My pride ..

I know it is difficult to understand something that you've never experienced, and this is why I am writing this now. It is now that I will do my best to help you understand what it is like to be a NICU nurse.

This is sparked by several recent questions of "What exactly do you do?" and of comments overheard by parents asking "That other baby is a "normal" size .. why is he here?"

I go to work, prepared for nothing. I could have a day where I bottle feed growing babies or explain to a family that today might be the last day they see their baby alive. Expectations for how a day will go are almost never met.

For the rest of this post, I will use the term "we", as there isn't a day that goes by that a child in the NICU isn't cared for by a team -- every last one that depends on the other. In our NICU, we are family.

We get babies so small that we can't save them, we get babies that are "just old enough" to TRY to save, we get babies that we MIGHT save, babies who aren't breathing, those that are completely blue or those that are screaming on the top of their lungs. Some days, we get babies that we're certain will be perfectly fine only to find that the next day we are bathing them for the last time. They may have tumors or look perfect, weigh 12 pounds or weigh one pound. They may need respiratory support or they may breathe perfectly fine on their own. We might be able to feed them a bottle or they may not receive milk for weeks. Some go home in 48 hours, others go home five months later.

On a day to day basis we do blood cultures, change diapers, teach parents, start IVs, give medications, fax orders, make phone calls, draw labs, bottle feed, assist with PICC insertions, assist with lumbar punctures, give tube feeds, mourn with parents, celebrate with parents, comfort parents, suction airways, measure bellies, check sugars, monitor vital signs, do assessments, hang fluids, calculate fluids, collaborate with doctors, physician assistants, nurse practitioners, specialists, occupational therapists, physical therapists and speech therapists. We praise the heavens for our HUCs, our respiratory therapists and our social workers. We give blood, take babies to x-ray, MRI and CT, we give baths, teach parents how to give baths and ohh and ahh over the tiny preemie outfits we get to dress our growing patients in. We monitor oxygen saturation, respiratory status and our respiratory equipment (oscillators, ventilators, CPAP, nasal cannulas and oxygen hoods) along with our fantastic RTs. We hold babies still for eye exams, ECHOs, ultrasounds, x-rays, eye injections, needle sticks, circumcisions, intubations.

We celebrate the days we get to roll our babies out of the unit in a red wagon, we mourn the days we have to walk through the dreadful basement to the morgue.

We admit babies who are so unstable that we are unable to leave their bedside all day. We discharge babies who need no continued support, medications or specialty care.

We admit babies who are only slightly sick, who need only moderate observation. We discharge babies who have tracheotomies, go home on a ventilator, get fed through a tube in their stomach and have pages of medications that their specialists will need to continue to monitor.

We see miracles. We ask ourselves, "Why?" Sometimes, we cry. Mostly, we are strong.

Our feet ache the days they feel 12 hours of standing. Our heads pound the days we think we can't store one more bit of information. Our hearts break to see both patients and parents suffering.

Our ears are grateful for swings, pacifiers, bouncy seats. Some days we snuggle our babies all day, other days not only can we not hold our babies -- the parents may have never held their baby. This can be true, even after several months.

The parents .. their kind words are sometimes what keep US going. Even when they are breaking, they still find the time to give us praise, give us love, show us thanks.

Their visits back to the unit and updated pictures make our days. Our hearts shine when we see a patient who can now smile back at us, who can walk, who can say their favorite word. And the parents? They are proud. They SHOULD be proud. THEY are strong.

This, my friends, is the physically, emotionally, mentally draining job that I praise God for. It is the job I have longed for my entire life. It is the dream I have given myself, even though the origin for the desire is unknown.

I am a NICU nurse. I am PROUD.