I'm a Neonatal Nurse AMA

[CasualDress]

Hi just thought this might be of interest to some people.
I've name changed to keep this separate from my other threads.
I'm going to work shortly but promise I will answer any questions when I get home.

Which do you prefer - working in SCBU, generally calmer with a lower ratio of staff:babies, or ICU where there's more staff and more action?

Also does your unit offer psychological support to the staff when a baby you've cared for/helped to try to save, dies?

whattime I love scbu. We have a ratio of 4 babies to one staff. I just like the busyness of scbu, getting babies ready for home, doing bottle feeds, baths and cuddles
ICU is a totally different kettle of fish, can be really stressful. Usually 1 to 1 but often 2 to 1 because of staffing.
We have got a brilliant family support sister who is brilliant to chat to aswell as a 'helpline' we can access
Usually when a baby dies there is a meeting for whoever was involved or whoever feels they need to talk about it.
I feel we have a good support backup.

Thank you so much for a very difficult (but rewarding) job.

My husband was born at 24 weeks in the mid 80s. They really didn't expect him to make it and he was in there for 4-6 months, can't remember how long his man said.

He's completely blind (but was born with shape vision but lost it due to glaucoma) but otherwise completely healthy. He's one of few blind people to climb to Everest base camp.

notanother wow! what an achievement to climb Everest!
I don't think many 24 weekers made it in the 80's technology has come on leaps and bounds since then! imagine his poor mum having him in nnu for 6 months, the mind boggles!!

Hi OP. I also wanted to echo the sentiments of previous posters in saying a huge thank you for all you do.
My niece was born at 23+5 and is doing wonderfully at 8 years old. Some areas of difficulty but minor in the scheme of things.

My question is about my little boy. He was born at term but was rushed off to HDU because he aspirated and was born in respiratory distress, later diagnosed with congenital pneumonia and ?meningitis. The care was amazing but I really struggled because he had four failed lumbar puncture procedures and I was told these likely failed because he was dehydrated. I was doing my best to breastfeed but because he had tongue tie, breastfeeding was not going well. I still feel desperately guilty that he had to go through that and it was my fault it didn't work (though I was expressing and syringe then bottle feeding my milk). Is LP really awful for babies? Is it sometimes hard to get the CSF out?

I also wondered how common congenital pneumonia is and whether you know if it has any long term effects?

Another thank you from me. Ive had two preemies, the most recent one a 25 weeker. The support that the staff gave me both times kept me going I think. My daughter (25 weeker) kept having to go back into the isolation room and I remember the staff put my blanket on the chair and got it all cosy for me. We were one of the longest residents at the time. And when they rang me to say that she was very poorly and we had to get to the hospital, the compassion and professionalism was second to none. Answering my endless questions and helping me do their cares. Dealing with the tears due to the never ending roller-coaster that is the Nicu. I shall be forever grateful, not something I'll ever forget.

Hi,
Im an adult student nurse in my first year but would love to specialise in neonatal.
Is it true that after 5 years in the field I wont be able to go back to adult nursing?
Also is there any tips or good books I can read to get a better insight?
Im waiting to hear from bliss about volunteering in my trust atm.
Thanks.

raratonga please don't blame yourself for the failed LP
it is a tricky procedure, More so in term babies as they have more fat to get through! Where I work it's a 3 man job!
we wrap baby in a blanket with its spine/bum exposed on the edge of the table., A nurse will hold baby still, trying to bend the spine a bit like a banana shape aswell as giving baby a dummy or gloved finger to suck. Dr will carry out the procedure and another nurse will catch the fluid in a sterile pot.
We always give babies sucrose before the procedure as it acts as pain relief and calms them. It is not an easy job!
Congenital pneumonia is fairly common and I've not known it cause long term problems.

violet sounds like you were a well loved part of the furniture
It certainly is a roller coaster ride for a lot of parents. I'm glad your experience was a good as it could be

giveovermyprecious
I've not heard that about neonates. I know if you did child nursing like me, you can't do adult nursing. But if you do adult nursing you can also work in paediatrics.
I'm.sure your uni should know about the 5 yr rule but I'm sorry I don't know.
I'm sure if you contact the matron on your local nnu you will be able to do volunteering. We have a big student turnover and some do volunteering along side their course.
As for books, it's an oldy but I don't think you can go wrong with 'neonatal intensive care' by JM Rennie and NRC Roberton.
Good luck!

Thabk you so much for your advice. :)

Another saying a big thanks.
My dd4 had a stroke at birth caused by a blood clot. Most of our time in there is a huge blur but I do remember how lovely the staff were.

Could I ask tho, would you know how you treat a baby who has had a stroke?

I know for the first two days no one knew why she was stopping breathing. She was then sent for an MRI which confirmed brain damage/ stroke. I don’t know what was done to help this if anything. The next morning upon visiting her she had pins in her head as they said she was having seizures, they gave her medicine to stop them but what could that have been?
After that she recovered slowly and got better and better.
As I said the whole experience is a massive blur.

