Hardest things to deal with in NICU...

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Specializes in ICU.

Hey there,

As someone who is interested in pursueing a career in the NICU, I am curious to hear what some of the hardest things to deal with are, from those of you with experience. It's obvious that in an intensive care unit you deal with very sick babies but I'd like to hear about what I might encounter. I'm nervous about my reaction to some things I may encounter. I consider myself a very strong person but I am also very compassionate and I think that I will be able to overcome my emotions by keeping in mind that I am there to help these innocent and helpless little ones.

Just looking for some insight, thanks:redbeathe

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Specializes in NICU.

Hello I just started working in the NICU in February and have been in Level III for the last 10 weeks. I think right now, the hardest thing is hearing the parents scream/cry when they are told their baby is about to die/has died. For me, it is harder than the baby actually passing because at least I can have some peace knowing the babies are (usually) in a better place free of suffering. The other thing that is hard for me actually surprised me...coding a baby. Last week my preceptor and I's patient coded and I did some of the chest compressions. Chest compressions on a 2 lb baby. It totally blew my mind, and still does. Luckily these moments are few and far between and its so rewarding to see the baby you had one week for PPHN, max settings on the oscillator, nitric, q 2 hr gasses, potential ecmo...screaming and nippling all the next.

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Specializes in NICU.

Before going into the NICU I knew it would be emotionally tough ..... we're dealing with sick babies that sometimes won't make it. But I never knew how incredibly heartbreaking some of the cases would be ..... and it's not something that you can explain to someone, it's something you have to experience first hand.

I never really knew what it felt like to actually have my heart ache and hurt, as it has in some of the situations I've seen over the last 2 years.

I never knew that the worst sound in the entire world is the sound a mother makes when her baby is dying.

I never knew how hard it would be to see druggies coming in having multiple babies, that they don't want, that end up going into CPS custody. Then to go into the next pod and see a mom and dad that have lost FIVE pregnancies ..... finally have a "successful" IVF twin pregnancy, in which one of the twins dies, then deliver the other twin at 24 weeks, very sick, with the prognosis of death.

I never knew how mad I could be at someone I didn't know ..... for leaving AMA so she could feed her crack habit, abrupting at home, delivering a "dead" baby that she kept on the ventilator for a week before pulling the plug.

I never knew how incredibly heartbreaking it would be to see a mom die after a car accident, with her baby surviving, and the family coming in ..... so bittersweet. Or how heartwrenching it would be to see a baby die after mom was hit by a drunk driver.

I never knew how frustrating something could be as to have a mom that had NO prenatal care have a baby that's now on ECMO, thanks to her stupid choices ..... put the baby through intense life-saving measures, for his/her very short life ..... and yet it could have been so different if she had just gone to the damn doctor.

To have a baby on the unit that you know will die, but the parents just "can't let go", but you have to put your feelings aside because it's not all about you ..... to let them have their time with their precious baby.

To have a chronic baby on the unit for months and months .... taking care of this child, and they end up dying. Then you feel bad for feeling relieved, this child is no longer suffering.

I never realized death isn't always the worst thing.

All of this is really something you can't explain. You can read about it, you can try to prepare yourself, but until you hear that mother crying while holding her dying baby, or taking care of a baby that you will know is going to die, or dealing with the heartbreaking social situations ..... you don't know how you will feel. But be prepared for your heart to ache at times and be prepared to cry.

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First of all I want to say THANK YOU! The NICU changed my life like night and day. I am not a nurse in the NICU but I had a baby in the NICU. He was born at 28 weeks with absolutely no explanation. I thought I was doing everything so perfect...I started having contractions in the middle of the night and went into the ER and they did not try to stop it they did not believe me because the machine was not picking up my contractions so they let me lay their having contraction after contraction..I had a UTI and they were blaming it on that. But indeed I was in labor so I had my sweet baby boy at 28 weeks at a hospital that does not deliver babies gestation before 34 weeks. He was transported to UAB and was there for 8 weeks. It was scary, emotional, so many words that I cannot even explain..but it changed my life and I hope to one day work in the NICU that my sweet baby was in. Thank you for what you do for those tiny little God given miracles!!!!!

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Specializes in Home Care, Hospice, OB.

i never knew how hard it would be to see druggies coming in having multiple babies, that they don't want, that end up going into cps custody. .

that was the toughest part for me...knowing that i'd see her again in six or eight months for the next addicted preemie:madface:

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Specializes in NICU.
before going into the nicu i knew it would be emotionally tough ..... we're dealing with sick babies that sometimes won't make it. but i never knew how incredibly heartbreaking some of the cases would be ..... and it's not something that you can explain to someone, it's something you have to experience first hand.

i never really knew what it felt like to actually have my heart ache and hurt, as it has in some of the situations i've seen over the last 2 years.

i never knew that the worst sound in the entire world is the sound a mother makes when her baby is dying.

i never knew how hard it would be to see druggies coming in having multiple babies, that they don't want, that end up going into cps custody. then to go into the next pod and see a mom and dad that have lost five pregnancies ..... finally have a "successful" ivf twin pregnancy, in which one of the twins dies, then deliver the other twin at 24 weeks, very sick, with the prognosis of death.

i never knew how mad i could be at someone i didn't know ..... for leaving ama so she could feed her crack habit, abrupting at home, delivering a "dead" baby that she kept on the ventilator for a week before pulling the plug.

i never knew how incredibly heartbreaking it would be to see a mom die after a car accident, with her baby surviving, and the family coming in ..... so bittersweet. or how heartwrenching it would be to see a baby die after mom was hit by a drunk driver.

i never knew how frustrating something could be as to have a mom that had no prenatal care have a baby that's now on ecmo, thanks to her stupid choices ..... put the baby through intense life-saving measures, for his/her very short life ..... and yet it could have been so different if she had just gone to the damn doctor.

to have a baby on the unit that you know will die, but the parents just "can't let go", but you have to put your feelings aside because it's not all about you ..... to let them have their time with their precious baby.

to have a chronic baby on the unit for months and months .... taking care of this child, and they end up dying. then you feel bad for feeling relieved, this child is no longer suffering.

i never realized death isn't always the worst thing.

all of this is really something you can't explain. you can read about it, you can try to prepare yourself, but until you hear that mother crying while holding her dying baby, or taking care of a baby that you will know is going to die, or dealing with the heartbreaking social situations ..... you don't know how you will feel. but be prepared for your heart to ache at times and be prepared to cry.

