Guest Blog Written By: gretchen Lawhon, PhD, RN, CBC, FAAN
Recently I was asked why I have worked in newborn intensive care for so many years and whether I found it too depressing. My immediate response was that I have always wanted to be a nurse who worked with babies and that I loved the newborn intensive care unit and would never want to work anywhere else. My journey as a neonatal nurse is perfect for me because it blends many aspects of my personal philosophy including service to others, unending learning and being with others. This is the story of my life from being one of thirteen children and caring for younger siblings from the age of nine years. The importance of relationships; promoting, protecting and cherishing my relationships both personal and professional fits neonatal nursing just right. The origin of the profession of nursing is the obligation to care for family and one’s community. My chosen community in newborn intensive care where for the past three and a half decades I have had the privilege to know hundreds of neonatal health care professions of all disciplines, individual infants who leave their imprint in my heart and soul and their unique family members who courageously brave this intimidating microcosm of a world.
Within newborn intensive care, as professionals, we strive to better understand the newborn in a variety of ways. For me it has been through their development within the context of Dr. Als’ synactive theory that I am able to observe behavior as the window to the infant’s brain. Neonatal nurses collaborate with other disciplines to continually work to ensure support for the most early born infants through enhancement of lung function, support for cardiovascular stability, close observation and protection of neurological function and deal with all potential complications that may involve the gastrointestinal system while avoiding potential infection and protecting from pain and discomfort. In the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) approach to neonatal nursing we use development as the dynamic evolving context for appreciating where each infant, family member and professional colleague is on their continuum of development at the point of our interaction. Our relationships within newborn intensive care are built on the respect of others and promoting further maturation as we continually strive to find the balance of just the right amount of stress to promote growth and not so much as to overwhelm.
An excellent example of this occurred yesterday as I was doing a neurobehavioral observation (NIDCAP) for a very young and very small infant requiring maximal technological support for her survival. The observation included an experienced neonatal nurse simultaneously providing crucial care to the infant while orienting a new nurse and supporting the infant’s mother in changing her daughter’s diaper for the first time. The extremely gentle and individualized pace required to accomplish the support for diaper change, skin care, provision of expressed colostrum for mouth care, repositioning and removal of phototherapy and eye patches to facilitate a brief and invaluable moment of alertness as this fragile infant peeked at her mother brought a tear to my eye as I was overwhelmed by pleasure and pride in all that it means to be a neonatal nurse.
September 15th is National Neonatal Nursing Day and I hope that all neonatal nurses will take the time to reflect on the wonders and privilege of our profession. Even when an infant is unable to survive, we as neonatal nurses can influence the family’s experience to be therapeutic in the level of care experienced. One of the wonderful things we can do as neonatal nurses is to re-energize and refuel ourselves by getting together with other neonatal healthcare providers and building on our knowledge to gain increasing confidence and competence in our work. In November we will be holding the 29th annual Neonatal Developmental and Behavioral Care conference (formerly known as Developmental Interventions in neonatal Care) in New Orleans. There is an outstanding international faculty lined up including all neonatal disciplines. You will have the opportunity to learn the latest evidence-based approaches to caring for infants and families and be prepared to gain immediate strategies and approaches to incorporate in your own clinical practice. This year we have developed the concurrent sessions in tracks that enable you to focus on infant/family mental health, foundations in developmental care, evidence-based practice and complex multidisciplinary care. There is no doubt you will come away with greater knowledge as well as new professional colleagues for networking.
