NICU: Behind The Scenes

I work in the Neonatal Intensive Care Unit, and when I tell people that it seems like they either have no idea what that is, or they think it is a baby nursery. So I am putting up some pictures and an explaination for those of you who are interested.

First of all it is an intensive care unit, so if you think of an adult ICU you can get a general idea of how serious these patients' conditions are. The next thing you should know is that most of my patients are EXTREMELY premature. A full term infant is born between 38 and 40 weeks... I take care of kids who are only 24 weeks gestation at birth. That means they were born when their mom was just under 6 months pregnant. Not cool. The majority have to be revived at birth and immediately put on ventilators. No part of their little bodies (usually just over 1 pound) is ready to support life yet. So there are machines breathing for them, they have central lines surgically placed to provide artificial nutrition, and we are pumping them full of drugs to keep their hearts going and blood pressure strong enough to perfuse their bodies. Often we have them under phototherapy lights to keep jaundice under control.

Some common complications that we work around the clock to prevent are blindness, brain bleeds, tissue death in their intestines, cerebral palsy, developmental delays, sepsis (blood infections), bacterial meningitis, apnea (they stop breathing constantly), dangerously low heart rates, and hearing loss. We usually end up keeping these kids on the unit until they reach what would have been their due dates.

These babies are covered in lines, tubes, and monitoring wires. As a nurse, my job is to assess them through the night and look for the slightest change that might indicate something is going haywire. I am constantly running and changing IV fluids and drugs, inserting nasogastric tubes for feedings, adjusting oxygen levels and pressures, inserting IVs, drawing blood for labs, checking capillary blood glucose levels, mixing and calculating formula prescriptions, physically assessing their little bodies, stablizing temperatures, changing miniature diapers, and interpreting all the subtle clues these guys reveal. Not to mention educating and coaching totally stressed out or uninformed parents, and interpreting for Spanish speaking families! It's pretty intense, but I LOVE my job!