Thanks if you can answer any of my questions

melmo I'm sorry to hear your DD had a stroke. It is something that is quite common. The pins in her head would have been the 'cfam' machine that records brain activity.
Usually a stroke is suspected if the baby appears to have seizures and/or stop breathing but behaves 'normally' in between times.
Treatment these days is 'cooling' which means slowly bringing babies temp down for 72 hours then 're warming.
Reducing temperature protects the brain from damage and I've seen some brilliant outcomes from this. it's a relatively new treatment but is becoming popular. But the cooling has to start within so many hours for it to work.
Lorazepam or medazolan are common treatments for seizures.
Hope that helps x

Thank you casualdress
You have been very helpful.
We won’t ever know everything that happened after DDs birth but thanks to all the work on her nicu we have a wonderful 5yo daughter still here with us. If it wasn’t for the staff like you we would have lost her {flowers}

thankyou melmo

Hi there and thank you for setting up such a generous and helpful thread.

My baby is in the NNU and I'm very lucky, she is doing really well. I am incredibly grateful for everything the nurses are doing. However, I've just had an incident that has knocked my confidence and I would love to know if this is due to something I've caused myself. My little girl has just done an incredibly smelly, albeit yellow and runny, poop (!) She's 7 days old and was born at 33+4. I'm expressing well and she's just started having a go at breast feeding. But the nurses looking after her have told me my diet has caused her to have a poop that apparently smelled so abnormal they wanted to send off a sample (although they didn't.)

I eat very well, all home cooked food and I like the odd spicy pasta dish. I still eat the same as I did when pregnant. Could my diet really be jeopardising my DD's health?

Hi Glasto and congratulations on DD
I'm sorry youve had your confidence knocked. It sounds like you are doing really well with the expressing and brilliant if
DD is going the the breast already.
Food you eat can affect baby's stools but is rarely cause for concern. The fact that it's yellow is a good sign. some poos do smell really offensive and if they continued to be smelly we may send a sample in case if infection, but usually baby shows other signs too if it has an infection.
What you eat won't cause the baby to have an infection!!
I wouldn't worry atall, you are doing really well, it's just one of those things. How's her poo today?

Just wanted to say thank you for the job you do! My iugr 29 weeker spent 12 weeks in nnu and i think the nurses looked after me as much as they did him (i wasnt even in the same hospital for the first week!). I worried i was being a pest going back to visit every 6 months or so but u have reassured me on that!
One question - my babys high flow oxygen had been reduced & he was doing really well & was going to be moved to SCBU. I went downstairs to phone DP and when i came back 10 mins later the nurses had had the results of blood tests (?) And ds was back on max level of high flow, had a long line back on & started antibiotics. I was so stunned i never got a grip of what had happened, would you have any idea?! And is a backwards step like that common? He was also off oxygen for 10 days later in scbu only to end up back on it till he was 12 months old!

My son was born at 28w+3 and had IUGR due to reverse flow of umbilical cord. He was very small for his gestation at 1lb 10oz and had various issues but nothing too terrible. He came home at due date as I put him on formula at the very end to get his weight up as I couldn't mentally handle him being in hospital any longer. He is showing signs of autism now which is hard for me, so my questions are do steroids before birth to help the babies lungs increase the likelihood of autism in prem babies? And could my undiagnosed (at time of birth) of crohns disease have caused the problems in pregnancy? Many thanks

Oh and he's now 9 years old and very elfin looking, features and small frame. He's a year below at school due to being emotionally behind, gets upset easily, cries a lot, can't handle being touched (poked, made fun of) or knocked into by other children.

And he wears glasses has week teeth and generally has weakness everywhere, so much so that his teacher thought he'd had lots of time if school due to an illness or something (he changed schools so she didn't know his full history).

I find life with him frustrating as it's like constantly pushing a donkey up a hill. I sometimes wonder if he has ODD. You buy new shoes, he wants the old shoes, you go to the beach he hates the sand and sea then once he's in the sea he won't get out! 😣

Another thank you for all you do for the babies and parents! I was born with TOF but it wasn't diagnosed straight away so I ended up with double pneumonia. Once I went home I then re-fistulated and had to go back. This second stay was longer as my phrenic nerve was bruised during the operation.

My parents had been TTC for years before having me and a couple of stays in NICU was not the start to parenthood they were hoping for! But the staff made a big difference :) One of their favourite memories is the nurses' excitement at surprising them by having me outside of the iron lung when I could breathe by myself again :)

Thank you from me too. My boy was born at 40 weeks by planned CS due to gestational diabetes (they wouldn’t let me go overdue and couldn’t be induced due to previous CS). He was big, 9lb 4.5oz, but had underdeveloped lungs and was taken to NNU when they noticed his breathing wasn’t right at an hour old. At the time they suspected sepsis. He was in NICU for the first 3 days, he was moved on to higher level breathing machines over the first 36 hours but then started to improve and was eventually moved next door to SCBU. We are very lucky that he was able to come home after 9 days and has had no issues since. He was more than twice the size of the next biggest baby in there and that in itself was strange. The treatment and care we had was excellent, I was treated far better there than on the maternity award during a very traunatic time (my mum was also terminally ill and died the day he cane home). However I did feel like some of the nurses/ HCAs on scbu didn’t know what to make of this big baby! I also never got an explanation of why his lungs weren’t right. A consultant said it was probably the GD but the diabetic MW said she’d never heard of that with a term baby and thought it was unlikely. With the grief for my mum and everything else I didn’t follow it up at the time. Have you ever come across this? Thank you

I should say that whilst they suspected sepsis it luckily turned out not to be that and they put it down to his lungs just needing more time to develop. This seems to be relatively common in preterm babies bit I’ve never been able to find anything about it for full term babies.