Obstetrics known as obstetrics and
gynaecology (O&G) deals with women's health. Australian
obstetricians are also gynecologists, meaning they treat all women’s health
concerns. The two disciplines comprise the OB/GYN title, which is considered
a single specialty.
An obstetrician is a medical
practitioner who offers preconception, pregnancy, delivery, and postpartum
medical and surgical treatment.Obstetricians are
responsible for the health of mother and fetus during, before and after
pregnancy. The role can vary from monitoring normal pregnancy to quick
decision making during obstetric emergencies such as severe pre-eclampsia or
postpartum haemorrhage.
Obstetrics is strongly linked to
gynaecology - diagnoses and treatment of disorders of the female
reproductive system.
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Specialisations:
maternal-fetal medicine MFM -
Obstetricians in Australia are also capable of specializing in
maternal-fetal medicine (MFM). Doctors with the MFM subspecialty
concentrate on chronic health disorders and abnormal pregnancy
complications.
medical genetics and genomics (MGG)
reproductive endocrinology and
infertility
specialise or conduct research in
areas such as fertility care or high-risk obstetrics
teach medical students or
postgraduate students in training
get involved in research at
universities, or private sector
Knowledge, skills and attributes
To become an
obstetrician, you would need:
excellent communication skills to manage a wide range
of relationships with colleagues, and patients and their families
emotional resilience, a calm temperament and the
ability to work well under pressure
teamwork and the capacity to lead multidisciplinary
teams
problem-solving and diagnostic skills
outstanding organisational ability and effective
decision-making skills
first-class time and resource management for the
benefit of patients
a high degree of manual dexterity
superb hand-eye co-ordination, excellent vision, and
visuospatial awareness
physical stamina to cope with the demands of surgery
Examines
patients to determine the nature and extent of problems after referral
from general medical practitioners and other medical specialists, and
undertakes laboratory tests and diagnostic procedures.
Analyses test
results and other medical information to make diagnoses.
Prescribes
and administers drugs, as well as remedial and therapeutic treatment and
procedures.
Records
medical information and data.
Order diagnostic imaging to identify signs of a
systemic or autoimmune disorder
Monitor the progress of an existing rheumatic
disorder
Prescribe medications to improve symptoms or
slow the progression of the disorder
Perform a physical assessment to better
understand the symptoms
Educate the patient on the autoimmune disorder
and discuss a treatment plan
Reports
specified contagious and notifiable diseases to government health and
immigration authorities.
Obstetricians are referred patients from general practitioners.
Their practice may take place in a number of different settings including
outpatient clinic, inpatient wards, operating theatres and delivery suits.
Most obstetricians work long and irregular hours. There is an on-call
requirement and frequently weekend / night disruptions. More obstetricians
are beginning to work part time or in job share arrangements.
Tools and technologies
Obstetricians should be familiar with a variety of tools and
technologies including:
ultrasonography and other imaging techniques
fetal tests including cardiotocography
serum screening, amniocentesis and CVS
surgical instruments
catheters
neonate resuscitation
Education and training/entrance requirements
To become an obstetrician, you must first become a qualified
medical practitioner and then specialise in obstetrics.
In Australia, postgraduate courses in medicine are offered by
universities. These degrees usually take four
years to complete. Entry requirements include completion of a bachelor
degree in any discipline. You must also sit the Graduate Australian Medical
Schools Admissions Test and attend an interview at your chosen institution.
On completion of the postgraduate medical degree, you must work in the
public hospital system for two years (internship and residency). To
specialise in obstetrics, doctors can apply to the Royal Australian and New
Zealand College of Obstetricians and Gynaecologists to undertake further
training and ultimately receive fellowship.
A caesarean section (C-section or caesarean) is an operation to
deliver a baby through a cut in the abdomen (tummy) and uterus
(womb).
There are several reasons why you might plan for a caesarean, or
your medical team might recommend you have a caesarean after labour
begins.
Why might I need a C-section?
