NICU - Guest Blog

When it comes to the birth of a baby, most moms will agree that things did not go the way that they were expecting.   Maybe the baby was born two weeks early while the father was on a business trip. Or perhaps, the baby decided to enter this world in the front seat of your pick-up truck while on the way to the hospital. Every birth story is unique, and most mothers are more than eager to share every detail of the birth story with anyone who will listen.  Unfortunately, for some parents, their unexpected birth story includes a detour into the NICU (Neonatal Intensive Care Unit). 

According to Dartmouth Institute for Health, approximately 78 infants out of 1,000 are admitted into the NICU (JAMA, 2015).  Some NICU’s have the capability to admit babies 23 weeks gestation and above. Those babies are considered micro-preemies and are usually quite ill. They will require intensive care by a multi-disciplinary team of NICU nurses, Neonatologist, Neonatal Nurse Practitioners, Nutritionists, Occupational Therapists and Physical Therapists.  Thankfully, most babies admitted into the NICU are not micro-preemies. In fact, babies are admitted into the NICU for a variety of reasons, including; respiratory distress, blood sugar instability, infection, feeding problems, and low birth weight.  Whatever the reason, an admission into the NICU can be a scary time for the parents.

In most cases, babies are taken straight from the delivery room or O.R. into the NICU. Depending on the urgency, there may be little time for one more snuggle. This is always the hardest part, taking the baby from the mother.  However, we know that the infant needs the equipment and resources provided in the NICU.

Inside the NICU can be a scary place for new parent, at least at first.  We try to keep the lights low and the noise level down but we also seem to have a bell, beep and a ring for everything.  Every infant has a monitor above their bed displaying their oxygen level, respiratory rate and heart rate.  The monitors ding and alarm for various reasons.  These monitors will inevitably cause many new NICU parents a lot of anxiety.  In fact, new NICU parents will most likely stare and fixate on the monitors. That will pass when they realize that not every alarm is indicating an emergency.

Depending on the infants’ condition, the NICU parent may or may not be able to hold their baby.  Yes, I know sounds awful. I too watched the Greys Anatomy episode where the doctor single-handedly saved a baby by doing Kangaroo care.  Full disclosure—it was the first and last episode I ever watched. The truth is, some infants may be too unstable or too stressed to move out of their isolette.  Rest assured that every NICU nurse has a goal of getting that baby in your arms and eventually home with you. 

The most common question in the NICU is always, “When will my baby be able to come home?” This is a hard question to answer.  Infants will be discharged from the NICU when the infant is ready. That means different lengths of stay for each individual infant.  For many NICU parents, the baby will not be discharged before the mom is discharged home. The length of a NICU stay for a baby can be a few hours up to a few months.  I often think about how hard it must be for the parents to leave the hospital that first time without their baby but hope that they are comforted by knowing that their baby is in great hands.  Thankfully, most NICU’s have liberal visiting hours, only closing for change-of-shift every 12 hours. Parents are welcome to visit and call whenever they desire. It is not uncommon for a mother or father to show up at 3 am to feed and hold their baby.  We are lucky to have wonderful NICU facilities in our immediate area, staffed by highly-skilled medical professionals.  It’s a very rewarding place to work.

My word of advice for the readers of this blog is, understand that your birth plan in YOUR birth plan. The baby has not been clued into the “picture perfect” entrance into this world.  Be realistic and flexible in your plan and if your baby is admitted into the NICU, know that you and your nurses are on the same team with the same goal- healthy babies!

Nancy Pion is a Registered Nurse and holds a Bachelor of Science in Nursing.  Due to her husbands’ active- duty status and PCS moves, Nancy has worked in 5 different neonatal units over the last twelve years.  

(JAMA Pediatr. Published online July 27, 2015. doi:10.1001/jamapediatrics.2015.1305. Available pre-embargo to the media at http://media.jamanetwork.com.)