NICU

I hemmed and hawed and procrastinated until my boss finally asked of my intentions. And then I did it. Hesitantly at first. Maybe a little nervously. And finally with a little more surety to my pen strokes.



I added my name to the list of staff interested in a full-time position in our new Level 3 NICU.

I've known this was coming since before I was pregnant with Zach. I didn't know how the cards were going to fall and which of us therapists were going to get to take on this new role. And how my name has come to be on the growing list has been a sort of journey.

When I first graduated with my RT degree, I swore off kids. Actually, it started before I even graduated. As a student, I was required to prepare a case study each semester. The patient population from which we had to choose changed each time based on the courses we had covered that particular semester. And these were really involved. Day-by-day summaries of care, tests, drugs administered. Appendices involving translations of every drug given, every side effect, every abnormal lab value. I think the shortest one I ever prepared was 60 typed pages. So my very last semester, we had to pick a NICU patient and I picked the preterm baby of a 13-year- old girl. And my baby's meconium tested positive for illicit drugs all the way up to 60 days after her birth. I was appalled. I was broken-hearted. I wanted to kill the mother. And the grandmother. And I wanted to take the baby home with me and give her a good home. I thought then that my heart just could not take doing that every day. And then I graduated. And my very first code as a credentialed therapist was a 6-month-old baby boy. He had been "napping" in a bed next to a bucket of mop water. The babysitter claims that she went in to check on him and found him submerged, head first, in the bucket. We did CPR on him for what seemed like hours, knowing full and well that there was nothing we could do to get him back. I'm not a drinker, but I turned into one that day, and for that day only, when I left work. And again, I swore I never wanted to work with babies. I can treat an adult who did something stupid to ruin their body. But a baby who is ill because of a stupid adult? I find it very hard to keep from being judgemental in those cases. And I took a position at a hospital where I thought I would never have to deal with it. A tiny rural hospital where I was the only night-shift RT. Ha! I guess it was the hospital's location at the midpoint between Cincinnati and Indianapolis, but we had "bad babies" all of the time. I figure it was because the moms didn't have time to get to the big cities and stopped there. But I resuscitated at least one newborn per night of work. That's when I began to carry certifications in NRP and PALS (Neonatal Resuscitation and Pediatric Advanced Life Support) to say that I knew how to resuscitate our smallest patients.

That's also when I learned that, although it wasn't exactly my favorite among my job duties, I was pretty good at it. And then something happened. I ran into a neighbor at our complex pool who kept staring at me. One day she finally approached me and asked if I worked at the hospital and what I did there. When I confirmed, she told me where she knew me. She had watched me resuscitate her grandson through the windows of the hospital nursery. I didn't remember her because I was focused on the baby, but she remembered my face from that night. I thought it was pretty cool, then one random day, she knocked on my door. When I answered, she was standing there with this blue-eyed blond little boy. She guided his hand to mine and said, "You don't know him, but he is alive because of your work." It was the baby. He was 2 then. And that had to be the most rewarding experience of my career to date.

Since then, as I have added years of experience under my belt, I have developed this love-hate relationship with caring for babies. First of all, if I am involved in their care, it is usually because they are pretty damned sick. That alone is sad enough. And then I find it hard to keep from seeing my own children in their little faces. I can treat dying adults all of the time. But the kids? The babies are the ones I take home with me. The ones I internalize and carry with me. The ones who form the emotional challenge behind my work.

So I have done some soul-searching. And I have determined that I am tailor-made for the job. My reactions to the sick babies shouldn't exclude me from the role of NICU therapist, but should actually be a qualifying factor in my selection for the job. Because over the years, I have become hardened to adults. But not kids. Never the babies. And after 2 horrendous pregnancies, I realize that I am the type of person I would want caring for my critically ill baby--someone who actually cares about them, who will cry when they suffer and celebrate when they are well. And when I look at the mom of a premature baby and say that I get it, I really do. As for the challenging logistics of the job? I am the type of person who is always looking to learn more and more. And if I am not challenged, I lose interest. What better patient population for me than our most challenging, most fragile? And as for my nervousness, I think it is healthy. You have to be a little nervous when dealing with any critically-ill patient, yet still be confident enough to do your job. Because no matter how sure of yourself you may be, no matter how arrogant and cocky, the critically-ill human body has a way of knocking you on your ass and showing you that you aren't as great as you originally thought. In that aspect, a healthy bit of nervousness keeps you on your toes.

And so my name is on the list. And I'm scared. And I know I'll cry. And there will be days when I hate my job. But I am also excited. We shall see...