NICU/Neonatal Nurses: Please Help Me.

Jo Dirt · Aug 2, 2008

This is what keeps me from working in the NICU. On one hand, I would like to work with and help those sweet babies, but on the other, I don't know if I could handle the bad parts. I imagine when it is sad there it is really sad.

RNDreamer · Aug 2, 2008

I will admit that seeing that episode and that baby was a reality shock for me, even though I know that babies die in the NICU. I also know that I still want to work in the NICU. I guess I will see how I really feel after doing my senior preceptorship.

ilstu99 · Aug 2, 2008

I'm not really sure how to respond...or what you're looking for, exactly. But I can tell you this...

It doesn't take long to realize that some babies are just not going to be okay if they stay in this world. Not anywhere close to okay. Sometimes you know before the head sono's done....before the GI studies....before the orders are even put in, that this baby is already gone.

Do I know for sure that they are going to a "better place?" No....I don't. But I DO know that if, for some wild reason, their condition doesn't end their life....their existence here would be one of long, painful suffering. I wouldn't wish the loss of a child on anyone, but neither would I wish for ANY person to watch their child in agony.

Pipsqueak, ADN · Aug 2, 2008

Do I know for sure that they are going to a "better place?" No....I don't. But I DO know that if, for some wild reason, their condition doesn't end their life....their existence here would be one of long, painful suffering. I wouldn't wish the loss of a child on anyone, but neither would I wish for ANY person to watch their child in agony.

I have never worked in a NICU, so I really can't answer your question from the perspective of a NICU nurse, however, I am a pediatric homecare nurse, and I am the one who takes care of some of the babies that come home from the NICU and I can totally relate to the above quote.

Some of the babies/children I care for were premies, some were not. All of my clients have either a trach, or both a trach and vent. Most have G-tubes. Some will eventually be decannulated and go on to live healthy, happy lives, and some will be chronically vented. It's different in every case. Not every ending is happy and it is a hard thing to see a baby die, even harder when you watch the parents love and cherish that child, you can feel their pain. After the death of my first pediatric client (which was an expected outcome), I almost quit. I'm glad I didn't as it can be very rewarding knowing you helped that family in their time of need. It doesn't get easier seeing children/babies die......but you learn how to deal with it better, to cry and be sad....but not dwell on it.

Sometimes I really do think it is harder seeing the ones that survive, but have no hope for recovery, have no hope for any quality of life, and are here only because they are kept alive by a ventilator.

calebsmom0822 · Aug 2, 2008

I've been a NICU nurse for nearly 8 yrs, as hard and emotional as it is to care for these precious lil 'angels', and to see some pass away, this is why its my passion. Yes, we get attached, our hearts break but I think this is what makes us special in this specialty and any other specialty. Our hearts are in it, therefore our unconditional care, skills and expertise that we give to these babies are shown through our actions. When I had to deal with my first premie passing away, I went home crying, and wasn't sure if I wanted to do this (NICU) anymore...but I leaned on my relationship with God and gained peace and strength through this experience. Every infant death in the NICU touches me just as hard, but I know that I give my best to these babies and their parents. I only hope that my passion and love for them shows.

hikernurse · Aug 2, 2008

It can be heartbreaking at times. I saw the Hopkins episode, too. It looked like they tried the baby on the oscillator and then just took him off. Were the parents nearby? Our unit (and most others, I would imagine) take great pains to make the death as positive an experience as possible for the parents; hoping they can take some small comfort in that.

It's tough, but as an advocate for these little ones, it gives us an opportunity to make things as positive as they can be. As nurses, we can promote pain relief, containment, etc. We can also give parents as many chances to hold, touch and bond with their baby as possible.

If the baby is going to be removed from life support, we make every effort for parents, etc. to be there if they want to be. They can dress, wash, whatever they want, the baby first. If the parents opt to not be present, a nurse will hold the baby until he passes. And doing the after care on a baby can be a very reverent experience.

I guess, my (long, sorry) point is that if you were a parent, wouldn't you want someone who cares for your baby and is sad at their passing? If this is the area you want to be in, your sorrow can be a strength if you let it :).

llg, PhD, RN · Aug 2, 2008

I recommend getting some experience in a NICU before actually taking a job in one. That will give you a chance to see how you will feel in that environment.

How do you "get experience" in a NICU without working in one? Try to get some time there as a student -- even if it is just observational experience. Perhaps you can do some volunteer work.

Even if it is not exactly NICU, you might benefit from spending some time in an environment with critically ill and/or suffering children -- to see how you handle it. Then you could use that information to help you with your career choices.

NICU is not for everybody -- even for those who care. Some people are simply not well-suited for it. But there are lots of environments in which you can work that might suit you. For example, a Level 2 nursery or NICU step-down nursery ... a pediatric unit with a predominately young population ... mother/baby unit. etc. If you feel unsure about the most intensive level of NICU work, perhaps you could start your career in a less intense environment and then move to NICU later if you feel ready at that time.

RaspberryTX, RN · Aug 2, 2008

You can't save them all. Sometimes making sure they have a good life is out of your hands and all you can do is see to it that they have a good death by keeping them comfortable and cared for until they pass away.

BabyNurse_PJN · Aug 2, 2008

Calebs: Thank you for sharing this, my passion is as strong as yours. Do you ever wonder if God is the reasoning behind this passion? I do. I really can't imagine myself working anywhere else, with this strong "need" and "want" to work around this field. Again, thank you.

BabyNurse_PJN · Aug 2, 2008

hikernurse:

Thank you.. you have such an amazing point.. I need to remember this, remember that what breaks us-only makes us stronger. You all are doing so great in keeping me motivated and reassuring me:redpinkhe

BabyNurse_PJN · Aug 2, 2008

llg:

I was in the NICU for 74 days while my son was there (Level III). He was a 2 pounder and being there initially is what sparked my passion and love for these babies-though I never witnessed the death of one. I definitely agree that maybe a lesser level NICU would work for me, and maybe even the well-baby nursery to start with. If the time came, and I was hired into the NICU-it would be hard to turn it down though. Guess we will see. You guys are awesome and I seriously can't thank you enough for your insights and input!