Thursday, March 29, 2012

SCR270. 4751
Prof. Teano
Mar 23, 2012
Jihwan Lee

NICU Observation

Image credit: Fit & Health

            The clinical rotation has been going smoothly and I find myself more comfortable being on the maternity unit than the first day of clinical.  Pregnancy and caring for pregnant women are a lot more complicated than I ever thought and I am so glad that I am learning about the miracle and wonder of life.  Today, I was also excited about having an observation in the Neonatal Intensive Care Unit (NICU).
            There are two rooms with six incubators, respectively, in NICU.  The rooms are equipped with cardiorespiratory monitors, infant ventilators, scales to measure newborn babies’ weights, and some other medical devices.  The babies in NICU were relatively smaller than term babies due to prematurity.  The nurse who I shadowed emphasized hand hygiene before and after taking care of each baby. 
            The baby, Williams, who I was assigned to was 20 days old and was born at 32 weeks gestational age.  Williams was admitted to NICU for prematurity and respiratory distress syndrome (RDS).  The boy was born prematurely, but his Apgar score was 8/8 which is considered a healthy score in general.  His mother had abruptio plancentae and came to the hospital bleeding due to premature rupture of membrane (PROM).  Williams’ chart says that the amniotic fluid was lightly blood stained, but there was not anything in his chart about what might have caused PROM such as maternal infection, smoking, or GDM.  I felt sorry for the mother since it was her first pregnancy and she had such a hard time, but Williams was doing well and also was gaining weight slowly.  Luckily, his RDS was resolved the night before my clinical day and his TPN regimen had ended since he got better and could tolerate breastfeeding.  His cardiorespiratory monitor went off just a couple of times when he cried, but mostly he was very stable and the nurse just checked up on him once in a while.
Image credit: Shishu Mangal Hospital
            What I found more interesting happened towards the end of my day in NICU.  A nurse came and said a baby at 37 weeks gestational age would be admitted soon to NICU.  Then the nurse who was taking care of Williams and another nurse prepared an incubator, and a person came to NICU to set up the infant ventilator.  When the newborn baby came to NICU, the NICU nurses got busier and started taking care of the male baby.  The doctors who delivered the baby were giving report to the nurses about the boy’s physical condition.  I cannot remember the order of the care that was performed by the nurses since a lot of things happened in such a short time.  For example, after they wiped the baby, a nurse put a hat on him, and they measured his weight and height.  The boy was transferred into the incubator and the nurses put several electrodes on his chest and abdomen.  A nurse tried to insert an intravenous cannula on the back of the wrist, but she failed a couple of times so the other nurse inserted the cannula on the other wrist.  They also inserted a nasal cannula in his nose since his lungs were not mature and there was something wrong with them.  His chest was vigorously pumping up and down as he breathed heavily.  It was very informative as well as interesting to see what medical assistance is performed for a premature baby in NICU.

Image credit: Baby Funny
The babies in NICU reminded me of my mother.  She had me through a c/section.  I was not a premature baby, but my mom was not in good shape, and I was not a planned baby, either.  She was not able to go through normal vaginal delivery.  Even after c/section, she was so sick and tired that she could not breastfeed me, so I was fed formula. However, I really appreciate that my mom and dad decided to have me and raise me with a lot of love and care.  I learned a lot about infant care in NICU today and am looking forward to going to L&D next week.