NICU NURSING: more than just cuddling babies

When I tell people that I am a neonatal nurse I am often met with the response of “what’s that?” As soon as I mention the B word …. babies, I am normally met with the response of “aww babies how cute, I bet you get to cuddle them all day”. I’d be lying if I said that as neonatal nurses we don’t get to enjoy some newborn cuddles but that is really only a fraction of what we do.

There is still a lack of awareness surrounding neonatal units. Everyday over 300 babies are admitted to neonatal care. I’ve often heard NICU parents use the phrase “I never knew the NICU existed until my baby couldn’t live without it”.

Neonatology is a relatively new speciality in comparison to others and there is constant research into improving and advancing the care of neonates. In the last ten to fifteen years the survival rates of babies who are born to soon has increased.

Shakespeare once said “Though she be but little, she is fierce” this is the perfect way to describe these teenie tiny humans. I’ve looked after babies who weigh less than a bag of sugar manage to fight me as I struggle to reinsert their feeding tube. I have learnt so much more from a 24 week old baby who has undergone numerous surgeries than I have from some adults.

Neonates and newborns are fighters, they are strong, they defy what statistics and medical books say will happen to them. They are so resilient and of course they are flipping adorable.

NICU is busy, it’s fast paced and no day is ever the same. You have to be on constant alert to any sudden changes of clinical deterioration due to the fragility of these patients. The NICU world is a concoction of hourly observations, two hourly feeds, medicines, blood gases, making nests, skin to skin care and that’s just scratching the surface. Oh and don’t forget the occasional being puked on and weed on.

Some days you’re on cloud nine because you’ve witnessed the birth of twins or a long term patient is finally going home. Other days your world is shaken by a baby passing and growing their angel wings.

Walking onto a neonatal unit you’re normally targeted by nurses asking “have you washed your hands?”, lowering the risk of infection to this population is key and as NICU nurses we are obsessed with hand washing. You will then probably notice how hot neonatal units are; great in the winter and a nightmare in the summer.

You would probably expect the sound of babies crying to dominate the corridors and although you do hear the wails of babies, normally the sound of NICU is filled with an array of alarms. Ask a NICU nurse what they hear when all is quiet, before they go to sleep and I can assure you it’ll be the sound of alarms. Alarms from respiratory machines, alarms from the milk warmer and the number one alarm culprit is from the machines monitoring the babies vital signs. Neonates have under developed lungs combined with an immature nervous system which normally means they forget to breathe. This of course means alarms! This is just one of many health conditions neonates have to deal with.

Being a NICU nurse isn’t just about looking after babies; it’s about supporting the mothers who feel like they did something wrong in their pregnancy and supporting the fathers who feel like a spare part or that they might hurt their baby if they handle them. Some parents can go weeks without being able to hold their baby. Ensuring that parents are supported and empowered to feel like parents during such a difficult time is crucial.

One of the most enjoyable parts of being a NICU nurse is some of the incredible bonds you establish with your patient and their family. From parents telling you they will sleep well tonight because you’re looking after their baby, to watching babies grow and achieve milestones like transitioning from an incubator to a cot is rewarding.

Sadly reports from the charity BLISS found that 64% of neonatal units in England didn’t have the staff they need with two thirds not having enough specialist nurses. Nonetheless there are meant to be long term plans of investing into neonatal units to increase the number of NICU nurses so hopefully there will be some positive change to come.

I hope this provides some small insight into the life of a NICU nurse.

To my fellow NICU nurses I salute you and applaud you for all the work you do and to all the teeny tiny humans who have spent one day or sixty days in NICU here’s a shoutout for you to.