Primary Care Nurses Help Precious Preemies Thrive
Shaniqua Thomas, 31, of Rockville, was on bedrest at Adventist HealthCare Shady Grove Medical Center due to a high-risk pregnancy when she started experiencing contractions.
My OB-GYN said, ‘This baby is coming tonight. She just kicked me,’” remembered Shaniqua. During an emergency cesarean section, beautiful baby Adley entered the world almost four months early – weighing only 1 pound, 13 ounces.
“She was a little nugget, so small her lungs were not fully developed,” Shaniqua said.
In addition to having underdeveloped lungs, premature babies like Adley are at risk for many other serious health conditions.
“Many of these babies require a vent to help them breathe, are at risk for brain bleeds and risk developing retinopathy of prematurity, which causes blindness,” said Susan D’Angelo, a neonatal intensive care unit (NICU) nurse at Shady Grove Medical Center.
The care premature babies receive in the first few days, weeks and months of their lives is critical and requires a special relationship with their nurses. Because of this, Susan spearheaded the NICU’s primary care nursing program. Whenever on duty, a specific nurse cares for the same newborn – for the entire length of the baby’s stay.
“You get to know the baby like your own child,” Susan said. “You build an incredible trust and partnership with the family. So much good comes from it.”
BENEFITS OF PRIMARY CARE NURSING
After delivery, Adley was taken to the Shady Grove NICU and became one of the first babies to receive care using the new primary care nursing model. Susan took expert care of her – and her parents.
Adley needed a breathing machine, feeding tube, brain monitor and a central line catheter to receive medicine and blood. To regulate her temperature, she was kept in a heated isolette, a special medical-grade bassinette.
“We were so nervous. To safely touch her, we put our hands in a special hand pocket on the incubator,” Shaniqua said. She and her husband Andre visited the NICU as often as they could. When they had to stay home and care for their older child, they were grateful to be able to call Susan for updates about Adley.
“We asked about her numbers. Did she have wet diapers?” Shaniqua said. When Adley needed special care, like a blood transfusion, Susan explained the procedures and reassured Shaniqua and Andre.
“As a primary care nurse, you care for the same baby each day for 12-hour shifts. If something isn’t quite right, you know it before anyone else,” Susan said. “You pick up on subtle cues and take action – sometimes before the baby gets very sick.”
Susan often partnered with Yanique Roberts, Adley’s primary care nurse at night.
“They were very loving and cared for Adley as their own,” Shaniqua said. “They gave us peace of mind.”
When premature babies are ready to go home, some still need monitors, oxygen and special medication. Primary care nurses like Susan make sure parents are prepared.
“In the weeks prior to discharge, we slowly taught Adley’s parents everything from feeding to temperature-taking to changing diapers while the baby is connected to wires,” Susan explained. “We want every patient’s discharge to be a day of celebration, not a day of panic. We work toward safe, effective discharges.”
Adley went home with her joyous parents after 85 days in the Shady Grove NICU, weighing 5 pounds, 12 ounces. And now, she’s thriving. She crawls, tries to pull herself up and laughs at her big sister.
“Premature babies are evaluated based on their corrected age – the age that they would have been if they had been born full-term. Adley is far exceeding her expectations, reaching milestones and is way ahead neurologically,” Susan said.
Shaniqua said she and Andre owe Adley’s success to the team at Shady Grove Medical Center.
“We thank our primary care NICU nurses at Shady Grove. They were phenomenal,” Shaniqua said. “We greatly appreciate the care they gave us.”