Monday, November 22, 2010

NICU Nurses: The good, the bad and the incredible ...

Remember how I said that the NICU has a way of turning complete strangers into friends and nurses and doctors into your family? Well, it's true. The strongest relationships you will form while your baby is in the hospital (or when you're in the hospital, too!) is the bond with their nurses.

The nurses who are good (which is far and away, most nurses we've encountered) are really, really good. Some have this sixth sense, superhuman ability to care for, comfort and treat the tiniest of babies (and their parents).

UNC Hospital practices something that a lot of Level IV NICUs do: primary nursing. Your baby's primary nurses are the two to four nurses that are "your" nurse; meaning, every time their on shift, they're assigned to your baby. This creates someone(s), other than yourself and your spouse, who know every, teeny, significant (and insignificant) detail of your baby.

At first, it might be a little unsettling (it was for me). I remember thinking, "I don't want someone who isn't me assuming the parental role for my child." But, quickly you lose that thought when you see the level of care your child receives whether you're present or not and you realize that they're not trying to be your baby's third parent- they just want to care for your baby like a parent. A social worker who visited us (no, they didn't call in DSS, every NICU parent gets a visit) shortly after Beatrice Kate was born reminded me that though the babies may know who the nurses or doctors are; they are always comforted by their parents. And, that little reminder was comforting to me!

We had four of the most amazing primary nurses at UNC. Two, Cindi and Jessica, we almost never interacted with except over the phone. Cindi was a night nurse each weekend and Jessica was often promoted to charge nurse during her shifts. But the other two, Hayley and Anne, became practically our only friends (because we didn't have time or energy to talk to others) and the closest thing to family we had within 50 miles!

It didn't matter, though, who we knew the best. They all handled our baby with the perfect combination of gentleness and know-how. They taught us how to change a diaper the size of a maxi-pad, how to hold Beatrice Kate so she would receive the maximum amount of skin-to-skin contact, how to expertly dress her for the first time avoiding the ever-so-delicate PICC line.

All four never once lost their patience or their cool with our never-ending streams of questions, calls (and there were a lot when we weren't there- "Exactly how much does she weigh now?", "Did she poop?", "How much exactly?", "How much milk did she get?", "How much was left over?"), or stupid comments ("Why is she wearing sunglasses?", "Why is she covered in fur?", "Is my baby a werewolf?").

Even if it was the 4,000th time they had heard us say something, or ask something about the treatment of our daughter, they acted like it was the first and were as quick to answer as well. They encouraged us to sit in on the doctors' rounds or, if we missed it that day, would give us a complete play-by-play about what was said about Beatrice Kate.

They were there to say kind words and give a hug when she got sick, gave us positive encouragement when things didn't look so rosey. They also gave us realistic expectations about Bea's day-to-day progress. Never giving us a false-sense of reality about just how critical her condition was at times. Initally, we were upset that it seemed the nurses never "bragged" about our baby; but came to fully appreciate their directness about her health when she did get sick.

They got excited when she graduated off the bubble CPAP to room air and were equally encouraging and positive when she was put back on a nasal cannula for a short while. They each made a big deal for us when Bea finally weighed enough to put on clothes and Anne searched the NICU closet for an outfit that could sort-of fit a 1300g baby. They all were delighted when we dressed Bea up in her "Easter dress" and helped stage the perfect photo-op by placing her in her Easter basket:
Not to be mistaken for the Cadbury Bunny
They also shared parts of their stories with us, making us feel (if not really) like part of their family too. We felt like we knew Anne's and Jessica kids, we were happy to hear how Hayley's Neonatal Nurse Practitioner program was going, how Cindi's drive from Denver, NC each Thursday and Monday went.

And it gets better! We didn't just "luck out" with amazing nurses. Each and every one of the nurses at UNC, our primary nurses or not, were amazing. All the nurses in our pod knew our family and showed concern and care for Beatrice Kate. We watched them do the same for all the families there. It wasn't just us!

When Bea was given the option to be transferred to Rex Hospital, Casey and I prayed a lot about what to do. We loved UNC and leaving our primaries would be difficult because the level of care she received there was out-of-this-world. Buttt.... Rex was 30 miles closer to our house, was a much smaller and (we thought) would be a lot quieter for her "feeding and growing" stage of life.

Deciding to have her transferred was a choice that would prove to be both a positive and negative in her development. We're not going to go into the whole story about this subject; except to say that we saw nurses who are dedicated to their work and fall into the "superhuman" category, and we saw nurses who simply were just "at work".

The best ones were some of the most amazing nurses ever (Diana, Deb, Rosemary, Shannon, just to name a few); we also encountered some of the most frustrating and pre-occupied individuals we've ever met. One actually held down my 3 pound infant to rip off the tape that held her feeding tube in place (I have never been so close to going to jail for assault in my life).

So, if you're a nurse (and chances are, you are amazing at your job)... we cannot even begin to say thank you for everything you do. You do a job that is often thankless, hard, demanding and sometimes heartbreaking and you do it everyday again and again. You may not know what an impact you have on the lives of your NICU families- but let me tell you... it's a big one. You're there for us when we're most scared, most worried and most joyful. Without people like you, families in the NICU would feel even more lost in a world of medical jargon and scary noises.


  1. You are right....there are some amazing nurses. One of our favorites at REX was Meg. She took care of our babies during the first week. She was so patient, gentle and encouraging. She did everything she could to make our babies comfortable and us!

    Thanks for sharing your journey.

  2. Meg was our discharge nurse. She really was amazing!!

  3. I was so excited to find your blog on wral the eve of Prematurity Day! Beatrice Kate is beautiful! It is so rewarding to see our "preemies" grow big and strong. Thanks for sharing your story. Give Bea a hug from "Nurse Deb" at Rex.