I'm a neonatal intensive care nurse AMA

[skinnytobe]

In view of the news of a very public trial of a neonatal nurse

Please ask me anything I will do my best to answer

5 years in a level three surgical unit

thank you for the work you do, and also for this thread

@FTMFML I chose neonates because I myself had a 29 weeker, a 32 weeker and a 33 weeker 😊

Thanks for answering, sounds sad but similar to the other areas of nursing 😊

How are they all now?

My first child was born at 28 weeks and spent the first 6 weeks of his life at the NICU. He's now at Uni. I feel nothing but gratitude for the NHS that supported us every step of the way and the unbelievably dedicated nurses that cared for him. Thank you and your colleagues for the amazing work that you do. Truly.

Do you sometimes feel that we are doing things because we can and not because it's right for the child?

How long did it take for you to get your head around drug calculations for neonates?
And when did you stop feeling Uber anxious when giving meds to teeny tiny babies? 😊

Do you feel eternally gratefully that not one of your patients weighs more than a few pounds?
You & your colleagues must have super healthy backs! (Adult critical care nurse here…)

@Nevermay they are 13, 17 and 21 now and fine thank you 😊

Absolutely too often. 🥲

The more complex ones still fry my brain sometimes! The corrections of calcium, potassium etc 🙈😂

Thankfully all out cots and incubators raise up to a height that suits us. So my back is fine! My elbows though! Are buggered from lifting at the elbow

Thanks so much, I really appreciate it! I feel so conflicted: so grateful for what they did for my wee baby and so deeply angry and hurt for what they put me through.

The power imbalance between staff and parents is horrendous, and some staff definitely take advantage. Us wanting to slowly introduce breastfeeding to ensure continuing weight gain, instead of moving all feeds to breast in one go (or allow bottle feeding, which would create hugely more work long term for me), was written up as us 'not wanting our baby to progress', where we just wanted to take a considered approach. Nurse pushed through, and baby really struggled that week. I was stuck expressing and bottle-feeding for the next year, as I wanted to give the benefit of breastmilk to baby. We experienced the 'we will write you up' as quite threatening. And this was the most minor (and least identifying) incident in our months there.

Wishing you the best in your work. The good ones made such a difference to our day.

My little girl wasn’t in the unit, but she had suspected meningitis so we had to stay in for almost two weeks. The NICU nurses came out to us on the ward to do her antibiotics three times a day and they were so gorgeous with her. Her cannulas kept coming out and they’d have to keep putting them back in, they were so patient and kind. Not just to her, but me as well as I was in a bit of a state over the whole thing.

So no questions, but just in case you were wondering if us parents forget you, no we don’t. We remember you and feel so grateful for you when our toddlers who were unwell at birth dance in circles outside the doorways of shops that are playing music and point out unicorns when they’re just about to turn two.

I don’t know where I’d be now if you and your peers hadn’t looked after her then.

Without a doubt

Could you please offer me more information, my 14 year old was born at 28 weeks, weighing 1lb 10oz and I just feel exasperated by him at the moment. Was it the steroids or the brain injury?

What changes or advancements have come into practice in the last few years? My first was in for 4 months in 2012 and things had changed even by the time my chunky 29 weeker came along 2 years later, I'd love to know what else has advanced in the last decade or so.

Still around to answer...

@skinnytobe How you handle care when it conflicts with the parents wants against what a consultant advises is best for baby … such as if nothing more can be done but a parent just wants to try to keep their baby alive no matter what.

We are generally guided by parents. If baby is comfortable on the ventilator we will wait until parents are ready. Some are ready quickly some take days/weeks.

It's hard for us as nurses because we know it's not in their best interest so it's upsetting but I always do my best to make sure the baby is comfortable

another one saying thanks for all you do...
my DD, now 12, was born at 37wks, weighting just over 2kg but with a previously undiagnosed diaphragmatic hernia. She had surgery at 2 days old, and I still remember the care and compassion the staff in ICU at Edinburgh's Sick Kids hospital showed us. I remember 2 nurses there taking 30 minutes to transfer my tiny baby, who was hooked up to what seemed like. million machines, from her cot to my arms so I could hold her for the first time.
but I wanted to ask about staffing - back then it was one ICU nurse to a bed, but I wondered if this was the same, or if staffing had suffered with all the pressures we see the NHS come under?

@DeathStarCanteenGal

My fave part of the job is helping parents have their first cuddle 🥰

We do still have guidelines in place

Itu patients one to one care

High dependency patients one nurse to two babies

Special care - one nurse to four babies

To answer your question, no it doesn't work like that because of nhs staffing issues

neonatal nurses undertake further training which makes us Qualified in Speciality - QIS. We are known as the experienced nurses on the unit,

We've lost over 25 QIS nurses in the last two years, we used to have 8-10 QIS nurses on each shift, now we have 3-5 QIS nurses, it's those nurses that take the complex ITU babies usually.

We quite frankly don't have the staff these days so newly qualified nurses who have yet to undertake the QIS training are taking these babies with the support we are able to offer at the time, or more often that not a QIS nurse will have two ventilated patients. Plus the emergency bleep to go to deliveries when that goes off,

Thankfully we have now reduced our cot numbers and it's more manageable, when I started my NICU career 5 years ago there was 20-23 nurses on each shift.

My last shift there was 11. There's a shift coming up this week where there is only 9.

It's breaking us, my DP is genuinely worried about my health atm because I'm so sad all the time because of work, I'm told all the time by many people that I should find another job, and I have seriously thought about it. But in all honestly I adore my job, I love being with the babies, I had three babies myself in nicu as a mother, I love supporting the parents like I was. And I can't imagine doing anything else

In my hospital, a baby is better off on PICU because the staffing is better.

@BusterGonad not a nurse, but am a 28 weeker myself with ADHD. My DPs were advised by my consultant there’d be a link between ADHD and pre-term birth, which turned out to be accurate. So I guess possible there may be links with other things. I had some really good information provided to me on this from the SENCO at hubs school

My son was in NICU for 4 weeks and there were a couple of good, empathetic and helpful nurses. But many were quite frankly horrible to me and my husband and made a traumatic experience so much worse. For example, I heard nurses talking about me, they said I was “over handling” my baby because I kept asking to do skin-to-skin; they’d go out of their way to tell me to put my son back in his cot to “rest”, they’d remove the privacy screen when I was having skin to skin to make me uncomfortable, etc.

Do you think NICU staff truly understand the trauma and stress that these parents are under? Or do you think that because you see so many people you start to become numb to it?

I would often think to myself I would rather sit in the chair next to my son’s cot overnight because I couldn’t bare to leave him. But I was told to leave him and I followed orders, but it was unbearable. To think of Lucy Letby harming those babies, the most defenceless and vulnerable humans , makes me sick. If I had another baby in NICU I would never leave there bedside.

I think there are some nurses out there who lack empathy.

Hard for me to answer that question because I've also been the nicu mum on the other side.

Often parents are told to rest, especially mums when they have pre terms because it can affect their milk supply. I've never told a parent to leave horribly. I've kindly suggested they get some sleep, but it's ok if you want to stay all night. I did it!

Same in my hospital. They have protected staffing numbers. Because they are intensive care. As are we. The mind boggles, this is my main grievance atm. They often leave us short to cover picu.