Mentor Interview #1

Mentor name: Jennifer Paas

*Email Address: ​Jennifer.paas@helendevoschildrens.org

*Phone Number: (616)-514-9767

Company/Business: Spectrum Health, Helen DeVos Children’s Hospital

Career Field: Registered Nurse

1. How long have you been working as a neonatal nurse?

I have been working in the NICU just over 6 years.

2. When do you start to feel interest in working as a neonatal nurse?

I have been a nurse for over 20 years. I first thought about it just a couple years after

graduating but due to circumstances beyond my control I took a job in an OB/GYN

office to have daytime hours and a more stable schedule while my kids were young.

When my kids became old enough, I decided to get back in the hospital environment

and NICU had openings.

3. What specific skills are needed for your work?

Good assessment skills are a must. Babies can show very subtle changes when they

are starting to become sick, it is not always very obvious at first. You must be very

observant and able to notice those changes. The ability to anticipate and critically think

are also very important. When babies become sick they can become sick quickly and
being able to act quickly and calmly in a stressful situation is important. You will deal

with all sorts of families and all sorts of social situations. It is important that you are able

to treat all family members with empathy and be very patient with them - it is so stressful

to have a child in the hospital and parents can react in all sorts of ways.

Communication skills are very very important. Not only to communicate with families

but also other members of the healthcare team. We work very closely with doctors,

nurse practitioners, respiratory therapists, occupational therapists, physical therapists,

social workers and child life workers. Not to mention other nurses. The ability to work

as a team is important. We are all one big team working to heal babies and help them

develop appropriately despite their physical problems.

4. Are there specialty nursing organizations in your field?

Yes. There is the National Association of Neonatal Nurses. SMANN - is Southeastern

Michigan Association of Neonatal Nurses. We have my nurses on our unit who are

actively involved in this organization. I am not currently involved but may join.

5. Are there special certifications required?

As a nurse on my unit we are all required to have BLS (basic life support), NRP

(neonatal resuscitation), and S.T.A.B.L.E. (stands for 6 assessment standard for

post-resuscitation and pre-transport stabilization of sick infants - Sugar, Temperature,

Airway, Blood pressure, Lab work and Emotional support). You can also become

certified as a neonatal nurse by studying and taking a test - this is not required for
bedside nurses.

6. What is the worst part of being a Neonatal Nurse?

This is a tough question for me - I LOVE my job. The worst part of my job is not specific

to neonatal nursing but rather nursing in general - It is always hard to work holidays and

weekends. Being pulled to other units is probably the thing I hate most about my job.

As far as NICU specifically it is always hard when a baby dies. It is most difficult to see

a family go through so much pain when they lose a baby.

7.How do you process the hard times?

​Personally I have a very strong faith in God. I am catholic and rely heavily on my faith

when I am having a bad day. When I take care of a dying baby I "give it to God" and try

to remember that He is in control and that He has chosen me to be present with the

baby and the family as he takes the baby home. We do bereavement follow-up with

families that lose infants. It is comforting to follow up with the families and continue to

provide emotional support in the months and years after their loss. Helping the family

keep their baby's memory alive is healing for myself as a nurse also. I currently have

two families that I have been following.

8. What tools or artifacts does a neonatal nurse use daily?

As a neonatal nurse we actually have very little that we have to bring to work.

We don't have to have a stethoscope because each baby has their own. We don't need
to carry around bandage scissors and wear watches like nurses typically do. Due to the

high risk of infection in our patient population we can't wear watches or carry scissors

and stethoscopes. I have a notebook with lots of notes that I keep in my jacket pocket

but this stuff is all available online on our neonatal web page - I just like to have it at my

fingertips. I bring my notebook and a pen to work each day. We have report papers at

work that we fill out daily on each patient we care for. We also need our badges to get

to and from the unit and to clock-in each day.

9. What is the routine after a women gives birth, for the baby?

For a baby that comes to the NICU the routine all depends on how premature and how

sick the baby is. The hope is that mom is able to see the baby and hold for a minutes

before the baby is brought to the NICU - at the very least we try to show mom the baby.