The most common reasons for having a caesarean are:
*concerns for the safety of you or your baby
*your baby is in the breech position (bottom first) and your doctor
doesn’t recommend a vaginal breech birth
*your baby is transverse (lying sideways) and can’t be turned
*you have twins and the first one is in the breech position
*your placenta is covering the cervix (opening to the womb) - called
"Placenta previa"
* you have had several previous caesareans
*there are complications such as severe bleeding
*your labour is not progressing
Around 1 in 3 babies in Australia are born by caesarean. This is
higher than the rate in many other developed countries. This rate is
also increasing, both in private and in public hospitals, although
you are more likely to have a caesarean in the private sector.
A caesarean might be planned (elective) if there is a reason
preventing your baby been born by a vaginal birth. Sometimes before
or during your labour, complications develop, and a C-section
delivery needs to be done quickly. This is called an emergency
caesarean.
Your doctor will discuss the reason you may need a caesarean based
on your individual situation and, in some cases, your preferences.
You may be in the operating theatre for one hour or more. The
operation takes about 30 to 40 minutes. The baby is usually born in
the first 10 minutes. The doctors will talk to you during the
operation and tell you what is happening.
In most cases your partner or support person can be with you. You
will also usually have a midwife with you. They will look after you
and your baby in the theatre and recovery area.
You will usually receive an epidural or spinal anaesthetic. This
numbs the lower part of your body and lets you be awake throughout
your caesarean birth. Sometimes emergency caesareans must be done
under general anaesthetic which means you will be asleep during the
birth.
A catheter (a thin flexible tube) will be placed into your bladder
to collect urine. This is because you will not be able to get up to
use the bathroom. You will have intravenous (IV) lines inserted into
your arm to give you fluid and medicines.
Your tummy will be cleaned, and the obstetrician will make a cut
through the wall of your tummy near the pubic hair line. The doctor
will cut through layers of fat and muscle and then through your
uterus. Your baby is birthed through your tummy this way. If your
baby needs to be delivered very quickly, the cut may be made from
just below the belly button to above the pubic bone.
The doctor will remove the placenta and close the cut with stitches
or staples. You will feel tugging and pulling if you are awake but
not pain. You will also hear fluid being suctioned. A screen is
usually put across your chest so you cannot see what is happening.
If you are awake, you can usually hold your baby straight after your
caesarean birth and begin skin-to-skin contact and breastfeeding.
Sometimes the baby’s nose and mouth need to be cleared of fluids or
the baby may need additional treatment from the medical team.
Who will be in the Operating Theatre ?
Your partner or support person will usually be able to be with you
during your caesarean. There may also be a lot of medical staff,
including:
obstetrician — who performs the operation and delivers the baby
anaesthetist — doctor who administers
the anaesthetic
scrub nurse — passes instruments to the obstetrician
scout nurse — assists the scrub nurse
anaesthetic nurse — assists the anaesthetist
paediatrician — doctor who looks
after the baby after the birth
midwife — nurse who looks after the baby
until you return to the ward
theatre technician — looks after the operating theatre and helps you
on and off the table
What are the pain relief options?
The types of anaesthetic used in caesareans differ. Your doctor will
choose the most appropriate for you.
Epidural
When you get an epidural, you receive a local anaesthetic then a
hollow needle and a small, flexible tube (catheter) are inserted
near the spinal cord in your back. The needle is removed, leaving
the catheter in place. Anaesthetic medicine is injected through the
catheter and can be topped up later.
Spinal block
Similar to an epidural, a spinal block injects a single dose of
anaesthetic directly into the fluid around the spinal cord. You will
go numb very quickly, but the amount of anaesthetic cannot be topped
up.
General anaesthetic
You might be given a general anaesthetic if
a spinal block or epidural anaesthetic doesn’t work
there isn’t time for a spinal block or epidural anaesthetic to be
used
there are concerns for your health or your baby’s health
you request a general anaesthetic
What are the risks and complications of C-sections?
A caesarean is major surgery. Complications are rare but they can be
serious. The risks include:
blood loss
wound infection
blood clots
possible damage to organs near the operation site, such as your
bladder
risks from the anaesthetic
The risk of complications increases if you are overweight.
If you have a caesarean, your future pregnancies will be considered
higher risk and there are more risks with future caesareans.
Sometimes babies born by C-section can have temporary trouble
breathing. The midwife and paediatrician will take care of your
baby. There is a very small chance your baby can be cut during the
operation. This is usually a small cut that isn’t deep and will heal
on its own.
