My first experience on neonatal intensive care (NICU) was as a second year student nurse. I am currently nearing the end of my children’s nursing degree and will be finishing the three years off in NICU, as I requested.
My first memory of NICU was waiting outside the unit, having buzzed to be let in, trying to control my dry mouth and sweaty palms. My first handover was a blur and all I remember was writing down the words and terms I didn’t understand/had never heard of before (most of them). When we stepped out of handover, my mentor gave me a brief tour of the unit and the equipment, before explaining what we would be doing that day. Apart from feeling generally overwhelmed and out my depth, I just remember thinking – surely you aren’t going to let me touch this baby? Have you seen how small it is? How thin its skin is? How many wires there are? And most importantly – how on earth do I even change its nappy through these submarine windows?
I was lucky, my mentor was wonderful (as were the rest of the team), and even by the end of our first twelve and a half hour shift together (not a long time when your brain is in overdrive), I felt able to complete basic cares such as cleaning and changing, and felt slightly (only slightly) more comfortable holding and feeding an extremely premature baby. In addition to this, I was lucky enough to witness three births in my first shift, terrified and amazed all at the same time. Lucky however, is a strange concept when you consider that as a student on NICU, I was only attending these deliveries with my mentor, and the rest of the paediatric team, because something had gone wrong, or a baby was being born prematurely, and the crash bleep had gone off (a noise that you start to hear in your sleep, along with every other beeping noise that sends fear through your body until you learn to get used to it and respond calmly).
The ‘crash bleep’ is the single most unpredictable element of any shift, and I strangely became quickly normalised to running with a qualified neonatal nurse, up the stairs to maternity with the crash bag in hand, having little information about what we were about to walk into. My role as a student nurse rapidly developed each delivery I attended, as I went from an observer to a scribe, to actually getting involved and helping out practically.
I have personally loved every placement as a student nurse, and enjoy experiencing different environments and seeing what new skills I can pick up along the way. However, it wasn’t until the end of my second year, when I was on placement on NICU that I realised exactly why I went into nursing, and that I wanted to be an intensive care nurse. All I can say is that it is more of a feeling than a thought process. The feeling of going home knowing that you have cared for a whole families physical and mental health, and spending your days and nights with the most vulnerable, yet strong and brave group of patients and families (in my opinion).
While the sounds of buzzers, alarms, and even the crash bleep are things that become a norm as part of the nursing team, and even the sight of traumatic births, the sight of a baby in pain, discomfort, or being resuscitated for example, is something that never ever becomes easier to watch, especially when you are the person inflicting pain upon them (even though you know it is purely for their benefit). What I will say is, the reason I love intensive care so much, and one of the many reasons I love nursing, is that when you witness something traumatic, your thoughts are instantly – what can I do? How can I help? How can I make this better? And as a result of this you don’t have time to dwell on how sad anything is (until you are driving home – the best time for reflection, and genuinely alike therapy for me personally).
I really hope that parents know that although staff may seem at ease with witnessing awful things, and in a way they are (because they have to be), I have not yet come across a member of staff in these situations that is cold and immune to this, no matter how long they have been a nurse or doctor. I was pleasantly surprised numerous times throughout my placement to hear other staff discussing openly that they had worried about their patient all night whilst they weren’t on shift, passing on concerns that a parent is struggling and asking for advice on how to help them, or calling specialist hospitals to find out how a patient that had been taken there was doing, not because they had to, but because they wanted to, and because the team as a whole had been thinking of them since seeing them transferred out (usually in a severely unwell state).
For me, one of the hardest things about being a student nurse on NICU is not having someone to talk to about what you have just experienced. Even if the team are lovely and inclusive like mine were, you still aren’t really a part of the team as you are only there for a small period of time, so you don’t have close friends in colleagues to talk to that truly understand what emotions you are going through. When you get home you can tell your family and friends that you have had a hard shift but that’s about it. And I have felt frustrated in the past when poor innocent family members moan about something that seems so insignificant to me after what I have witnessed on a shift, and I snap and then feel guilty but can’t explain why I am in a bad mood without disclosing confidential information.
My time on NICU taught me so much, I was able to learn more skills and knowledge than I ever have before, and witness truly incredible and inspiring medical professionals at work. I also got to witness just a glimpse of how incredibly difficult having a baby on NICU must be for parents, siblings, and all members of a family.
I feel truly privileged that my soon to be job allows me to relieve a babies pain, make sure they are comfortable and cosy, be a familiar voice for a tiny new human that has entered the world by being poked and prodded, and ensure that they are well looked after whilst their parents cannot be there. In addition to this, I am lucky enough to be able to support parents when they are grieving, or terrified to hold their baby for the first time, devastated because their baby seemed to be getting better but has got worse overnight, anxious because they have just been told that the joy of finally taking their baby home will now be partnered with home oxygen, gutted that their maternity leave is being spent in a hospital, or elated because they are one tube down! All of these things are the reason I went into nursing, and pretty much the only thing that gets me through endless exams and essays, because I know that at the end of it, as mentally and physically exhausting as it may be, I get to do a job I love, I feel honoured to be there for children and families in the dark times and I honestly wouldn’t want to do anything else.
Thank you so much to Beth for sharing her experience as a student nurse going on to a NICU placement. Images are courtesy of Leo’s and do not feature Beth or the NHS Trust she works in.