What to expect in the NICU
When a newborn is in the intensive care unit, it can be scary. A veteran NICU nurse explains what parents will see and hear.
I have been taking care of babies in the hospital for more than 35 years, so I feel at home in the neonatal intensive care unit at Monroe Carell Jr. Children’s Hospital at Vanderbilt. For our new moms and dads, though, the NICU can be a frightening and overwhelming place.
Understanding what to expect in the NICU may help you feel more comfortable. Here are some things to know about the NICU.
1. Our NICU at Vanderbilt is a locked unit.
As welcoming as we aim to be, the first experience that you have when entering the NICU is that the door must be opened by someone inside the unit. Your baby’s safety and privacy is important to us. That’s why the doors must stay locked.
2. A medical receptionist will greet you and ask you who you are here to see.
With as many as 100 babies in the unit, and all the parents and visitors who come in and out all day, it is nearly impossible to keep every name and face in mind. The receptionist will ask to see your ID band or bracelet, which identifies you as a person who has a precious infant in the unit. He or she will make sure that there aren’t too many others at the bedside already; we limit the number of people at one time. We strive to keep your baby’s room in the NICU like you would at home, as quiet as possible to allow as much rest as we can. If it’s your first visit, someone will assist or direct you to your baby’s room. This first sight of your tiny baby in a medical setting can be frightening.
3. You’ll see a flurry of activity at some babies’ beds while others are quiet and still.
Always, you will see a nurse — not in a white starched uniform, but a nurse, male or female, in colorful scrubs, who will welcome you and give you an update on your baby’s care and condition. Other team members will include your baby’s doctor or nurse practitioner, who will be able to answer your questions and discuss baby’s plan of care with you. You’ll see care partners, who assist the nursing staff with babies’ care; and social workers who will help you with many questions and concerns. You will also be assigned a case manager, who will follow your baby’s progress and work closely with you and your team as the time for your baby to go home nears.
Never forget that you, the parent, are the most important part of this team. We need you and baby needs you!
4. You’ll hear beeps and alarms.
All of our babies in the NICU are connected by tiny electrodes or wires to a heart monitor. This helps us see your baby’s heart rate and other vital signs. These machines are set with alarms to tell our nurses if and when your baby’s heart rate drops below our preset number or it runs too high. If your baby is on a ventilator to help with breathing you may also hear sounds of air and mechanical movement.
5. You’ll see feeding tubes and intravenous lines.
Most babies first admitted into a NICU are much too ill to bottle feed. They may have a feeding tube in their nose or mouth, as well as an IV (intravenous) line that enables us to give fluids. To maintain temperature and other conditions, some babies are in incubators, which we call Giraffe beds, after the name of the product. Others are in cribs or bassinets.
6. Always, always ask questions.
As much as we try to remember, we can sometimes forget how frightening this all can be. if you are unsure or do not understand something, always ask. After all, we share the same goal: making sure your baby — and you — receive excellent care. We want to help in any way we can. There are resources that help you, the parents, cope with the stress of a NICU stay. This father learned excellent strategies for dealing with his daughter’s long NICU hospitalization. Ask your baby’s care team about resources that you need.
After your baby goes home, you will receive a call or a survey about your experience. We know it will be a busy time at home, but we would be extremely grateful if you will complete the survey and let us know about your experience.
This post was written by Marlee Crankshaw, who has worked in nursing for 35 years at Vanderbilt. She currently serves as the Administrative Director for Neonatal Services for the Children’s Hospital, which includes both Newborn Nursery and the Neonatal Intensive Care Unit. She is the mother of four, grandmother to 13, and great-grandmother to three.
Vanderbilt’s Children’s After-Hours Clinics offer the convenience of a walk-in clinic with care provided by a board-certified pediatrician from Children’s Hospital. No appointment is necessary, but we recommend calling your pediatrician first. Learn more about services and find locations for Children’s Hospital After Hours Clinic locations.