What should I expect when recovering from a caesarean birth?
There is usually a slower recovery after a caesarean birth compared
with vaginal birth. You may feel pain for a few days, but this can
usually be treated with pain-relief medication. Usually, you will
stay in hospital for three to five days.
Your obstetrician and midwife will provide advice about your
recovery.
Embryologists work closely with other medical
professionals to perform diagnostic tests and procedures such as in vitro
fertilisation (IVF) to assist patients with reproductive health issues.an lang="en-gb">
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Knowledge, skills and attributes
To become an embryologist, you would need:
empathy and care for others
an interest and ability in science, medicine,
anatomy and physiology
good communication skills and the ability to
explain procedures to patients
self-confidence
practical skills for performing technical and
clinical procedures
Embryologists often work irregular hours, including early mornings,
evenings, weekends and public holidays. Part-time or flexible hours are
usually available.
Embryologists usually work in positions involving either clinical practice
or fertility research, in fertility clinics, hospitals and research
laboratories. When you are working in a laboratory, you would wear a hat and
mask, and work in controlled conditions, in close proximity to colleagues.
Education and training/entrance requirements
To become an embryologist, you usually have to obtain a bachelor's degree in
biological science or biomedicine at university, followed by a master's or
postgraduate qualification in a relevant field such as reproductive science
or clinical science. To get into bachelor's courses you usually require a
senior secondary school certificate or equivalent.
Entry into this field is very competitive.
Additional Information
Students and graduates may be eligible for membership with the Fertility
Society of Australia (FSA) and with the Scientists in Reproductive
Technologies (SIRT) sub-group. SIRT is a special interest group representing
the scientific membership of FSA. They promote the education and training of
scientists working in reproductive technologies.
Employment Opportunities
Demand for embryologists is expected to grow moderately with the increase in
the use of assisted reproductive techniques.
This is a specialised occupation, so while the actual number of roles
available is quite small, qualified embryologists should be able to readily
find employment in larger population centres.
Once you are employed you will receive on-the-job training in protocols.
There are fertility clinics located nationwide in capital cities and larger
regional centres.
With qualifications in Genetics and Assisted Reproduction
Technology, Lydia trained to be a Clinical Embryologist in
Birmingham.
With research experience in early embryo development at the French
National Research Institute and clinical practice observation in
Australia, she brings her wide-ranging expertise to Manchester
Fertility to help give you the best chance of a baby. My Day starts at 6.30am
My day starts at 6:30am with coffee and breakfast, then a quick dog
walk. I usually cycle into work and change into my scrubs ready to
open up the lab for 8am. We start the day by checking the
temperatures of all our equipment and making sure that everything is
ready for us to handle eggs and embryos safely.
My first task is to check the eggs from the day before to see if
they have fertilised. The embryos are in our time-lapse incubators,
the EmbryoScopes. So I can to review an overnight video of each
embryos while they remain safe in their stable environment inside
the incubator. I then phone the patients to give them details of how
many embryos they have and answer any important questions.
Once this is done I check the embryos for that day’s embryo
transfer, again using the EmbryoScope. For day 5 embryos
(blastocysts) we assess the size and then assign a grade for each
part of the blastocyst based on their appearance. The EmbryoScope
also generates a score, and allows us to review each embryo’s whole
period of development for any unusual behaviour. It feels very
special being able to watch from the first signs of fertilisation
through to blastocyst formation, contemplating how something so tiny
can have so much potential.
Once I’ve graded the embryos and chosen which are suitable for
transfer and cryopreservation (freezing), I will contact each
patient to confirm details for their transfer. I then use a pipette
to carefully move the chosen embryo into a new dish containing
EmbryoGlue. (EmbryoGlue is not an actual glue, but it acts like glue
by increasing the chance of implantation of the embryo to the womb). At 11:00am
It’s time for the embryo transfer. This is one of my favourite
procedures as it’s an exciting time; after five days of waiting (and
of course often months or years before that) the patient can see
their embryo for the first time. I’ve heard some nice embryo
nicknames, and lots of jokes from patients that their embryos look
like their dads.