:yeahthat: i think that is the best explaination that anyone could ever say. you need to live in the nicu as a nurse to understand the bad and the good. there are harder things than you ever thought that you would find but there also is great good.

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Before going into the NICU I knew it would be emotionally tough ..... we're dealing with sick babies that sometimes won't make it. But I never knew how incredibly heartbreaking some of the cases would be ..... and it's not something that you can explain to someone, it's something you have to experience first hand.

I never really knew what it felt like to actually have my heart ache and hurt, as it has in some of the situations I've seen over the last 2 years.

I never knew that the worst sound in the entire world is the sound a mother makes when her baby is dying.

I never knew how hard it would be to see druggies coming in having multiple babies, that they don't want, that end up going into CPS custody. Then to go into the next pod and see a mom and dad that have lost FIVE pregnancies ..... finally have a "successful" IVF twin pregnancy, in which one of the twins dies, then deliver the other twin at 24 weeks, very sick, with the prognosis of death.

I never knew how mad I could be at someone I didn't know ..... for leaving AMA so she could feed her crack habit, abrupting at home, delivering a "dead" baby that she kept on the ventilator for a week before pulling the plug.

I never knew how incredibly heartbreaking it would be to see a mom die after a car accident, with her baby surviving, and the family coming in ..... so bittersweet. Or how heartwrenching it would be to see a baby die after mom was hit by a drunk driver.

I never knew how frustrating something could be as to have a mom that had NO prenatal care have a baby that's now on ECMO, thanks to her stupid choices ..... put the baby through intense life-saving measures, for his/her very short life ..... and yet it could have been so different if she had just gone to the damn doctor.

To have a baby on the unit that you know will die, but the parents just "can't let go", but you have to put your feelings aside because it's not all about you ..... to let them have their time with their precious baby.

To have a chronic baby on the unit for months and months .... taking care of this child, and they end up dying. Then you feel bad for feeling relieved, this child is no longer suffering.

I never realized death isn't always the worst thing.

All of this is really something you can't explain. You can read about it, you can try to prepare yourself, but until you hear that mother crying while holding her dying baby, or taking care of a baby that you will know is going to die, or dealing with the heartbreaking social situations ..... you don't know how you will feel. But be prepared for your heart to ache at times and be prepared to cry.

Well said! I feel exactly the same way!

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I would really, really like to know who is responsible for mental health/family support in the NICU. I am not a nursing student (although I am considering it), but I am a psychology major with an interest in mental health. I also have a particular interest in the NICU and in neonatal and pediatric medicine.

Would a nurse be able to provide family support/counseling in a certain role, or would that be the role of a different type of provider?

Thank you!

Lindsay

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Specializes in Level III NICU.
I would really, really like to know who is responsible for mental health/family support in the NICU. I am not a nursing student (although I am considering it), but I am a psychology major with an interest in mental health. I also have a particular interest in the NICU and in neonatal and pediatric medicine.

Would a nurse be able to provide family support/counseling in a certain role, or would that be the role of a different type of provider?

Thank you!

Lindsay

Well, we're all responsible for family support. By "we," I mean the nurses, the docs, the NPs, social work, the chaplain, whoever else may have a role in the baby's care. Also, I would imagine that the nurses in L&D and on MB units that care for the mothers before, during and after the delivery of a sick or preterm baby have a role in providing support to the families. We also have a family support group that meets once a week in the evening during the hour and a half that the unit closes for shift change. It's run by one of our nurses and the chaplain, and they often have different guest speakers. We as nurses don't do any type of formal counseling or anything, but there have been plenty of times where I've sat at bedsides with parents to talk, and sometimes more importantly, to just listen.

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Thank you for the info. I am interested in providing family support/mental health, maybe in the form of a support group or something, if I ever become a nurse.

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Don't be nervous about your reaction. Embrace it! I have found reserves of mental strength and faith that I never knew I had before. I have developed a deep appreciation for life, health, and family, and I am happier than I have ever been in my life - even in the face of personal tragedy.

And no matter what you encounter on the floor and no matter how overwhelming it may feel, your colleagues will be there for you. The teamwork and solidarity on a NIC floor is better than on any other. The day after my primary passed away, I found cards and chocolates in my mailbox. When my baby is on the verge of coding, I have three nurses at my bedside asking me to delegate to them. In NIC, the tears may flow when a baby dies, but the very next week we regroup and throw a potluck.

So I know that I'm rambling, but my point is... yes, NIC can be hard to deal with, but it is also extrememly rewarding and inspiring. Give it a shot, and you may suprise yourself with just how strong you are. :pumpiron:

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Specializes in NICU.

A baby that is the sole survivor of a multiple IVF pregnancy .... that the parents have wanted and tried SO incredibly hard for.

Baby has a bad head. Taking the baby off ..... multiple losses in a matter of days.

It takes a lot to get to me, but it's been a long week and these cases break my heart more than anything :crying2:

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