Huge care for tiny patients at St. Luke’s East
Lisa Torrey knows what it means to care for even the smallest patients.
In the NICU the name of the game is regulating body temperature, getting babies to feed by mouth and most importantly grow. Torrey is dedicated day in and day out to manage all of the measurements, feedings and most of all time spent with her patients because most often little ones need their rest to simulate the womb. It’s all part of a day in the life.
Torrey has worked in the NICU for three years, and prior to that two-and-a-half years in adult ICU. She always knew she wanted to be a nurse, but more specifically a NICU nurse because when her brother was born he was cared for in the NICU. She said the nurses were just so much fun that it left an impression on her.
Tiny and intricate
As we quietly approach our first room Torrey showed me all of the machines and what they do for each little patient. There’s the expected monitors, ones for heartbeat and breathing. If something were to happen like shallow breathing, her phone will beep to alert her to attend to the baby. There’s also the very precise, the isolettes, can be programmed to an infants weight to keep the right temperature for growth and the bed continues to adjust to the infant’s temperature as they change and grow. A machine for feeding which measures breast milk by the millimeter, and another machine to tell how much milk and infant will need to keep growing. Small curved pillows that look like bumpers and “frogs,” pillows that simulate a weighted touch, help cradle the baby inside the warmed isolettes. Small fabrics drape across the baby to help with boundaries. Torrey said a baby likes to feel boundaries when they stretch out to simulate the womb.
In our next room, we find mom holding her little one, and dad resting on the sofa. Rooms allow for parents to stay the night. She carefully passes him off to Torrey who listens to his heartbeat and changes his diaper. This one no longer has to have his diaper weighed, because his growth has advanced to the next stage. His little arm reaches out of his swaddler. NICU babies get a special kind of swaddle because of their size. As he reaches his arm up Torrey sticks a thermometer under his arm, and he lets out a little cry. “I try to save the things they dislike the most for last, I want them to see interaction as a positive thing,” Torrey said. Taking a temperature is the least favorite for most babies. As the thermometer goes away he gives us a smile and is passed back to mom. It’s time for him to eat and we give mom and dad their privacy.
In instances where mothers don’t produce enough milk the hospital has a milk bank. Mothers who produce more milk than needed can give to the milk bank. It’s screened and pasteurized and stored by date, and labeled pre-term or post-term. Pre-term milk helps with the very small because of the nutrients needed for growth.
The smallest amounts of breast milk, heated precisely to the right room temperature with the help of a special machine helps the babies to grow in the most effective of ways. Too warm and you lose nutrients, too cold and it’s not good for their tummies.
With properly heated milk we go back to visit our first patient. Torrey carefully moves tiny wires, with delicate hands to keep her patient happy. He only cries a little during his diaper change but calms quickly when he gets a fresh diaper. Diapers are rolled down, to not interfere with his belly button.
After a fresh diaper it was time to apply the shades. The shades help block out the light from a bright lamp that shines into the isolette to act as sunlight. The shades Velcro to the sides of the baby’s head on little blue dots. Tape and little stick-ums are applied to keep the baby’s skin protected from tubes. Special binkies are made with an indention so they will fit around their tubes. A little bandage is attached to our fragile patient to protect him from the tubes leaving marks on his delicate skin.
“I try to always put them in a new position, then the last to care for the shape of their heads. This time we will put him on his stomach.” Torrey said. Like an expert in comfort, she rolled up a blanket and placed it in between his arms and legs and gently turned his head then next turned his body. She then carefully placed bumper pillows and frogs around him, quietly closed the isolette door and covered it with a giraffe blanket. At the top of the isolette a little spotlight is filtered in on our little guy’s back. His small back goes up in down with his little breaths. He was off to dream land.
– Ashlee Hendrix