A Day in the Life of a NICU Doctor

Concentrated Excitement

"The thing that is most dramatic about the NICU is the majority of couples who find they need us are really totally unprepared. The reasons why? Often, they are young -- they haven't thought about the difficulties of life. Having a baby is a happy, great moment in any couple's life. When that is shattered with a problem with their baby, there is shock of dealing with bad news, overwhelming emotions, new medical terminology, who will help. The thing that strikes me about families in this environment is the shock.

If you have a habit in life like smoking and you get cancer, that's a consequence you should be prepared for. We know smoking causes cancer. But when you have a normal pregnancy and you're a healthy woman, you don't expect there to be complications with your infant.

[There are] two scenarios: finding out about a potential problem during pregnancy and complications in the delivery room. If the couple is able to prepare weeks ahead instead of waiting for delivery, there is a process of awareness and meeting the team that allows the family to prepare psychologically and emotionally about what happens next. We also put families in touch with other couples who have gone through it. The shock is what is most dramatic.

Ultimately, no one really knows until that moment of birth what is going to happen. In the hospital setting, there is an expectation of treating and correcting everything. There are times where you go into a situation and you have no idea what happened. There are hundreds of reasons why complications happen. Decreased fetal movement is common. There's a vision from everyone in the room that this is the rest of someone else's life.

In the delivery room, it's a combination of all the wonderful things about having a child, a family is growing, and there's a lot of blood and people crying in pain and it's totally unpredictable until it's done. It's concentrated excitement. The decisions we make -- what needs to happen now, in the next five hours, in the next five weeks -- all need to happen quickly and be communicated to the family. If they understand how and why you're doing things, they're better involved and less panicked."

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