Caring for sick or underdeveloped newborns is a difficult process technically, mentally and emotionally, but staffers in Neonatal Intensive Care Units (NICUs) are dedicated to taking on the task. “People have this idea that the NICU is just like an extended nursery, but it’s not,” said Linda Rankin, BS, MSN, MBA, MJ, director of the Neonatal Intensive Care Unit at Sunrise Children’s Hospital. “It’s a full-fledged intensive care unit that specializes in treating critically ill newborns.”
While the urgency and importance of the work that takes place in an NICU is undeniable, it’s all done with tenderness and consideration for the tiny patients.
Who does the NICU treat?
NICUs accept infants 30 days old or younger, most of whom come straight from the delivery room and stay anywhere from a couple of days to 13 months.
Low birth weight is the most common reason babies are sent to the NICU, but any critical illness, injury or condition such as a birth defect, sepsis or breathing problems are reason to be admitted.
What does the NICU do?
The NICU provides 24/7, one-on-one care for every patient in the unit, employing special nurses who stay at children’s bedsides around the clock to tend to them and monitor their vital signs and behavior. “It really requires a special eye and attention to detail,” Rankin said. “The baby can’t tell you how they’re feeling or what hurts. The attending nurse has to be able to decipher small changes in symptoms and behavior, and come to conclusions about what those things mean in tandem with the baby’s vital signs.”
NICU nurses work closely with physicians, called neonatologists, when creating a treatment plan for the infant. “The nurses relay any of their diagnoses and interpretations to the neonatologists, so it’s really pivotal that they know exactly what’s going on with the infant at all times,” Rankin said.
Depending on the severity of the case and the individual needs of an infant, respiratory specialists, developmental specialists, feeding specialists, social workers and neonatal surgeons also may be involved.
In addition to administering treatment, NICU staffers work with families to explain the baby’s condition, set expectations for what’s to come and prepare the families for any ongoing care that may be necessary once the infant is discharged. “Many of our nurses develop strong bonds with the infants and their families, especially when they’re there for an extended stay,” said Mo Aslam, BSN, RN, NICU manager at Sunrise Children’s Hospital. “Some parents bring the child back for visits even after being discharged, which is amazing for us to see how they’ve been able to grow and change since they were babies.”
NICU Transport Team
The NICU at Sunrise Children’s Hospital is the largest Level 3 NICU in the area, so it’s common for babies to come there from other hospitals for treatment. Given the critical and time-sensitive nature of NICU cases, the transport team works to ensure that any infant in need receives timely and appropriate care. The transport team picks up neonatal patients from hospitals in the Las Vegas Valley, other cities in Nevada and nearby states, and brings them to the NICU at Sunrise for treatment.
The transport team includes NICU nurses who have been specially trained to deal with transport, a respiratory therapist and a neonatologist. Depending on the distance being traveled, the team drives or flies to the destination, stabilizes the patient, prepares him or her for transport, then brings the baby to Sunrise for continued treatment.
“Most often, the infants we’re transporting are coming from hospitals that don’t have the resources to deal with the critical circumstances,” Aslam said. “In some cases, we’ll know if it’s a high-risk delivery ahead of time, and we’ll be there in advance to transport the infant. In other cases, we’re called in after the fact.”
What are the challenges of being a NICU professional?
Being a nurse in the NICU can be both challenging and deeply rewarding. “On demanding days, the NICU can be a difficult place to work, but our nurses are drawn to that challenge and want to make a difference,” Rankin said. “Once they finish registered nursing school and are licensed, they must complete additional and ongoing training to work in the NICU.”
Every nurse, doctor and counselor is given specialized training on how to care for neonatal patients. Furthermore, advanced medical technologies are required for treating such small patients. “Treating babies who are a normal size and weight can be difficult enough, but we see infants who are small enough to fit in the palm of your hand, so we have to use special tools that are able to accommodate even our tiniest patients,” Rankin said.