The tiniest patients receive the best care at East Tennessee Children's Hospital's Haslam Family Neonatal Intensive Care Unit (NICU). Many staff members, including neonatologists, nurse practitioners, nurses and patient care assistants, put your baby's health first. Each year, more than 600 babies are treated here. Some are born premature, while others are brought in after encountering complications at birth.
This virtual visit is designed to ease fears about your child being admitted to the NICU. If you know that your baby will be coming to the NICU after birth, we hope this information is helpful. The success of the unit speaks for itself. Ninety-seven percent of the babies treated here eventually go home.
The following is the story of a fictitious mother, Carlota, and her daughter, Ines, who was a patient in the NICU.
Hi, I'm Carlota. Recently my husband and I had our first child. However, because of some complications at birth, our daughter, Ines, could not come straight home,
but instead came here to the Haslam Family NICU at East Tennessee Children's Hospital. Along with all of the normal fears new parents face, we also had additional worries about her hospitalization. The staff in the Haslam Family NICU understood what we were thinking and feeling and gently helped us through Ines' stay. Ines is now home and is doing great. I would like to tell you about our stay in the Haslam Family NICU so that hopefully yours will be easier.
When you first arrive on the Fifth Floor, you will see a sign for the NICU. Press the button outside the door, say you are here to see your child or grandchild, and a nurse will let you in. This security measure is put in place to protect you and your baby. When you arrive the first time, a nurse will explain the entire unit to you.
Once inside the NICU, you'll notice a wash area. Here you'll be asked to carefully wash your hands and forearms for three minutes. Then you must put on a gown over your clothes, and the NICU secretary will take you to your baby.
Inside the NICU, you will hear and see many different machines, some of which have "alarms." These provide vital information to the nurses and doctors about your child.
Ines' bed was called a radiant warmer. Ines had a little probe placed on her skin that measured her temperature. When she was warm, the bed cooled off, and when she was cool, it warmed up. That way she didn't have to use any energy staying warm, and she did not need any clothing.
Other babies were in isolette beds that resemble a clear plastic box. The environment within the isolette can be controlled to closely resemble the mother's womb. There are arm holes on the side of the isolette so that parents and nurses can still touch and care for the baby.
All of the babies in the NICU are on monitors, so you might hear lots of sounds when you come in. Don't be worried. The staff know what the alarms sound like, and there are always nurses, doctors and nurse practitioners in the unit. The monitors check heart rate, breathing and blood pressure.
Ines had a little probe on one of her feet to check her oxygen level through pulse oximetry. If the doctor believes a baby needs oxygen, there will be a little hood over his or her head. Don't be worried -- it just gives the baby a little bit of warmed oxygen. Some babies had a breathing tube in their mouths because they needed extra help with breathing. The tubes were attached to a machine called a ventilator, which helped them breathe.
Ines also had an IV in her arm. This may move locations several times in some babies. Babies don't know how to hold their arms still, so sometimes nurses have to reinsert the IV in a new location. Ines moved around a lot, so they had to relocate her IV several times. Some babies have their IVs in their umbilical cord or belly buttons, or even their head. It looked a little scary, but the nurses assured me that it doesn't hurt the babies to get their fluids this way. Also, Ines' blood work was drawn from her heel, so there was usually a little cotton ball on her heel, but this is very normal.
Each baby has his or her own equipment at the bedside. Ines had her own IV pole, pump, scale and stethoscope. Aside from the equipment, which is specially designed for babies, Children's Hospital also has several specialists on hand to assist in the babies' care. Those specialists include neonatologists, who are doctors specifically trained in pediatrics and how to care for critically ill babies.
Nurse practitioners are advanced-practice nurses who specialize in the medical aspects of your child's care under the supervision of a neonatologist. Children's also has social workers who are trained to help with any aspect of family care, whether it is finding assistance with your family at home, or having someone talk about your concerns. Since I decided to breastfeed Ines, there were lactation consultants who gave me information and answered my questions.
Ines slept in a cotton snuggly that wrapped around her and gave her some boundaries. It helped to make her feel like she was still inside of me, which provided some security. We were encouraged to talk to Ines and hold her once her condition permitted. The nurses also told us not to pat Ines, but to gently touch her instead. They also told us to put our finger in her hand because newborns like that. Most babies heal faster when they are loved, caressed and encouraged by loved ones.
For a while, Ines also had phototherapy lights over her warmer to treat jaundice, which is common in new babies. When the doctors said it was necessary to have the lights on, the nurses put a phototherapy light protector mask, or a bili mask, over her eyes to protect them.
Visitation is limited to two people at a time because of the space available in the NICU. Visitors are welcome all day and night, except between 6:30-8:30 a.m. and 6:30-8:30 p.m. because staff give reports at that time about each baby's condition. We were also sometimes asked to step out of the NICU during emergencies or new admissions during regular visitation hours.
The nurses encouraged us to bring in some of Ines' toys, as well as music and tape recordings of our voices to make her feel more comfortable. We brought a teddy bear that Ines' grandmother bought for her and a book that I loved when I was a little girl.
When Ines was well enough to go home, the staff made sure that we knew everything we needed to do to keep her healthy, including feeding, diapering, caring for the umbilical cord, bathing, infant safety, and keeping our home "baby friendly." They taught us about proper car seat installation, and we took a class in infant/child CPR.
The great staff in the NICU made our difficult situation much less frightening.