DiversityNursing Blog

BY CHIARA SOTTILE

Twice a day, Michele Forth drives 45 miles to the Neonatal Intensive Care Unit to visit her 4-month-old baby she affectionately calls "Miss Madilyn." She is a 6-pound fighter in pink pajamas — but to her family and the nurses who care for her day and night, she is so much more.

"Hi, pumpkin! You just waking up?" Forth coos. Nurse Adrianna "Adri" Zimmerman, wearing purple scrubs and a warm smile, hands Madilyn to her father who is quickly surrounded by his wife and two young sons.

"She fights harder than any adult that I know, let alone a 6-pound baby," says father Shane Forth, softly stroking Madilyn's delicate left foot in his hand.

It was in that spirit that the nurses chose to see Madilyn, one of nearly 100 babies cared for in the NICU at Children’s Healthcare of Atlanta every day. "We always talk about how feisty this one is or how sweet this one is,” Zimmerman says.

That bedside chatting took on a whole new life with a photo series called "From the NICU to the Moon" that imagines what the babies dream about as they wiggle and smile in their sleep, and what they might become someday. It also aims to educate parents about safe sleep for newborns.

The nurses and hospital communications team imagined Madilyn as a physician, surrounded by stethoscopes and Band-Aids. The photo series also features Brentley, the future astronaut, Arianna, the future chef, Sofia the ballerina, and Carolina as an Olympian.

Madilyn was born two months early and has what is called vacterl association (a collection of birth defects), resulting in multiple surgeries and months in the NICU. Zimmerman remembers Madilyn's arrival in the NICU like it was her own child.

"I think she's strong and she's definitely got the will to see whatever it is through to the end, so, if that happens to be med school in a few years, I would not be surprised," says Zimmerman. "It's funny how much personality these babies have."

And Mom is happy with the depiction. "Even though Miss Madilyn does have a whole bunch of obstacles ahead of her right now," she says, "she can do amazing things and she can aspire to be anything that she wants to be."

Carolina, the tiny Olympian, is “a strong-willed patient who has a lot of heart and she is letting nothing hold her back," says Jessica Wright, a NICU Nurse with 10 years of experience. "Just because they were born early doesn't mean they cannot do whatever they want when they grow up in life."

True to her athletic depiction, Carolina is hardly ever still in her crib. Gazing up at the green alligator and orange lion of her soother, Carolina playfully kicks her feet back and forth, her bright eyes fixed on Nurse Wright. "What are you thinking about?" Wright asks, her hand on Carolina's blue and pink ensemble, "You tell 'em about it, wiggle worm."

Sofia, the ballerina in the photo series, is also on the move. Since she was photographed, Sofia was able to leave the NICU and go home with her parents, Fred and Dawnyale "Dawny" Hill.

In the pale orange light of an Atlanta sunset, Fred and Dawny cradle their daughter in their arms on the family's front porch. It's Sofia's first time outside on the porch and her longest stint outside in the evening since she went home. "What do you think? What do you think? Hill asks his daughter, holding her hand. "Interesting, huh?"

Sofia spent 157 days, 20 hours, and 6 total minutes in NICUs. Respiratory and reflux issues keep this 5 1/2-month-old on an oxygen tank and feeding tube.

"She has some accessories, as we like to refer to them as," says Mr. Hill, about the oxygen tank and tubes. "They kind of travel with her."

But in the "NICU to the Moon" photos, Sofia left all the tubes behind for the stage and curtains. "It made her seem normal. The way the pictures kind of erased all of the cords. All of the tubes," says Hill of his daughter. "I saw the innocence of Sofia as opposed to my child in the NICU."

"She's got a family full of dancers on both sides so we definitely are excited to see Miss Sofia the ballerina come about," Dawny says with a laugh. "She'll be dancing around."

But for now, the Hills cherish moments with Sofia at home, like their evening bedtime routine. Mr. Hill carries Sofia on his chest while Dawny wheels the oxygen tank and other cords towards the bedroom. "Good holding your head, Sofia. Look at you," applauds Mrs. Hill.

As they gently place her on her back in her crib, Sofia rubs her eyes.

"Hey, you had a good day. You had a good day, right? Are you sleepy?" asks her father, the machine beeping and sighing next to the crib.

