The Early Days of a Micropremie

Introduction

How can we really know what a micropremie senses, knows or thinks as they experience life in the NICU? How does a premie feel when we change its diaper? How does a premie feel when we quickly pull blood off its UAC and just as quickly return it? How does a premie feel when we suction its ET tube? We can not truly know. This is just one NICU nurse's interpretation of what one of the smallest and most fragile of our patients might percieve and think, if he had words, as he experiences such typical interventions and problems as mechanical ventilation, hyperbilirubinemia, hemodynamic instability, echocardiogram, cranial ultrasound and peripheral IV insertion. It is hoped that this "diary" heightens the awareness of the affect that NICU staff has on a premie's physiological and developmental state (good and bad), and therefore the final outcome, as they carry out their jobs.

The outcome is not determined here. This could be a baby that will die during a code, or die in it's parents arms after life support is withdrawn. More likely, it could be a baby that survives its premie course and goes on to experience life with any degree of physical or mental deficits. Undoubtedly, the more gentle, the more developmentally supportive and the more aware the care given to this premie, then less is the likelihood of severe deficit later. Experienced NICU nurses have seen the "miracle babies"; the ones that grow up physically and mentally capable after repeatedly calling on the angels in their earliest days. As NICU care progresses in all areas we can hope that miracle babies become the norm.