Two posts in a row, what is this madness?!
Ehhh I’m in the mood, plus I wanted to take a hot second to thank you all for your support and words on yesterday’s post! As I said before, confidence is a word we hear about ALL of the time and one that has been in our lives since childhood. Confidence is such an important concept yet somewhere along the line I managed to morph this term into something that had a foundation in self-hatred. I mean that’s really what it comes down to… yet another piece of this humongous puzzle I continuously work to put back together.
I allude to future topics I wish to discuss on a constant basis, yet I rarely actually take the time to elaborate on the topics. They remain in the archives in my brain (or in my “to write” folder on my desktop), and are reserved for a later time. Alright enough of that, how about I actually talk about one I have been excited to share with you? Yes, good plan.
What I wanted to discuss today is my new job! Well not so new at this point, as I’ve been there for about 2.5 months now and honestly? I could not be more pleased with the position.
My title is “Clinical Associate/Administrative Associate” in the Special Care Unit in a hospital near me… also known as the NICU (neonatal intensive care unit). I’m sure most of you, if not all, know what this department of a hospital is and what exactly it does for newborns (or sometimes older babies), but allow me to give you a few additional details
This type nursery is designed to care for babies who need medical monitoring and specialized services not routinely available in standard maternity rooming-in environments or community hospital nurseries. The patients include…
- Babies, twins and triplets who are born prematurely and need extra time and care to grow stronger
- Babies who need special monitoring, continuous observation and/or medical interventions
- Those who need assistance breathing until their lungs develop further
- Infants with mild to severe jaundice who need to have doses of bilirubin lights to rid their bodies of the toxic substance
- Babies who have received specialized care and have been stabilized at another, higher level of care hospital (in this case for my area- Boston Children’s Hospital) who need additional hospital care closer to home
- Babies with health issues who were born at a Boston hospital and are stable enough to stay in our Special Care Nursery, close to home, until they are ready to go home with their parents
The above picture is what we often see… one that is very sick, but receiving the correct amount of care.
In the last two and some change months, I have witnessed all different types of care that are specifically designed for the situations mentioned above. The second point, those who need medical interventions, are often a particularly difficult and sad patient to care for, as the child is in need of care to wean of the addictive drugs their mother was on during the pregnancy. Any sort of addictions are serious business (durrr), and although we would like to think differently, pregnancy will not necessarily modify the life-style choices of someone who has a dependency of some sort.
*None of the pictures here are from the facility I work in… found simply on Google Images
When a mother abuses drugs throughout pregnancy (even those that are prescribed, such as pain killers i.e. oxycodone), the baby will be born with a “need” for the drug, as they were both sharing the same blood and fluids during the time of development. Therefore when born, the child will also have a dependency and need medical intervention in order to wean the baby off with the most comfortable way possible.
Withdrawing is painful and causes illness, even death sometimes, and it’s not something a small newborn with little reserves is able to handle. To alleviate the pain of this process, the baby is given a small dose of morphine or other type of drug in a controlled amount, and is weaned off it slowly but surely. Common street drugs that are found in a mother are heroine, cocaine, methamphetamine, and prescriptions for anxiety and stress. Unfortunately, such illegal substances are often found in the women around this area and in certain towns.
Even with all of the care and controlled dosages, the baby still has a heck of a time with this and they are on the ones who are most difficult to care for during the weaning process. They are uncomfortable and they’re going to tell you about it, mostly in the way of screaming, trembling, crying, screaming, hiccups, and some more screaming. It’s a terrible situation to witness, and there will always be a social worker involved with the family when drugs are found.
Prematurity is a common case we care for, along with those needing extra support in order to breath. In the case of the latter, respiratory care from that department, will set up a machine called CPAP, that pushes oxygen into the newborn’s lungs. There are lower levels of breathing care, including nasal cannulas, blowbys, and oxygen hoods. They don’t stay on these for too long (most times), as sometimes the baby only needs a few or one day to get themselves to a stable state and support themselves.
The facility where I work is considered a Level II care area, where for example Boston Children’s Hospital, about 35 minutes away is a Level III care facility for more advanced treatments and higher levels of medical intervention. There have been a few times since I began to work at the SCN where the nurses and doctors have needed to send a baby to Boston (or to “town), for more advanced care. Some situations include a baby that needs to be resuscitated (once stable they are transferred), intubated, or one that has another sudden serious medical issue (a seizure for example). That’s a brief overview of what is done at my job, so what exactly do I do? As I said earlier, my title is CA/AA and basics include:
- Helping the nurses with the patients if they are too busy or need an extra pair of hands- changing, feeding, taking temperatures, and holding them if they are seemingly inconsolable and touch seems to aid them
- Paperwork/administrative stuff- putting together charts for admits (also taking them apart for D/Cs), faxing various items to the babies Pedi, outpatient care team, etc.
- Cleaning isolettes, warmers and cribs when applicable, along with setting them up for use.
- Getting flowsheets and daily forms ready for the next day.
- Making appointments for discharges, helping mothers find the location, talk to outpatient care team in order to help the mother as much as possible before they leave
- Order materials, medical supplies, baby formula, diapers, and so on
- Whatever other administrative stuff pops up… something new seems to happen each time I’m there!
This job is perfect for me right now as it keeps me very busy for the entire shift (I work in the evening, 3-11 pm, 4-5 days per week), and most helpful, I’m being exposed to the very stuff I failed on last semester… well a part of it at least. The second semester of nursing school was maternity and pediatrics, so yes, very applicable to the information taught! I also really like the nurses who I work with, everyone is overall nice, and yeah, just a good place for me to be right now.
It’s also allowing me to better understand whether I actually want to be a nurse or not… something I am currently unsure of, though I know I don’t want to be one in this type of place. I like being the one who helps out, gets the paperwork together and does the secondary work, rather than the person who is being relyed on to save a young infant’s life. Maybe I will feel differently in time, but for now, I know I couldn’t handle that kind of pressure.
Though maybe that has to do with my (lacking) confidence in myself at this time, and again, it could change as I make the next decision of where my life should go. <– No big deal right? HAAAAAA. :-/
So that’s the job and environment in the most condensed way I could explain… which turned out to be LONGER than I thought it would anyway. Let’s be honest here, I’m just no good at summarizing what I want to say Please let me know if you have any other questions about this place or what I do! I think the whole unit is quite interesting, and I’m sure I left a whole lot out here that maybe some of you are wondering about.
-For those who have had children, were any of them in the NICU/SCN for a certain amount of time? What was the reason?
-Have any of you ever worked as an AA or a clinical associate before? What was your experience like?
-Have you ever worked in a place that helped you to realize it’s NOT what you actually want to pursue?
-Again, please let me know if you have any other questions! I would be happy to do an additional post on this.
On that note, I have work later today and need to get some stuff done before! I hope everyone has a most glorious rest of your day Be back soon!