"To perform to the best of my ability and knowledge, life saving actions". In about a year from now, those words will be my motto and part of my code of ethics as a Nurse. Every day I will be held to the standard to provide to the best of my ability and knowledge, care to my patients.
Yesterday, my schedule for clinical was switched from Labor and Delivery (L & D) to the NICU (neonatal intensive care unit). Being a 'graduate' of the NICU personally, I spent the first 7 weeks of my life in a NICU in IN. My mom had 'preeclampsia' which is basically extremely high blood pressure, so much that the stress of pregnancy/delivery could possibly take the life of the mother and or the baby. They delivered me at 33 wks, weighing in at 2lbs 14oz. That was almost 29 yrs. ago! Technology has come a LONG way since then!
Myself and one other classmate were in the NICU from 5:45a.m.-2:30p.m., assigned each to one nurse. I was and still am a little nervous to be in that area, to be with the little babies who range in weight from 1 lb to 5lbs and from 25 weeks to term. What those numbers mean is this: 22 weeks gestation (pregnant) a baby is considered 'viable', meaning if it were to be born, he or she would have a slim chance, but a chance at survival. 38-40 weeks is considered 'term', meaning the baby will be fine to deliver, probably no complications w/ his/her development. Some of these babies in the NICU were born almost 4 months too early! Time is against them and every second counts toward their development. Everything is so tiny, from the baby, to the stethoscope we listen to their heart with, to socks, hats, diapers, wires that keep track of heart rhythm and lungs, needles, IV's, bottles and even CPAP masks. CPAP machines are breathing machines for apnea (absence of breathing). Some times these tiny little babies forget to breath because their lungs/lung capacity is not mature yet! The CPAP machine reminds them and fills their little lungs w/ pressure. The mask on them is probably no bigger round than a nickel, IF that!
My nurse was assigned to two little girls. One was a twin 31 wks, not quite weighing in at 2 lbs, whose sister is doing much better and will probably get to go home in the next two weeks. The other girl was 33 wks, probably about 2 1/2 lbs, doing very well, bottle fed for the first time and I was able to witness it! It takes so much energy for these babies to even survive, let alone drink half an ounce from a bottle...they get exhausted SO easily! Many of them get cranky when they are hungry or have a dirty diaper and when you mess w/ them, b/c for some, it hurts to be touched. Their skin is so sensitive. They like to be left in their warm, quiet, dark incubator! If they are fed, clean and warm, they will leave their nurse alone. But get them worked up and it creates a job!
Our day was going along smoothly, I had changed a diaper, listened to hearts and lungs, calmed one of them down who was cranky and followed my nurse like a shadow! Out of the blue our 33 wk girl set off her heart monitor. Her heart rate was rapidly climbing past 290! Normal heart rate for adults range around 60 beats/minute, babies range from 120-160/minute. Hers was NOT stopping at 290, the highest number recorded was 313! DANGEROUSLY high! The longer the heart beats uncontrollably, the more chance of failure, the more often it happens, the weaker the heart gets. But to look at her in the incubator, she was asleep, calm as could be! Her hearts rhythm had gotten itself out of whack 3 times, all 3 times the number climbed higher. The nurse was so quick at hitting the 'record' button to print out the heart rate, listen to the little heart and confirm 'tachycardia' (rapid heart rate) and instruct someone to get a bag of ice, while she started an IV in the tiny little hand to administer medicine. I wondered what in the world she was going to do with a bag of ice and a 2 lb baby! I soon found out that for them, when their heart is racing, you want them to hold their breath so they will instantly slow their heart. The nurse placed a bag of ice over the babies face, she held her breath and dropped her heart rate, then screamed her little, but strong scream! After twice w/ an ice bag on her face, her heart decided to act appropriately.
As a former NICU patient, I stood and watched the entire event begin and end... stunned, humbled, grateful for the knowledge and care from my own nurses 29 yrs. ago, and thankful over and over again for the health of my own baby...constantly asking myself...."am i READY to perform to the best of my ability and knowledge, life saving actions?!" I'm ready but I need more knowledge! If you know a nurse, thank her for ALL that he or she does! It's sleep depriving, energy extracting, amazing and some times heroic work!
