As I develop a new product I find myself in a conundrum.
Previously, when I dealt with only respiratory items, I could conveniently look at the NICU world as if it were an entire room full of little lungs. When I was embracing developmental considerations, I could wrap my head around that: normal eyes, normal hips, normal hearing, normal skin, and normal eating skills were some of the goals to be achieved after leaving the NICU and going home to be cared for by Mom and Dad. I can now see that even then I gave lip service to the baby as a whole picture; I didn’t imagine, and probably couldn’t have imagined, just how tricky the balance of total-care for our babies actually is. While addressing the many issues in the NICU there is definitely a fair share of critical issues but does that mean we can’t, we won’t, or maybe we just don’t, address the developmental issues?
For a moment, let’s think about what parents experience when they come into the NICU, into the room where their baby has spent hours, days or maybe even months attached to tubes and wires, surrounded by machines. Does every piece of effective equipment have to look like it’s from Starship Enterprise? Would it interfere with the function of a fluid pump if it had baby animals on it? These parents had an expectation of taking their newborn home to a cozy, comfortable room that they had prepared for him. Instead, they are confronted with a completely different set of circumstances. An unknown, undefined, much scarier set of circumstances. From the bedside in the NICU, I believe we are addressing this issue the best that we can. I really hope that these thoughts and questions can be considered by manufacturers too. When dealing with a cardiac issue do developmental, or respiratory goals have to be put on hold? In my opinion, it seems like they are most of the time. It’s not intentional and certainly I understand that the critical considerations have to come first. (If I were in an accident, I am all about focusing on not dying before I worry about what my hair looks like. If the hair has to go to accomplish job one then… ok. Duh.)
I have seen units so focused on high humidity for their micro babies that in addition to their smallness, they then have to try to stick things to wet babies. Very difficult. And, adhesive can’t be too sticky or the baby’s skin gets injured. Arghhh. Maybe a little drier so things can stick? Maybe a little darker so the baby eyes are protected, or brighter so the nurse can see to accurately put in that IV? The recurring theme about teamwork pops up again. I’ve seen the tape to secure IVs rubbed with cotton so it wouldn’t be so sticky, but of course then it doesn’t hold the IV in either. Between a rock and a hard place. Should we use wide pieces of tape that have less adhesion or smaller pieces that stick well? See? A conundrum…
My admiration goes out to those bedside caregivers who balance. The specialist who sees the need to balance and compromise. The physician who acknowledges the concerns that are ongoing, though they may not be on the critical list, considers them once again after the storm passes.
To the NICU graduates… You all had an entire team looking after you from your tiny lungs to your tiny (yet big) heart. From your abducted hips and many poked heels, to your phototherapy and your swaddling. That hardworking team, when it was at its best, kept your care and comfort the very best it could be and kept the bad parts to a minimum.
In the case for ALL the precious babies fighting to stay alive couldn’t we at least take into consideration every aspect of the total-care and try to accomplish as many things at a time and also maintain some sense of sanity? I know it must be possible. Even though there are so many things to balance, surely there must be a balance. Things to de-prioritize but not to forget. Things to remember and things to let go of. There must be answers about how we can provide the very best TOTAL-CARE for our babies. And that’s why I do what I do. I want to challenge the conundrum, face it head on, and find some answers.