I love this line from a poem by Garrison Keillor:  "Some babies come in on a wing and a prayer".  
As a NICU nurse, I have felt that way about quite a few patients...tiny little babies not yet ready to be here.  I thought I would share Garrison Keillor's entire poem with you today.  It is written in a "fun" way about an emotional journey....enjoy!  

We were talking to a sales rep this week about upcoming (and quite amazing) technology in the NICU world.  It got me thinking about the way we do things now and how much has changed.  I've mentioned in this blog before that Neonatology as a practice is actually quite "young", so I thought it would be fun to share with you some "firsts" in the field (with the help of this awesome timeline from Neonatology on the Web).

First use of oxygen in newborns: 1780 



First description of intubation for resuscitation of infants: 1834



First report of gavage feedings for newborns: 1851



First published description of an incubator in Western literature: 1857



First use of oxygen in preemies: 1889



First neonatal surgical unit: 1953



First air transport of a newborn: 1958



First use of the terms "neonatologist" and "neonatology" in a textbook: 1960



First NICU: 1965







Pretty amazing, huh?  The things that we now consider routine were new and unexplored areas of practice only a relatively short time ago.  I am so blessed to work in such an amazing and dynamic field of nursing.







Does this timeline surprise you?  What "firsts" are you most thankful for?

Happy Spring Break! 



Julie Hudson, MSN, RN

It has been a very busy time in our NICU and L&D departments!  We are seeing record numbers of babies being born...amazing and such a blessing. 

Statistically speaking, most deliveries go off without a hitch and the babies go home with their Moms within a day or two.  Then, there are NICU babies....those who stay in the hospital for awhile (sometimes a long while).  Unfortunately, there is also another group of babies.....those who never make it to the NICU or Nursery, who never make it home with their loved ones.

This past week our own NCBH family suffered the loss of one of these precious little ones.  We mourn with his parents, shed tears for them, and pray for their peace.  For all of you who have been down this road, we offer our heartfelt condolences and prayers.



Julie Hudson, MSN, RN

NCBH NICU

Cradle of Wings - In Memory

by Pam Armstrong and Susan Armstrong Lunn There's a place in your heart, the angels know

Where the love for your child begins to grow

And they sing out the joy of that tender glow

Hallelujah, Hallelujah, Hallelujah

Hallelujah, Hallelujah, Hallelujah Though there's much to see through new little eyes,

When they start to close, with soft weary sighs.

In a cradle of wings, the little one lies

And the angels' Hallelujahs hush to lullabies

And the angels' Hallelujahs hush to lullabies There's a place in your heart, where you realize

That the love for your child, will forever abide

It's the cradle of wings, where your little one lies

Where the angels' Hallelujahs hush to lullabies…

It's where the angels' Hallelujahs hush to lullabies Lullaby, little darlin' lullaby,

Lullaby, my sweet darlin' lullaby,

We will hold you and we'll see you by and by

We love you and we'll miss you, bye bye Cradle of Wings Productions

Copyright 2006

 

 

 

I came across this poem and thought I'd share it with you this week:



               

Did you ever wonder how the mothers of premature babies are chosen?



Somehow, I visualize God hovering Earth, selecting his instruments for propagation with great care and deliberation. As he observes, he instructs his angels to take notes in a giant ledger.



"Armstrong, Beth, son. Patron Saint...give her Gerard. He's used to profanity."



Finally, he passes a name to an angel and smiles. "Give her a preemie."



The angel is curious. "Why this one God? She's so happy." "Exactly," smiles God. "Could I give a premature baby a mother who knows no laughter? That would be cruel."



"But does she have the patience?" asks the angel.



"I don't want her to have too much patience, or she'll drown in a sea of self-pity and despair.

Once the shock and resentment wear off, she'll handle it.



I watched her today. She has that sense of self and independence so rare and so necessary in a mother.

You see, the child I am going to give her has a world of it's own. She has to make it live in her world, and that's not going to be easy."



God smiles. "This one is perfect. She has just the right amount of selfishness. "

The angel gasps, "Selfishness! Is that a virtue?"



God nods. "If she can't separate herself from the child occasionally, she will never survive. Yes, here is a woman whom I will bless with a child less than perfect. She doesn't know it yet, but she is to be envied.



She will never take for granted a spoken word. She will never consider a step ordinary. When her child says "momma" for the first time, she will be witness to a miracle and know it.



I will permit her to see clear the things that I see - ignorance, cruelty, prejudice - and allow her to rise above them.



She will never be alone. I will be at her side every minute of every day of her life because she is doing my work as surely as she is here by my side."



"But what about her Patron Saint?" asks the angel, his pen poised in the air. God smiles.

"A mirror will suffice.

Happy Valentine's Day!

Julie Hudson, MSN, RN

Caffeine....not in the coffee or Mt. Dew form.....is a really common part of a premature infant's medication regime in the NICU.  Caffeine, you say, really???

Caffeine Citrate is a stimulant that is used to treat apnea of prematurity.  If your baby was a preemie, especially, an extremely low birthweight (ELBW) neonate, then he probably was on caffeine therapy for awhile.  According to research, it is a safe therapy and it works!  We've seen it ourselves in the NICU.

An article was just published this month with some interesting long-term data that was not previously available.  The research demonstrates that the effects of caffeine therapy seem to lessen over time......."In previously reported results from the randomized, placebo-controlled Caffeine for Apnea of Prematurity (CAP) trial, newborns who received caffeine therapy had a significantly lower rate of death or disability by 18 to 21 months, driven by lower rates of cerebral palsy and cognitive delay.But by age 5, the difference in death or disability became nonsignificant" (Neale, T., 2012).

The research continues and more long-term data will come from these studies, but for now, we know that caffeine therapy works on our little patients.  As stated in the article:  "This trial also highlights how fortunate preterm patients have been in the routine use of caffeine, a drug previously untested in newborns. All along, neonatologists were using the first safe neuroprotective agent in this vulnerable population," (Neale, T., 2012).

See the link below to read the full article.

Enjoy your week!

Julie Hudson, MSN, RN

NCBH NICU

 

 

Quotations and Article can be found here:

"Caffeine Benefits for Preemies Mostly Gone by Age 5" By Todd Neale, Senior Staff Writer, MedPage Today