We spent 2 wonderful days in the Neonatal Intensive Care Unit. We were all excited…and some of us more nervous than others to begin. Miss Karla was a good instructor and helped us with basics and getting over our initial fears. The NICU is a sterile area, which required us to change our scrubs everytime we left and entered the unit. We were also required to wear slippers, or as we would call them, sandals. They are used as a method for infection control. They were very uncomfortable and we felt they were not ergonomically appropriate for a nurse working a 12 hour shift. They did not support and we felt tired after wearing them, even for an 8 hour day.
The unit had space for 18 babies. There was 1 isolation room, room for 5 babies in the intensive area, and in the well-baby area there was room for 16 babies. During our two days there, there were 10 babies in the well-baby area, and 4 preterm infants in the intensive care area. In the intensive area it was 1:1 nursing care, while in the well-baby area it was anywhere between 2-5 babies for 1 nurse.
We felt slightly apprehensive at first; the bodies of some of the preterm infants fit snugly in the palms of our hands. They were so tiny and fragile, but our motherly insticnts kicked in and we provided the babies with what they needed, the sense of touch. These babies needed constant monitoring because they are so delicate and susceptible to microorganism.
On the well baby side of NICU, the babies had either come into the hospital with some kind of problem or had just been delivered via C-section. Three of the babies were under the light that filters a specific light wave to help with treatment for jaundice. It was difficult to comfort these babies and try to keep them under the light at the same time. Many time they would begin to cry, but even a soft touch to their body often would calm them.
On the intensive side, there were 4 babies who required the use of the incubator. Other treatments included oral and gastric tube feeding, breathing tube, oxygen monitor, and IV’s. These babies were unbelievably tiny, only taken out when a new IV needed to be started. We noticed the use of black, red and white color markers; researchers say that those 3 colors are of the first that are identified by a premie and can aid in the development of the eye and color distinction.
The importance of touch therapy really came into play. It was hard giving the injections, as the babies would always cry. In Erickson’s Model of Development the first stages are trust and mistrust. A strategy used to help with the proper development baby was picking him/her up and calmed with the use of gentle speech, humming as well as holding baby close and rocking back and forth; it ensured security and safety in the baby.
Another new task that we learned to perform was feeding through tiny oral-gastric tubes. The babies who required these either were having trouble sucking, or could not keep food down. Some of the babies were there due to elevated white blood cell count, which indicates infection. Another strategy used to increase infection control was the restriction of parents visiting. In many cases parents were only allowed to view their baby from a window for a set amount of time. Moms were allowed to come in to breast feed, but were required to change into a specified uniform.
We were conflicted with this practice only because of our beliefs in the importance of touch therapy, but understood the importance of decreasing the chance of spread of infection, especially with lives that have just begun. It was hard for some of us to terminate with these patients because they were so vulnerable, and our maternal desire to protect them had kicked in. All in all this was a great rotation, learning the importance of safety not only for the protection from outside sources, but also ensuring our tiny patients felt safe and secure