The doctor and I use our electronic witnessing system to confirm we
have both checked the correct dish is ready. As well as our manual
checks, every dish in the laboratory is electronically tagged, so
the system would alarm and stop any potential error at any stage.
When the patient and doctor are ready I load the embryo into a fine
plastic catheter and quickly hand it to the doctor, ensuring it
spends minimum time exposed to room temperature. After a minute or
so the embryo has been replaced into the patient’s uterus and I
perform a final check that the catheter is clear.
Meanwhile my colleagues have been performing egg collections,
preparing frozen embryos for transfer, and preparing the partner and
donor sperm samples for treatments. The lab can feel quite busy in
the mornings, especially because some procedures like egg freezing
are really time critical. Luckily, I have a great group of
colleagues. We’re all really close and have lots of strategies for
working effectively as a team and ensuring everything runs to time,
something I definitely appreciate on busy days.
At 12:00 noon
In the afternoon our jobs include Intracytoplasmic Sperm Injection
(ICSI). This involves injecting a single sperm into each mature egg.
We’ll also rapidly cool suitable embryos, a process known as
vitrification, and load them on to a tiny plastic device for storage
in liquid nitrogen.
We have regular case meetings, visiting speakers and journal clubs,
ensuring we’re aware of any new developments in the field that can
further help our patients. There’s often news of positive pregnancy
tests or baby photos being shared around. There’s a brilliant sense
of shared celebration hearing these updates after all our hard work
and you can really see the love everyone has for their job - we are
one big team.
We’ll also catch up on our own side projects and any patient call
requests and messages through our Salve app. Although we can’t
always come to the phone immediately we’re always happy to make time
to discuss a patient's embryos. By 4pm
We’re closing up the laboratory, making sure everything is clean and
performing all of the temperature checks again ready for another
busy day. End of Day
At home I try to get outside as much as possible to unwind; running,
growing vegetables, camping with friends and hiking with my
girlfriend and our puppy. I do find myself thinking about certain
cases, especially if someone only has a small number of embryos or
has had a particularly difficult fertility journey. But hearing
positive news from patients and knowing I had even a small part in
that is the best feeling, I can’t imagine doing anything else.
Most neonatal nurses work in units
called neonatal intensive care units (NICU). These professionals provide
care and support during the first month of a newborn's. They particularly
monitor babies that require special medical attention. The level of care
they provide to newborns depends on their needs, and each state and
territory in Australia maintains its own tier system for NICU
classifications. Typically, healthy newborns receive care at the first
level, while those who require specialised care for illness or congenital
disabilities receive higher levels of care.
A neonatal nurse is a registered nurse (RN) who
specialises in providing supportive health care to newborn infants up to
four-weeks-old. Neonatal nursing involves caring for infants born with a
variety of problems ranging from prematurity, birth defects, infection,
cardiac malformations, and surgical problems. The neonatal period is defined
as the first month of an infant’s life; however, some newborns may require
ongoing care.
Neonatal intensive care nurses help
provide various levels of care and support to newborn babies and their
families. They care for healthy babies and those with health challenges.
A neonatal nurse’s role involves varying aspects, such as clinical,
educational, managerial and research. You will find a neonatal nurse
typically in a neonatal intensive care unit, nursery, baby care unit,
postnatal ward, emergency room, or even amongst the community.
Caring for newborn infants can be one of the most rewarding experiences in
the nursing profession, but can also be just as heartbreaking.
Alternative names: Neonatal
Intensive Care Nurse, NICU Nurse,
Knowledge, skills and attributes
Neonatal nursing is a very challenging profession. It is a technical job
which requires a lot of monitoring and administering complex treatment, as
well specialised care for neonates with serious and complicated medical
issues. Dedication and high resilience, are must-have qualities to
successfully confront these challenges and to maintain a long career.
Moreover, one of the most challenging roles of a neonatal nurse involves
providing end-of-life care to the unwell baby and providing support to the
grieving family. Emotional strength is necessary when facing this aspect of
the job.