If a baby is very premature they often require respiratory support via ventilator.

Temperature instability and glucose instability are also a big concern in the hours and

days after birth. We work hard to keep baby warm and monitor blood sugars carefully.

They will almost always require fluids so IV access is gained either by umbilical lines or

peripheral IV. Lab work is done and monitored carefully. The baby is placed in an

incubator that will help keep baby warm and if a baby is very small/premature they can

be placed on a warming pad/bag and we add humidity to their incubator also. When

mom comes to visit the NICU for the first time we encourage skin-to-skin holding if baby

is stable enough for this. Skin-to-skin holding helps with bonding, temperature
regulation and can decrease oxygen needs for baby. When baby is stabilized feedings

will begin usually via feeding tube. This will usually happen on day 2 or 3 of life.

10. Any advice for nurses who may be interested in this area of nursing?

I would advise you to shadow a nurse in the NICU. It is a very specialized type of

nursing and different than any other type of nursing. Not only are we trying to fix

physical problems but we spend a lot of time working on neurodevelopment especially

with our very preterm infants - we work hard to "grow" brains and this requires a quiet,

gentle atmosphere. Some shifts can be so very busy that you don't get breaks and

some shifts can be very long because there is not much to do other than monitor and

watch your patient. You definitely have to have a love for babies but also a love for

families - mom and dad are a big part of the process and just as important in their

babies health. In the NICU you will experience many ethical questions/concerns - such

as "are we doing more harm that good by keeping a baby alive?" Babies born very

premature will potentially face many life-long issues. You definitely have go be able to

put your own beliefs aside at times.

11. My job is to create a presentation where I will show my judges the

importance of a neonatal nurse in the health and development of the baby, also I

will show them the principal tasks of a neonatal nurse in their job. What do you

recommend me to show them (what activities, what tools should I bring to my

presentation, what should I say)?

We take care of babies that are preterm - as young as 22 weeks gestation and also

term babies that have heart defects, traumatic births requiring resuscitation and babies

who are born with all sorts of birth defects. Some babies just have trouble transitioning

from the uterine environment and need a little respiratory support for a few hours and

then can go back to mom. The NICU has such a diverse patient population, yet all our

babies have one thing in common - they are too sick to leave the hospital after they are

born for one reason or another. Some babies stay with us for a day and others

celebrate their first birthday with us. I personally work with our "micro-preemie"

population a lot - any baby born before 27 weeks gestation. We have a special area

call the SBU (small baby unit) for these babies. We keep it very quiet and very dark in

this unit. Our goal is to mimic the uterine environment as much as we can. We do

two-person care with these babies - one nurse does the assessment and care while

another nurse or parent, if a parent is available, provides containment - hands on the

baby to provide comfort. The goal of doing care this way is to help with

neurodevelopment of our babies. Their brains are still very immature and the more pain

and discomfort we cause the more difficult it is for their brains to develop normally. This

is a fairly new way to care for these babies and we are constantly learning more and

more about brain development. As advances in prenatal care continues and advances

in neonatal care continue are seeing more babies born earlier and being able to survive

- this can also bring more kids who experience complication later in life due to their

prematurity - our job is to try to work hard to decrease the complications they

experience once they leave the NICU and continue to grow. It would be very interesting
to find a case study of a premature baby that has grown up - to see what challenges

they experience now. Children who are born very premature commonly experience

many problems including: ROP ( retinopathy of prematurity), feeding intolerances/oral

aversion, chronic lung disease, ADHD/ADD, learning and cognitive delays. What we do

in the NICU and how we care for our premature patients can have lasting effects in their

lives.

12. Do you know where can I get the tools needed for my presentation?

I would check with the internet and see if you can find a case study. You could use a

tiny baby doll to demonstrate 2-person care. If you know of any parent who has had a

patient in the NICU they would be a good source of information also. You-tube may

have some good videos also - look for micro-preemie videos or NICU in general.
 Mentor Interview #2

Mentor name: Hannah Marciniak

*Email Address: ​hannah.e.marciniak@gmail.com

*Phone Number: (269)-277-1436

Company/Business: Helen DeVos Children’s Hospital

Career Field: Neonatal Registered Nurse

1. How long have you been working as a neonatal nurse?

I have been working as a neonatal nurse for nine months. This is my first nursing job

since graduating from college in April 2017.

