What goes on in the Neonatal Intensive Care Unit (NICU)?

Neonatal Nurses Day is celebrated every year on September 15th, but Erlanger celebrates its nurses every single day of the year.

Neonatal nurses are staff who work in the Neonatal Intensive Care Unit (NICU). But what exactly does a neonatal nurse do, and why might your baby end up in the NICU?

The birthing process

Let’s start at the beginning. When you’re having a baby, mothers and their families are brought to the Labor and Delivery room. This cozy area is meant to be as comfortable as possible, where moms are surrounded by family members and staff who, for a short time, become a part of the family.

After delivery, it is important for mother and baby to spend time in skin-to-skin contact. After a baby leaves the womb, she is cleaned and placed right on its mother’s bare chest. The baby can feel her mother’s heart beating and hear her mother talk. These first special moments help soothe the transition from being inside the womb, to suddenly living in a very different type of world.

Families remain in the Labor and Delivery room for about two hours, enjoying uninterrupted bonding time. After two hours, when everything has settled, mothers are moved downstairs to the Mother-Baby room. This is a quiet, low-key area where mothers stay until it’s time to go home. They are provided with resources and educational handouts to ensure they have adequate parenting support.

Originally Erlanger had just one area for new mothers and babies, but serving the entire Chattanooga area, including 57 communities, they soon outgrew their space. Having these two different areas provides a much better flow for hospital staff and patients, and creates a really special atmosphere during those first two hours of a baby’s life.

In the case of any complications or issues arising during or after delivery, the Labor and Delivery room is located inside Erlanger East, providing access to a wide range of resources and specialists on campus. An amazing resource is the Neonatal Intensive Care Unit, or NICU.

Neonatal Intensive Care Unit (NICU)

The Neonatal Intensive Care Unit at Erlanger East is just across the hallway from the Labor and Delivery room.

There are different reasons that a baby would need to go to the NICU. A lot of times, it is just for closer observation for a couple hours before being cleared to go home. The most common issues nurse Betsy Morton sees are problems with breathing, temperature, or sometimes an infection.

In some instances, such as severe prematurity, it is already known that a baby will need special attention. Other times you won’t know if a baby needs NICU services until they are born. That is why a NICU nurse is right there in the Labor and Delivery room to make sure the baby gets any help they need the moment he or she is born.

If the baby is stable, it can be cleaned and immediately start the skin-to-skin contact described earlier. If not, it is an easy transition into the NICU where the baby is treated and monitored by specialized equipment.

Level 4 clinic

All Neonatal Care Units (NICUs) help babies who need extra care. However, depending on your baby’s needs, there are four different levels of care.

Erlanger East’s Neonatal Intensive Care Unit is a level IV, meaning that it provides the highest level of neonatal care. It is rare to have such an advanced NICU in a smaller city like Chattanooga.

Nicholas Sherrow, MD, a neonatologist at Erlanger’s NICU, grew up thinking he would become an astronaut. But his path in life took him into a very different but highly rewarding profession. Dr. Sherrow sees all sizes of babies, but the smallest baby he ever saw in the NICU was under 1 pound!

At that size, the human body is so fragile it brings an additional level of technical difficulties beyond what is seen with premature babies. Luckily the capabilities of a level IV NICU provided Dr. Sherrow with specialized equipment that is small enough to access blood vessels, airways, even the stomach, to perform necessary procedures to stabilize a baby of that delicate size without causing further harm.

A nurse’s role

In some hospitals, nurses can feel expendable. At Erlanger, everyone is seen as an integral part of the team. There is a reason Erlanger East has been voted 10 years in a row as the Best Place to Have a Baby, and a big part of that is due to the hard work of our incredible staff.

Betsy Morton has worked in the NICU for about 10 years. After completing nursing school, Betsy went on to get additional certification as a NICU nurse. Unlike Dr. Sherrow, Betsy always knew that she wanted to work with babies.

Even though every day is different, Betsy says working in the NICU has been a “joy and pleasure.” On any given day, nurses like Betsy help with deliveries, assess a baby’s condition and admit the ones that need to be transferred to NICU. Once in the NICU, nurses provide whatever care is necessary to help stabilize babies and their mothers, from obtaining vital signs to helping with feeding.

It can be a long process for some families, but for Dr. Sherrow the end goal is always the same: “for the baby to go home with the parents in a happy, loving way.”

Are you expecting? Learn more about the Prenatal classes offered by Women’s Services at Erlanger East Hospital. Don’t have a Neonatologist? Find one here.