-on care of the babies. I love when I can take them out of their crib and hold them, bottle feed, talk to them, and truly interact with them in a meaningful way. Their little worlds just light up when they are loved!
Q: Does it make you more afraid / worried about having your own child? Or are you more prepared?
A: Both! I am in the stage of pregnancy where if my baby were born, she would be extremely premature and in the NICU for several months. I put myself constantly in the shoes of moms who have babies struggling to survive. I do however feel more prepared once my baby is born and home. I think knowing babies well and working with them all the time helps reduce worry and anxiety about what is normal vs concerning.
Q: How do you comfort babies?
A: It depends on what is ailing them. Drug withdrawal? Lots of love (and a little morphine). General stress or discomfort? Drops of sucrose, pacifiers, tight swaddles, dim lights, decreased stimulation, soft music or white noise, butt taps, baby swings.
Q: Do you ever get sad seeing sick babies?
A: Yes, absolutely. The sadness is usually temporary, though, because NICU baby outcomes are usually favorable!