The Little Itty Bitty Ones: a.k.a. premies in the NICU

Updated: Feb 27, 2019

I didn’t think it would happen but I fell in love with my Neonatal Intensive Care Unit babies. Here’s how it went down: Sign out prior to the beginning of the rotation: From the Intern finishing up her rotation: “everyone just survives this rotation, be prepared to write lots of total parenteral nutrition orders (TPN).”  Sign out ended with me congratulating myself that I hadn’t started crying just hearing how sick some of my new patients were. Day 1: Examining those tiny babies had to be the scariest thing I have done in my life. I’m used to 6 pound babies in newborn nursery, not 1 pound babies who are ventilated and in incubators. I made it, my patients made it. I’m used to talking about urine and stool counts and giving breast feeding advice. I’m not used to talking about glucose infusion rates, assist control ventilation, bubbles CPAP, and making split second decisions based upon arterial blood gases and urinary output. Weeks 1 - 2: struggled with patient management, presentations, note writing (many nights I finished around 10pm), and TPN. Struggled with missing Zo’s bedtime. Weeks 3 - 4: started getting used to the routine and began enjoying deliveries (dry, stimulate, and ventilate). I also began enjoying the daily mechanics of managing my “feeders and growers” and even got to do a really cool creamatocrit to assess the nutritional content of a patient’s maternal breast milk. Surprisingly, I also started to really like managing my complicated patients and the daily brainstorming that goes on with our consultant specialties. Establishing relationships with the parents was really the best thing about this time and the staff who work in the unit are outstanding and know their trade exceedingly well. On the homefront, I still had not gotten used to the lack of sleep and was really started feeling badly about how junky our house was becoming and how my husband had essentially become a single father.   Week 5: started feeling the first tinges of confidence or was that my upper respiratory illness superimposed with sinusitis and a head full of medicine? I guess I’ll never know, but I was sad on my last day. Sad that I had to sign out to another Resident (who I totally trust but still they are “MY” patients and families). Sad that I was just starting to become confident and then bam, on to the next rotation. Sad that I wouldn’t see the daily progression of the little itty bitty babies who had surprisingly stolen my heart.

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