Neonatal nurses perform a number of tasks with newborns including providing
general care, administering treatment, performing tests, documenting patient
history and operating specialised equipment. Their duties may also include:
preparing and checking medications
managing a baby’s fluids
recording observations and documenting a baby’s
care
initiating appropriate basic resuscitation in an
emergency situation
educating and supporting parents
Basic neonatal care
Neonatal nurses care for newborns beginning immediately after birth. Some
common duties for primary neonatal care include:
weighing and measuring the baby upon birth
bathing
monitoring the health of the newborn
providing support to the medical team and family
educating new parents about newborn care and
breastfeeding - educating families about caring for
their newborns
communicating with the newborn's doctors, nurse
practitioners, physician assistants, nutritionists and surgeons
providing basic care, including frequent diaper
changes, skin care needs and positioning
giving medications as prescribed for the
newborn's condition
Advanced neonatal care
Besides providing basic newborn care, neonatal nurses provide advanced care
to babies who require extra medical attention. Neonatal nurses may work with
newborns with a variety of health concerns such as:
issues related to premature birth
congenital defects, such as heart issues
chronic health conditions, such as genetic
disorders
surgical issues and other body malformations,
such as a cleft palate
Working conditions
A neonatal nurse's shift is similar to that of other RNs. RNs usually work
12-hour shifts in the hospital or 13 shifts a month. Depending on where you
work and the level of care you provide, a neonatal nurse may work:
Neonatal nurses often work in stressful environments, where they remain calm
and provide support and care to newborns and their families. It's important
for neonatal nurses to be quick problem-solvers who work well under pressure
and have excellent communication skills.
Additional Information
Being a nurse exposes you to all types of emotions on a
daily basis especially when working in an intensive care unit. Sudden
changes or health deterioration can take place quickly and emotions can be
subject to extreme highs and lows. Along with these emotional challenges,
you have to provide special and often complex nursing care to an unwell baby
while also providing support to the family.
Education and training/entrance requirements
To become a neonatal nurse, you must first be a registered nurse (RN) and/or
midwife, both of which require the completion of a Bachelor of Nursing &
Midwifery. As a graduate you may then have the opportunity to be placed
within a neonatal ICU (NISU) or specialised nursery unit.
It is not essential for a neonatal nurse to possess a postgraduate
qualification in the neonatal area, but it is often preferred by many
employers. This may include a Graduate Certificate or Master’s level
qualification in the specialised field, which will involve some mandatory
placement. To gain entry to one of these courses, many education providers
will require you to have some experience in neonatal before being admitted
to the program.
There are also other certifications and short courses that be undertaken to
develop your career in neonatal nursing.
After you graduate with your bachelor's degree, register with the Australian
Health Practitioner Regulation Agency (AHPRA) to become an RN. The AHPRA is
a governmental regulatory body that oversees the credentials of health care
professionals. The agency requires all nurses to apply for registration
before practising and to renew their registration each year.
Employment Opportunities
Nurses and midwives, in general, are highly in demand in Australia. Neonatal
nurses can work in various settings, in a private or public institution.
Depending on your qualifications, both academic and practical, you can
choose to work as a practitioner in a hospital, be an educator, participate
in research or eventually take up a managerial role.
Did You
Know?
The following information is taken directly from
Qld Health.
The stories are about three Neonatal Nurses and the NICU at Royal
Brisbane Women's Hospital.
In hospitals, the Neonatal Intensive Care Unit, or NICU, is a busy
micro-world. The staff who run the NICU, a team of round-the-clock
nurses and doctors, are highly trained to offer specialist care to
the newborn babies and families in their ward.
We spent some time in the Royal Brisbane Women’s Hospital NICU ward
with nurses Haley, Beth and Sarah, learning what life is like inside
the NICU and what it takes to be a NICU nurse.
NICU Neonatal nurses (from left) Haley,
Sarah and Beth attending to baby Henry.
What is NICU?
A Neonatal Intensive Care Unit provides care for newborn babies that
are very unwell. Often, these babies have been born prematurely,
with some babies born as early as 23 weeks gestation. Full-term
babies – babies who have been born around their expected due date –
might also be placed in the NICU when they are born if they are very
unwell.
Like an Intensive Care Unit for adults, the NICU is reserved for the
sickest patients. “Sometimes people don’t realise it’s an Intensive
Care Unit,” says Haley. “It’s not a normal ward for babies. They are
receiving very high care.”