2. When do you start to feel interest in working as a neonatal nurse?

When I was 5 years old, my little sister was born prematurely and was admitted into the

Neonatal ICU. Although I was young I remember sticking my hands in the isolette and

being in awe of her tiny feet. When I entered nursing school, I knew that I had a love for

pediatric patients, preferably babies. Those types of clinical rotations were the ones I

looked forward to the most. In my final semester of nursing school, we have something

called "immersion" which is 160 hours of clinical experience with a preceptor. I was able

to complete these hours in the Neonatal ICU, where I truly fell in love with the patient

population and aiding in the growth and development of sick and premature babies and

their families.
 3. What specific skills are needed for your work?

You need to have a passion for working with babies and partnering with parents. To be

any nurse you must have time management and critical thinking skills, as well as the

ability to be flexible. Specifically in the Neonatal ICU it is important to have a calm and

caring demeanor and a passion for continued learning.

4. Are there specialty nursing organizations in your field?

Yes! National Association of Neonatal Nurses is an organization of neonatal nurses

committed to promoting the growth of the profession. There are also state-based

chapters to participate in.

5. Are there special certifications required?

To be a neonatal nurse, you must have a Registered Nurse license. Most organizations

also require you to be Bachelor of Science in Nursing prepared, which is the four year

degree. Furthermore, once you are hired you participate in Neonatal Resuscitation

Programs as well as STABLE, which are both neonatal specific courses to further your

practice.

6. What is the worst part of being a Neonatal Nurse?

The worst part about being a Neonatal Nurse is patient deaths. Losing a patient is never

easy for any nurse, but when you form relationships with the babies and their families it

makes it that much harder. This also goes into question.

 7.How do you process the hard times?

I have incredible coworkers, educators, and supervisors there to support me when times

get tough. It is also important to set boundaries between your professional and personal

lives.

8. What tools or artifacts does a neonatal nurse use daily?

Neonatal Nurses work with babies in their isolettes, or special cribs that are able to

keep the baby warm and connect to different types of monitoring systems. We have

respiratory equipment, which helps the babies to breathe. Sometimes our patients are

really sick and require different needles and medications, while other times they are

working on eating and growing and so we need lots of blankets and bottles.

9. What is the routine after a women gives birth, for the baby?

The routine after a woman gives birth depends on how many weeks gestation the

mother is, and how the baby act when it is born. A full term pregnancy is 40 weeks

gestation; some of our premature babies are as early as 22 weeks gestation. For these

babies, or any baby that is born and struggling to adapt to life outside the womb, the

baby is brought to a warmer. There, they are stimulated and dried, their nose and mouth

are suctioned out to clear their airway, and they may be given a mask or breathing tube

if they have trouble breathing on their own. In more serious cases, the baby may need

certain medications to help their heart beat. After the baby is stable, he or she is shown

to the parents before being brought up to the NICU.

 10. Any advice for nurses who may be interested in this area of nursing?

If you are interested in this area of nursing, I recommend finding a neonatal center near

you and asking about any job shadowing experiences. With this, you can follow a

Neonatal Nurse around to see firsthand what they do. You can read different articles

online about the profession, and it is important to focus on your studies in order to

succeed in nursing school!

11. My job is to create a presentation where I will show my judges the

importance of a neonatal nurse in the health and development of the baby, also I

will show them the principal tasks of a neonatal nurse in their job. What do you

recommend me to show them (what activities, what tools should I bring to my

presentation, what should I say)? Do you know where can I get the tools needed

for my presentation?

Some interesting things to show may be a nano- or micro-preemie sized diaper; they

are smaller than the palm of a hand. Also the masks we use for breathing treatments

such as CPAP or PPV. You should be able to collect these items from a NICU.