This entry was posted on Friday, November 7th, 2008 at 6:27 pm and is filed under The Preemie Adventure. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.
I’m pleased to announce a special guest for the third entry in our Preemie Adventure series. This series typically consists of a collection of real-life stories from real-life parents that deals with the emotional roller coaster associated with pre-term birth.
This installment comes Barbara, who writes TherExtras, and presents a unique perspective, as she tells of life in the NICU as an OT some thirty years ago.
Barbara H. Boucher, PT, PhD, OT has devoted her career to the health and well-being of children. She is a specialist on the treatment of movement disorders and developmental problems. Her credentials include a degrees and licenses to practice occupational therapy and physical therapy, and a doctor of philosophy in Human Development and Family Sciences. She has clinical experience in rehabilitation hospitals, neonatal intensive care units, private homes, and public schools. She was a university faculty member and taught graduate students in physical therapy for 6 years. Stop by and check out her blog…it is a vast wealth of information.
Drama in the NICU
I first walked into a NICU in 1978. I was a young adult, recently graduated from college and newly licensed as an occupational therapist. Not to be so ‘about me’, but as a developmental specialist – I look through a lens that sees every moment in time as exactly that – a moment in time. I set the context for my early NICU experience with who I was then.
The NICU was usually calm but with the constant-many-metronome-like-beeping of life-sustaining machines – I can imagine the sounds again without effort – as I’m sure you can also. Visually the NICU was a ‘busy’ room and at the same time, almost monochromatic save for the carefully spaced, mostly-brownish babies in isolettes or open ‘warmers’ for those who required more constant care, er, touching by medical personnel. Specialists in neonatology were only beginning to discuss the effects of 24-hour light on the babies.
The first NICU I worked-in was in an old inner city hospital serving mostly ‘indigent’ patients (terminology of the times) - meaning the patients received care from a government (county) administered entity. They did not have choices for where to obtain medical care. Despite our real and obvious differences, the mothers of the babies and I had to adjust to the near-foreign environment of the NICU. It was not a place many people entered or experienced. Completely created for a small number of people, the NICU in 1978 was rough and competent at the same time.
Matt posted statistics on preterm births that ring true with my experience in terms of both women in poverty and girls (younger than 17 years) who give birth. Without means or maturity, a pregnant female is less likely to get pre-natal care which is associated with preterm birth.
Before entering the NICU I was required to don a gown and do a surgical hand-scrub. Was it just me or was the NICU always a bit warm? The nurse manager was exceptionally nice to me while explaining the temperature control measures for the babies. Pushed from a warm environment too soon, temperature was something that could be controlled for the babies.
OTs started and ran the ‘infant stimulation’ program, but the PTs wanted to get in on it. A bit of a turf war rumbled as an undercurrent in this place. I was an outsider in the NICU, too, among nurses who spent 8-hour shifts with the babies while I visited the room only daily, 2x/day at most. Don’t even think I had more than the merest awareness by the physicians. Classical medical hierarchy was in place. While unknown to most of the community that paid for the care, the NICU was a microcosm of the society surrounding it. Within a space no bigger than your home, staff and MDs interacted on personal and professional agendas despite a communal mission to grow babies out of the nursery.
One day I was doin’ the usual infant stimulation to Baby-who-weighed-enough-for-the-OT-to-touch-him. The routine included some touching (massage), touching to the mouth (oral stimulation), changing the baby’s position (handling), gently moving the baby (vestibular stimulation), talking to the baby and tinkling a bell near his ear (auditory stimulation), moving a black-and-white cardboard target in front of his face and watching for his eyes to follow (visual stimulation). I glanced to my left and saw the neonatologist with an unfamiliar physician working on a baby nearby. Without any prior information I knew what he was doing. He was inserting a small plastic reservoir between the baby’s skull and scalp to collect excess fluid from the brain. Neurosurgery less than 4 feet from me and my tinkly bell.
I pause to think more on that memory and its impact on me, a mother for a while now.
In the NICU were the drama of coming to life and the potential of death.
Like a mechanical womb trying to give birth to numerous babies the NICU showed young-me graphically the intensity and frailty of humanity.
No mothers or babies were turned-away from this hospital. With fewer choices than others they came and were given everything available to survive premature birth.
The numbers of preterm births in the US look big, but you know you are in the minority of birthing mothers and participating fathers for your experiences in a NICU. If family and friends don’t get it, can’t distinguish the mark a NICU experience makes on you, let that reinforce your membership in an elite and proud group of parents. Upon entering the NICU you experienced your child in most unique way, profoundly and dramatically.
You can subscribe to Barbara’s feed here.
In honor of Prematurity Awareness Month, please take a moment to stop by The March of Dimes and sign the Petition For Preemies. Your signature will help raise awareness of this rapidly growing phenomenon, and hopefully gain support for prematurity-related research and data collection.
If you would like to submit your preemie stories and photos for inclusion in The Preemie Adventure, drop us a comment, or email us at matt@redsparks.com.
Matt & Aline
November 13th, 2008 at 5:26 pm
The description of Barbara’s NICU experience from 1978 seems eerily similar to the current times. Having had a child who spent 4 months in the NICU, it is very interesting for me to hear the descriptions from someone on the inside.
“Upon entering the NICU you experienced your child in most unique way, profoundly and dramatically.” I love this line!
Thanks for sharing!
Blessings From Aboves last blog post..Happy, Happy Birthday
November 20th, 2008 at 6:07 pm
Wow. This was incredibly interesting.
Misss last blog post..Two Years Ago (Yesterday)