Work

I work as a registered nurse in a neonatal intensive care unit (NICU) at a major medical center/school. Although it is supposedly a 35-bed unit, we frequently have 40+ patients. Most of our patients are premature infants requiring ventilatory assistance or support, but we also have term patients requiring surgery or critical nursing care due to illness contracted before birth. Occasionally, we keep infants overnight just for observation, such as babies born to diabetic mothers.

When I tell people where I work, usually the first thing I'm asked is, "isn't it sad to work there?" No, not really. While we do have a few loses, most of our little patients leave the unit in fairly good health. Regardless, we have given an infant a chance for life that he/she wouldn't have had 20, even 10 years ago and that is a good feeling.

Major advances have allowed even babies weighing barely a pound to survive. Setbacks are common in infants this small, and few escape death unscathed, but it does happen. Ethical issues disturb us with the very small preemies (micro preemies). Is it truly ethical to subject a tiny infant to the tortures of tracheal intubation (putting them on a ventilator) and numerous needle sticks for IVs and lab? Is it better to safe a life regardless of quality? Who should decide where the lines are drawn?

Anyone who lasts long in this area of nursing learns to quiet these questions. There are no answers yet. Perhaps there can be none. This is an area of greyness...an area no one really wants to tread. TV news features abound concerning neonatal units and the tiny lives within. Court cases exist in which parents have struggled with the ethics and opted to allow their helpless infant to pass away gently rather than perhaps linger slowly, only to have a third party intervene on the behalf of the infant.

What is my opinion? I try very hard not to have one. If the parents are willing to put themselves through the hell of having a critically ill child in the hospital for weeks and months at a time, I will continue to do everything in my power to keep that child as healthy and comfortable as possible. If they deem that the infant has suffered enough and it seems hopeless, I respect their decision. It is not an indication of weakness to let a child go.

There are many resources on the web related to NICUs and other issues I have raised here. For the curious, check into them. There are also some wonderful sites for parents who are enduring the tremendous stress of having a ill or premature infant. I invite all of you to follow the links to my work-related sites. As the saying goes: read more about it.

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Last modified August 25, 1997