Some babies will require ventilation, which means a machine helps
them to breathe through a tube down their throat, because their
lungs aren’t fully developed. Most will also have different tubes
and monitors attached to their bodies to help them feed, receive
medicine and monitor their health.
As the babies gradually grow and get healthier, they can be moved to
the Special Care Nursery of the hospital to receive ongoing care.
Eventually they are released to go home with their families. Despite
the best efforts of the team, some babies don’t respond to the
medical care they receive in NICU, and the decision may be made to
withdraw their care and provide palliative care instead.
Life inside the NICU
The NICU at RBWH is separated into a series of rooms, each
containing six cribs. There can be up to 28 babies in the NICU, many
who will stay for over 100 days until they are well and strong
enough to move to Special Care and eventually go home.
The NICU is a busy place. Each NICU room is allocated a set of
nursing staff, who look after one or two babies each throughout
their shift. The nurses work with doctors and other allied health
professionals to provide 24-hour care for the babies and their
families. At any one time, there can be three nurses in a NICU room,
a Neonatal Education Support Team (NEST) staff member who helps them
with their work, doctors, other health professionals, and parents
and families visiting their babies.
Neonatal nurse Haley enters patient
observations and other details into a patient’s chart.
The NICU is not the type of environment new parents would typically
dream of for their baby’s first home. Large cribs dwarf the babies
they contain, who lie inside tiny and fragile, fighting for life.
Bright fluoro lights line the roof so staff can see clearly when
doing detailed work on their small patients. The air smells of the
hand sanitiser that is constantly used to rid staff and visitors of
infectious germs, and the monitors and machines beside each crib
beep and flash to give second-by-second updates on the babies’
health.
Where possible, small details are put in place to make the NICU more
homely. Rooms of the RBWH NICU are decorated with an ‘under the sea’
theme, and brightly painted dolphins, turtles, seahorses and fish
splash, dive and swim along the walls. While the babies don’t wear
typical baby clothes, in their cribs are pillows and blankets
covered in colourful children’s fabric.
The NICU isn’t filled with the cries and coos of babies you would
expect from most nurseries. Some of the ventilated babies aren’t
able to make sounds around their breathing tubes, and because they
have been born prematurely or are unwell, most NICU babies also
spend a lot of time asleep. “They’re using a lot of energy,” Beth
explains. “They’re learning to move in a different environment,
learning to breathe and to eat – it’s exhausting for them, so they
sleep a lot of the time.”
But, Beth says, the babies still behave like babies. “Like any baby,
they do let you know when they need a nappy change!” she says.
Working to routine
The NICU revolves around routines. Nurse shifts can be either 8 or
12 hours, and a detailed chart updates them on where each baby is at
when they start their shift.
Each baby is fed every couple of hours, and a large fridge sits
outside the room with containers of mums’ breastmilk labelled for
each baby, as well as donated milk supplies from the Milk Bank.
Other regular forms of care include changing the babies’ nappies and
turning their heads to rest on alternate sides.
Sarah says that people often think that NICU nurses spend their days
holding babies, but in reality, they don’t touch the babies that
often. “We turn the babies over every six hours. We try not to touch
them too much, because it makes them uncomfortable,” she explains.
Cuddles are reserved for parents, though it can take a long time for
some babies to be well enough to be held out of their crib. One
mother is visiting her 10-week-old baby, born at 24 weeks, who she
has only been able to hold twice. Instead of cuddles, she places her
finger in his little hand and holds his head, soothing actions NICU
teams called ‘hand cuddles’ that are beneficial for both child and
parent.
There are some routines that vary for each patient. The babies may
be prescribed medications that need to be given regularly. Some of
the babies require frequent tests to monitor things like the levels
of carbon dioxide in their breath, which gives an indication of
their health. The nurses might also use charts to record the outputs
of the monitors that track the babies’ vital signs and the work of
their ventilators.
Some tasks only happen as needed. When one of the babies needs an
x-ray, a medical imaging team come to the ward with a portable x-ray
machine that they can use to complete her scan without moving her
from her crib. One baby requires the tape securing her breathing
tube to be replaced, as saliva and fluids have made it come unstuck.
