A NICU Nurse’s Story
The Neonatal Intensive Care Unit (NICU) is a remarkable unit for the reason that it encompasses compassion, critical thinking, plus the management of a sick or premature newborn.
It takes an extraordinary person to become a nurse, but even more so, it takes a courageous and persevering individual to become a NICU nurse.
As a former NICU nurse with over 25 years of experience in a variety of clinical settings I loved my Neonatal Intensive Care Unit experience the most. I remember “swaddling” and holding an infant on Christmas Eve. Additionally, I remember explaining all the IV lines and monitoring devices to the infant’s father who appeared shaken at the site of his newborn lying defenseless on the radiant warmer. Above all, I remember the never-ending noise and the bright lights of the unit. It seemed strange to me that a sick infant had to endure noise.
I encourage all NICU nurses to read a wonderful book entitled Baby ER. The author describes the NICU environment like a novelist rather than a physician. He describes the NICU with vivid images like, “the room was in perpetual motion like an aquarium with fish swimming in all directions;” and “the noise was like the thundering cacophony of an orchestra tuning up.” I can relate to these metaphors.
While in the NICU, I imagined what it may have been like in utero – dark, quiet, comfortable, and without hunger.
I pictured the infant making that horrific journey down the birth canal to be greeted not by his or her mother, but instead received by nurses that “rough you up.” I wondered how a premature infant felt surrounded by the bright lights and terrifying noise of the gray and cold room NICU. In fact, the greater the degree of immaturity of the newborn the more injurious the physical environment will be for the premature infant.
Preterm infants are unable to shut out stimulation for rest. Consequently, over excessive handling, noise, and equipment may further stress the neonate. Interestingly, a term infant can self-regulate to this environment with thumb sucking and boundary seeking, but the premature baby is incapable of self-regulating. Unlike the term infant, a neonate is often denied being comforted via skin to skin, or physical contact due to its fragile state. As a matter of fact, in one way or another, a premature infant can sense when he or she is not comforted by a Mommy or Daddy.
Furthermore, the healthy newborn has a need and reflex to suck – not because he/she is hungry but to calm himself/herself. Yet for NICU babies there is nothing to suck. Moreover, infants prefer to be wrapped up tightly, like they were in-utero; instead the NICU baby must lie flat on a hard surface with limited movement. Last but not least, infants desperately yearn to be comforted by Mom, but for a NICU infant his or her mother can only stand by the radiant warmer helpless to comfort her infant.
Imagining what a NICU infant’s life was like in the moment helped me as a nurse to thrive within the Neonatal Intensive Care Unit environment.
It is essential that nurses wishing to begin a career in the Neonatal Intensive Care Unit be aware of the abstract needs of a sick and premature infant. In conclusion, nursing is more than being adept with physiological interventions. A good nurse is one that deeply understands his or her patient and one who goes above and beyond to meet their needs on a physical, emotional and even spiritual level.
Good luck in your NICU experience. It will be rewarding and challenging.