"trust the journey"
one nurse’s sage advice for any NICU parent
In honor of NICU (Neonatal Intensive Care Unit) Awareness Month, we talked with nurse Ploy Limpraphanonta about all things NICU. Read her amazing take on the tiny miracles that take place there every day.
- So, you’re a NICU nurse in NYC. What’s that like?
Being a NICU nurse in NYC is very busy and demanding, but also very rewarding. It’s such a diverse environment where I'm exposed to so many various ethnicities, cultures and nursing challenges on a daily basis. Every day is totally different and you never know what to expect. Many pregnant mothers just walk in with what they think are minor complaints but end up giving birth to their baby prematurely. We have babies as young as 24 weeks gestation and are barely 1 pound! It definitely is a satisfying job when you are able to build relationships with families who are here for sometimes months at a time and we’re able to watch their little ones grow together until they are ready to finally go home.
- NICU stands for the Neonatal Intensive Care Unit – which sounds incredibly scary to any person, parent or not. What are some of the things you might tell parents that could assuage their fears?
After working in the NICU for two and a half years, my advice for parents is that they need to be as patient as they can be and to trust the journey. Having mothers just give birth to a precious baby who ends up in the NICU is always worrisome. Sometimes these patients are in the NICU for just a few days but it can also be for several months. Due to the potentially critical status of the patient, parents should feel free to ask any type of questions they have on their mind. They should also try to be involved in their baby’s care as much as possible. Babies can definitely feel their parent’s presence which aids in their healing and growing process. Our NICU team always encourages skin to skin care where parents are able to create bonds with their little ones. It also has many health benefits such as stabilizing the baby’s heart rate, breathing, temperature, blood sugar, and promotes breastfeeding.
- Can you tell us a little bit about the different levels of NICU care?
Every hospital has a different level of care for their nurseries and NICU’s. There are four different types which range from levels I to IV. Level I would be considered a well born nursery where stable, healthy babies go to. Level II would be a special care nursery where moderately ill newborns are taken care of. Level III – (my hospital’s NICU), is considered a NICU where very premature or sick newborns can be cared for. Level IV’s are the highest tier usually classified as regional NICU’s and are for very sick babies. They are highly specialized in surgeries, cardiology and respiratory issues, thus other hospitals often transfer their most unstable or difficult cases for care to a level IV NICU.
- We can only imagine what your day-to-day looks like – it must always be so different. How would you describe, on average, what the typical day looks like for a NICU nurse like yourself, and what it is that a NICU nurse does?
Every day brings new challenges. A typical 12 hour shift in the NICU includes assessing and providing care for our patients. We provide feedings by bottles or feeding tubes, administer medications intravenously or orally, encourage bonding time with parents such as skin to skin care and assist with various procedures like x-rays or IV line insertions. We have to be prepared for any kind of situation since our babies’ conditions could decline rapidly. It is a very high stress unit and many unexpected things can happen. As nurses, we are intimately involved with patient care and are the first responders if any issues do occur. Doctors depend on us to inform them of any changes and trust our assessments. We can grow so attached to our babies since we experience many milestones with them during our care. Some examples include a baby finally reaching 2000 grams – a healthy weight for a baby to go home – or if a baby can finally breathe on room air after being on oxygen support for months. These little things make being a NICU nurse truly rewarding.
- What made you decide to take this career path, and to become a NICU nurse specifically?
The reason why I decided to take this career path as a NICU nurse was because of my own mother. She was a NICU nurse for 10 years and encouraged me to also join this field. I was always motivated by her personal stories and experiences. I love working with babies and I am able to learn so much from this unit. Being in the NICU allows me to also focus on my patients and provide the best care. We really do see miracles happen in the NICU and it’s an amazing thing to witness.
- What does being a nurse mean to you?
I’m proud to be a nurse and wouldn’t have it any other way. Being a nurse has its challenges but is also so satisfying. There are times when we work tirelessly on our feet for 12 hours straight without any breaks but we do it because we always put our patients first. A lot of compassion and patience is needed in this field. At the end of the day, I’m happy to be able to say that my profession is saving lives.
- Can you name a NICU case or patient that made the biggest impact on you?
There are so many NICU cases I've seen that have left some sort of imprint on my heart but one of the most memorable ones happened recently to me. I have been taking care of a very critical baby all day who was just one day post-operation. He was intubated, in pain from just having surgery, and basically hanging on for dear life. I made it my duty to make sure I gave the best care possible, took my time with him, and quickly relayed any issues I encountered to the doctors. As I was working with his IV line on his arm, he suddenly gripped my finger so tightly. Worried something was wrong, I took a look at his face and I saw the biggest, cutest smile. My heart felt so happy and full because he was thanking me for helping him feel better.
All the NICU babies that I have encountered over time have taught me a valuable lesson: that time is of the essence. Every second, minute, hour, day, week, and month has so much value in the NICU world.
- What’s the biggest advice you can give to NICU parents?
My biggest advice to NICU parents is to be patient and to enjoy the little moments. The journey of a premature baby is fraught with many ups and downs but having the support of their loving parents is extremely vital. Witnessing parents who never give up on their baby inspires hopefulness to the babies and the NICU staff. Each of the babies I have encountered in the NICU are strong, little troopers. They may look fragile and tiny, but they are a lot stronger than they appear. They fight for their lives and with a little help from us, miracles truly do happen here.
My name is Pairploy Limpraphanonta but everyone calls me Ploy! I’m a Registered Nurse and have been in this profession for over four years. I currently work in the NICU but also have experience in geriatrics and psychiatry. I am back in school for my Master’s as a Pediatric Nurse Practitioner. In my spare time, I love to travel the world.