Today’s “What It’s Like” post hits me in all the feels, as Kirsten and Logan both spent time in the NICU, with incredible nurses caring for them. While our author today wasn’t one of their nurses, I can’t help but wish Jette had had the chance to care for them. Her caring heart and gentleness seep from her words and I hope you join me in praying for her and her husband as they wait to add a baby of their own to their family.
Enjoy reading this feature, what it’s like to be a NICU nurse!
* the story included is fictional, an amalgamation of various interactions over the years and not reflective of a single patient story. All patient confidentiality has been protected.
I walk into work and see her* sitting quietly at her baby’s bedside. As I carefully clean my fingernails, scrubbing like a surgeon in preparation for my time at work, I watch her carefully touch her baby. Maybe they are in an isolette, protected from the world- sights, sounds, smells and temperature controlled precisely. She watches the monitor hanging above the bed, telling us all about her baby’s heartbeat, breathing, and oxygen saturations. The ventilator hums, and when it makes a sudden sound, mama jumps expectantly, looking around to make sure she is okay. This is definitely not what she planned for her sweet babe.
As I get report from your dayshift nurse, I hear her story for the first time in clinical terms and start to translate. A G3P0 delivered for pre-eclampsia, received betamethasone, magnesium sulfate, and recovering from a C-section. What this really means to me: she did everything she could to take care of her baby, to keep her inside where she was safe, but now the baby is here… two months early. She sits with vigilance at her baby’s bed, because there are two babies she’s lost before this little girl arrived.
After report, I come over and introduce myself. I tell her that my plan is to help her baby rest and grow tonight, and to provide the support she needs to oxygenate, digest and maintain her vital signs. I ask if she has any questions or requests, and she shakes her head with a small smile. I ask if you’d like to hold your baby tonight, and her eyes grow wide, half moons staring back at me in the dimmed light. “Are you sure that’s okay? Is that too much for her?” she asks. “No, she needs to feel you and smell you. And you need her too, mama. You are the best medicine we can give her,” I reply and smile. She looks terrified.
I begin care time, taking her temperature and listening to her heart and lungs. I assess her from head to toe, though it may not look like I’m doing much… I touch her head, I watch how hard she works to breathe, assure she is perfusing her whole body with blood, feel her belly to make sure it is soft. I have mama help me, cupping her head and feet to provide boundaries- helping her to feel safe in this new space, with so much room, almost too much space. We weigh her together, and her husband comes in. He is so excited and nervous, asking protective questions like “does moving her head like that hurt her?” and “be gentle, she’s so tiny”. After close to a decade working in the NICU, I know he needs to be included, supported too- so I reassure him, explaining each step as I go, and assign him jobs as we start to prepare for the transfer from bed to mom. “Now dad, your job is to watch the breathing tube and make sure she doesn’t pull on it. Then you need to make sure mom gets lots of water, and take all the pictures you possibly can.” He looks determined, set to make sure he can do this.
She’s tiny, but not the smallest baby I’ve seen. She’s hearty to me, and I know she’ll do just fine when she’s in mama’s arms. But this is brand new to her mama and we go slow so she will feel safe. She gently holds her body in your arms, and I hold all her IV tubing, the tangled spaghetti wrapped along one arm, and her breathing tube equipment in my other hand, keeping all her lifelines intact. She slowly sits back, and I quickly work around her, straightening and securing, repositioning so the baby is chest-to-chest, heartbeat to heartbeat with her mother. I wrap a blanket over them both, dad is beaming and snapping pictures frantically over mom’s shoulder. Almost in disbelief, she looks up at me. “Is she okay?” she asks, “She is perfect. She’s settling right in. This is exactly where she wants to be. You’ve worked so hard for this, mama. Relax and enjoy your baby”, I respond. Suddenly, dad looks at me with tears in his eyes. “You have no idea how hard we’ve worked for this,” he says, and begins to share the story- the heartbreak, the loss of hope, and unexpected joy when the stick turned pink this time. He talks about the other babies, and you are both crying now. I’m holding back tears, trying to find the right words to express my understanding. “Your other babies are looking down on her now, sending all their love and protection to their sister,” I say, and we all cry now. It is such a special privilege to be a part of this moment in your life, to hold your story in my mind and heart.
Sometimes endings aren’t happy. The grief I carry for that mama, when she leaves with empty arms, is more real than she may ever know. Her cries are seared on my heart; I hear them in my sleep. Long after the tears have fallen, and I’m alone with the body that held her baby for a short time, I bathe them and tell them how loved they were. I say a silent blessing- the same one I say when babies get to go home happy and well: The Lord bless you and keep you, the Lord make his face shine on you, and be gracious to you; the Lord lift up His countenance on you and bring you peace. I will always hold these memories- her little one is not forgotten. It is an incredibly brutal privilege to be part of the darkest moments in someone’s life, to see the loss and experience grief alongside those who are suffering.
NICU nursing involves science and art, putting together the clinical picture when a baby isn’t “acting right” and figuring out what this little being needs when they can’t use words. I love the mystery, the uniqueness of each patient, blending years of training and experience to provide care. I partner with an incredible team of physicians, nurse practitioners, respiratory therapists and many others to ensure we are caring for the whole being, seeing the big picture and the small details. Who knows how many future teachers, lawyers, mothers, and presidents I’ve cared for in my time at the bedside. Working with families is a joy as I watch them grow together and care for their baby over time. Having a baby in the NICU is scary and unexpected most of the time, and to help a family bond while in an unplanned setting is really rewarding. I know that many families won’t remember my name or what I said, but I hope they remember that I tried to make them feel welcome, at ease and comfortable being parents to their child.
At the end of my shift, I know the work that I do truly matters. I am blessed to share in these moments, and it is worth it every time, to see the miracles unfold and see each family come together. Supporting and caring for these precious babies is a gift to me, and I am so grateful to do this work.
Jette is a NICU nurse who has worked in the Midwest for 7 years. She’s done high acuity NICU transport, administration and everything in between with neonatal intensive care, and is currently in school to become a neonatal nurse practitioner. When she has a free 20 minutes between work and school, she loves hanging with her husband and cats, reading Harry Potter for the thousandth time, and drinking copious amounts of coffee. She and her husband have struggled with infertility for five years, but continue to hope and pray for their dream to come true. You can connect with Jette on Instagram at @Jettebens.