Caring for the World's Tiniest Patients
"One of the most interesting things to see is the babies born with organs outside their bodies that are meant to be on the inside."
I wanted to write about what the heck it means to be a neonatal intensive care (NICU) nurse. A neonate is just a medical name for a newborn baby. I wasn't initially very interested in being a nurse for babies, but from my time in nursing school onward I have grown more and more interested in this field of work. I’ve always loved asking people with different jobs what a typical day of work looks like for them, so why not let you know mine?
I think there are so many careers that I would have loved to do! While I absolutely adore my job as a NICU nurse, I have no idea if I’ll do it forever, so I’m very open to growing as a nurse and moving up the NICU nursing career ladder, exploring different areas of nursing, or even possibly branching out to a new field all together. My sister was an elementary school teacher, and a part of me thinks I would LOVE teaching! It’s not on the cards for me any time in the foreseeable future, but it doesn’t stop me from watching way too many teaching vlogs on Youtube... oops!
To start - how did I end up as a NICU nurse? I hadn’t always planned on being a Neonatal ICU nurse, and it wasn’t until the end of nursing school that I set my sights on it. To back up, my career in health care circles back to my dad. He was a Neuro-Oncologist (think doctor for brain cancer) and from an early age I adored him and what he did. I didn’t understand the weight of his job as a child, but I knew one thing was certain - my dad helped sick people. He was good at it, and he was so passionate about it. I wanted to follow in his footsteps and grow up to care for sick people too. Heading into university, I decided I wanted to study nursing and applied for nursing school after finishing my prerequisite courses. After my first year of nursing school, when I was exactly halfway done, my dad was in an accident and died unexpectedly. It’s safe to say this shook my world.
After spending a week in the Intensive Care Unit before he passed, I had no desire to return to nursing school. The thought of going into a hospital made me queasy. I took that summer off and debated not returning and instead buying a one-way ticket to Thailand. In the end, I decided to finish what I had started and packed my bags to head back to school for my fall semester.
Going back was hard. I felt so heavy with grief that it exhausted me and made it hard for me to focus for long periods of time. I had many days of shadowing nurses that second year of nursing school, and during those times in the hospital I had to excuse myself to the restroom to vomit or cry on occasion because it made me physically sick being in a hospital setting. I was convinced I could never work in any kind of intensive care unit and even unsure I could work in a hospital setting at all (problematic when you’re studying to be a nurse)… until I had a day shadowing a nurse in the NICU.
Going into a NICU for the first time can be very overwhelming. You see tiny babies hooked up to wires; some have machines to help them breathe, some have tubes coming out of their mouths, some are under blue lights... the list goes on. But I was hooked. I could not believe people got paid to care for tiny babies all day. From then, I set my sights on NICU, and thankfully Seton Medical Center in Austin took a chance on me as a new graduate. I had an amazing team there who taught me so much, and I’m so grateful to still be working as a NICU nurse in England today!
So let me tell you a bit more about the NICU. While the neonates are typically classified as 0-28 days -old, many babies stay in the NICU much longer than that. The severity of sickness that babies in the NICU have can widely vary as well. Some babies may only have a very short stay. These babies may include those who are having some initial trouble keeping their blood sugar up, maintaining their body temperature, or may need something called phototherapy treatment, which is where they are placed under those blue lights. We also have severely ill babies in the NICU. A full pregnancy is considered to be 40 weeks long. We may have babies in the NICU that were born 23 or 24 weeks into the pregnancy. Textbook says life isn’t viable before 24 weeks. These babies are TINY and so fragile.
Every week in pregnancy, the baby grows and different organs and body parts develop. When a baby is born early, they haven’t fully developed, and depending on how early they were born can help determine what organs are underdeveloped. For example, the lungs fully form in the 37th week of pregnancy. If a baby is born before then, it is very possible that they will need help breathing on their own and will likely require some kind of respiratory support.
Some other things you may see in the NICU are infants with heart defects, gut problems, neurological (brain) problems, abnormalities (one of the most interesting to see in my opinion is the babies born with organs outside their bodies that are meant to be on the inside), different syndromes, and babies who were born to mothers who were on drugs or took drugs during the pregnancy that are experiencing withdrawal symptoms. There are many things you might see and experience in the NICU, so you’re definitely never bored!
Why am I so passionate about it? Babies cannot communicate the way we do. They can’t speak for themselves, they can’t tell you what’s wrong, and they can’t explain what’s hurting them and where. I love being able to try and figure out what’s bothering a baby and what I can do to help them feel better. Plus it’s babies y’all!! I’ve spent so much time rocking a sick baby to sleep - and I get paid for it! I’ve even cared for babies that weigh in at just barely a pound. It’s an inexplicable feeling to hold a tiny life literally in the palm of your hands. These babies are so fragile that you have to take careful precaution to move and handle them because they are at such a high risk of bleeding in their brain.
It is so special to watch these tiny humans grow and develop. I’ve been at the bedside the first time a baby opens their eyes, the first time their parents hold them, for their first bath, and for many other “firsts”. There is no better feeling than seeing your patient grow well enough to go home with their family. I’m not sure what the future holds for my career path, but I know for now I am so grateful to be caring for the world’s tiniest patients.