Two of the nurses are required to do this delicate task, as the tube
must stay in place so that the baby continues to breath while the
securing tape is changed.
NICU Nurses Haley and Sarah
replace the respiratory and feeding tubes for a patient, which is
delicate and fine work performed through the hand access points in
the crib.
Whole-of-family care
While the babies are their first priority, the nurses also provide
support and care to their patients’ families. Having their baby stay
in NICU is usually unexpected for parents and not part of the
journey they had envisioned when planning a pregnancy and birth.
“I do the best I can to support families,” says Beth. “This work
makes you appreciate how short life is, and how the impact of an
experience like this can carry on over an entire lifetime. Their
relationships can suffer, and it’s good for them to have someone to
be able to listen to how they feel and say, ‘That’s normal’.”
The nurses provide emotional support for the parents and families,
help them understand their baby’s condition and medical care, and
refer them to support services like counsellors and social workers
when needed.
Because NICU babies might stay in hospital for many months, visiting
them in hospital can be difficult. Some parents need to go back to
work after they’ve run out of available leave, and many don’t live
close, meaning they might not be able to visit their babies as often
as they want.
When a baby’s family isn’t able to visit often; because they live
far away, have to work or have other children to care for, the
nurses keep them up-to-date with regular phone calls, so they still
feel connected to their child.
“You don’t just look after the babies, you’re looking after the
families here and at home, too,” says Haley.
“They’re all amazing,” says one mum, who has driven to Brisbane from
Warwick to visit her baby. “They keep me from going crazy and make
sure I always know what’s going on and understand everything. They
provide a listening ear and a shoulder to cry on when I need it.”
Beth with mother Morgan and baby Henry.
What is it like to be a NICU nurse?
When Sarah started her general nursing training, she didn’t know
that NICU existed.
“I did six months in the Special Care Nursery during my training,
and I discovered NICU during that time,” she says. “From the
outside, you don’t really know NICU exists.”
She’s now worked in NICU for five years and says she enjoys the
family care aspect of her job. “I love looking after the families
and meeting people through my work.”
Haley has been working in NICU for 10 years, and is now part of the
NEST program, which means she supports new NICU nurses as they do
their work, and is on the ward to help out if anyone has questions
or needs an extra set of hands.
“The best bits for me are watching the parents when they get to
experience those normal milestones for the first time, like getting
to bath their baby or getting to hold them,” says Haley. “Of course,
seeing them spend so much time here and then finally get to go home
is amazing.”
Beth echoes this sentiment. “That rush of emotions for parents when
we’re getting them out the door is overwhelming,” she says.
This is Beth’s tenth year in NICU, and her fortieth in nursing,
having spent her earlier career in paediatrics. “In nursing, you
know when you’re in the right place,” she says, “and I’m in the
right place. I find babies less difficult than adults – babies are
what they are, they don’t have any other agendas. I’m getting to the
end of my career and I can honestly say I’ve never wanted to do
anything else.”
Like all nursing roles, there are also difficult parts of the job
for the NICU nurses.
“Not all of our babies make it,” says Sarah. “Everyone gets affected
by that in different ways.”
“The hardest part is end of life,” agrees Haley. “Having to watch
the parents go through that is very difficult.”
Leaving work at work can be difficult. Time spent in the NICU can be
tense, especially if a baby isn’t doing well.
“The babies are so little,” says Beth. “When they go downhill, they
can go downhill really fast.”
“The hardest part is self-care,” she says. “There’s constant grief
and loss. Not just if a baby passes, but of the whole experience.
Mums and dads lose the experience they thought they were going to
have. You have empathy and sympathy, but you also have to draw the
line for yourself.
“On my days off, I’m an outside person. I get out in nature, go to
the ocean, and remind myself that I’m a small cog in the machine; I
don’t have to be responsible for the whole outcome.”
Even though there are challenging days, the nurses relish the
opportunity to work with their NICU babies and families.
“The babies teach us so much,” says Beth. “Their fortitude, their
will to keep going. They are my proof that here, miracles do
happen.”
A premature baby's job is to recover,
strengthen and grow through sleep. (Source: Qld Health)