"Ready? Time to pray," Mr. Hill says, kneeling over the crib next to his wife. They pray for every organ in their daughter's body and give thanks to the doctors who helped bring her home.

"We will be keeping up our bedtime routine," Mrs. Hill says, looking at her husband. "Until she can start saying her prayers," he answers.

"Any child that has to go through that much opposition from day one, there's got to be something great for them to accomplish out of life, so my hope is that she accomplishes exactly what she was sent here to do," Mr. Hill says.

And with that, the bedroom light switches off and one more former NICU baby gets to dream of her future in her own crib.

Source: www.nbcnews.com

By Liane Clores

I glance at the wall clock as I finish off my breakfast with the last sip of coffee. 6:14 am. Duty is about to start in about 46 minutes. I have to hurry up, I don’t want to be late for the endorsement. I fix my neatly ironed scrub suit and smock gown, pick up my things, which I prepared last night and head out the door with my game face on. Another day of saving lives is about to start.

“It’s like having a taste of both heaven and hell on earth,” Carmel* tells as she describes what it is like being an ICU nurse. “You get to save lives and be of help to patients who are sick, but what’s depressing about being a nurse in the ICU is seeing a life fading from a person’s eyes from time to time,” she adds.

6:30am. I arrive just in time for the nurses’ endorsement. I warm up and whisper to myself, “I can do this” as I get ready to face anything that may happen within my 8-hour duty shift. I grab the kardex first and try to read through my assigned patient’s information. Next, I take hold of the chart and read thoroughly, asking questions now and then from the outgoing nurse-on-duty, checking every sheet on the chart. We then proceed to bedside endorsement. Icheck if the IV site is patent and is not yet infiltrated, the labels and drips of they are on time, the urine catheters if clogged up or not, machines attached to the patient if functioning well.

“You have to be meticulous though, everything can be significant. You must check everything in the chart, from orders to what medications are to be administered and what has been the status of the patient within the previous shift. You must possess good assessment skills and must never be afraid nor shy to ask questions, or else it will only result to you getting confused, making mistakes, and worse taking your patient’s life at stake,” Rachelle shares.

After all the assessment and baseline vital signs taking, I proceed to checking the stocks and supplies. Once satisfied that the stocks can last the entire shift, I take the medicine cards from the medicine rack and organize them. I plan out my activities for the shift and prioritize them according to urgency, for today is going to be a long day of turning and lifting patients, administering medications, suctioning, monitoring and catering the patient’s needs.

The ICU is where seriously sick persons are admitted and are cared for by specially trained nurses.  They need a higher level of care compared to those patients admitted in wards. They should be monitored intensively and are closely monitored. Even though the ratio of patients and nurses is 1:1, some still consider it stressful being an ICU nurse. Since nurses are assigned to one patient each, each is expected to render comprehensive care to the clientele.

My patient’s BP has dropped from 180/100mmhg to 150/80mmhg. I call the resident doctor on duty to update him on the latest progress and after examining the patient, he orders to decrease the rate of the AC drip in decrements of 5 until the BP reaches 130-140/80mmhg.I decrease the rate from 10 uggts/min to 5uggts/min and recheck the BP 30 minutes later. The attending physician arrives to conduct his daily rounds and I update him regarding my observations on the patient’s current condition. I show the latest vital signs, laboratory findings and assist him as he examines the patient closely. I suggest plans of care which he acknowledges courteously. After which, I carry out the doctor’s orders and prescribe due medicines and supplies while continuing monitoring the patient closely making sure that the patient remains stable.

ICU nurses are trained nurses who are assigned to critically ill patients. Since these patients have unique needs, nurses must be equipped with proper training to handle them more appropriately such as Intravenous Therapy, Basic Life Support and ACLS trainings. They must have critical thinking skills and make snappy decisions. In the battle of life and death, they must come prepared and have a knowing on what to do since by working every day, they know that they are making life and death decisions and one wrong move can make matters worse.

I step out of the unit feeling tired and relieved. My 8-hour shift is now over as I turned my patient over the next nurse-on-duty. I feel fulfilled to know that today, I saved another life. It really is exhausting being a nurse and even the salary isn’t enough compared to all the sacrifices you have made in a day of duty. But sometimes, small things can make a big difference, like for us, nurses, just hearing a simple “Thank You” from either patients or their folks is enough to wipe the stress away.

Source: NursingCrib