Inside the neonatal intensive care unit

Báo Khánh Hòa•07/04/2023

In stark contrast to the bustling life outside, inside the neonatal intensive care unit of the Pediatrics Department (Provincial General Hospital), every moment, every minute, and every breath of premature, weak babies is nurtured, cherished, and fought for by the medical team, who strive to ensure their survival so they can return healthy to their parents' arms.

High-pressure job

At over 7 o'clock, after handing over her shift, nurse Dang Thi Thu Huong began checking the veins of the seriously ill baby, then the less seriously ill ones; checking blood sugar and IV lines; administering treatment according to doctor's orders; preparing paperwork, contacting family members; bathing, changing diapers, feeding the babies... More than a dozen underweight, premature, or sick babies in incubators or heated beds were continuously monitored by the nurses. Around 12 noon, nurse Huong quickly ate lunch before hurrying back to continue her work so that other nurses could have lunch as well.

The joy of nurses when the babies get better.

Dr. Phan Huu Chinh, Director of the Provincial General Hospital, said: " The efforts of the medical staff and nurses of the Pediatrics Department have miraculously saved the lives of many critically ill children, contributing to the hospital's efforts to maintain and improve the quality of treatment. In the future, the hospital will continue to invest in essential equipment for the Pediatrics Department in emergency and resuscitation for children, especially newborns. It is expected that in April, the Pediatrics Department will be equipped with a modern mobile hypothermia device specifically for children."

Neonatal illnesses are complex and often progress rapidly, worsening just as quickly. Therefore, the monitoring, treatment, and care of these babies by doctors and nurses are always more demanding than usual. A 12-hour neonatal resuscitation team typically consists of 2 doctors, 4 nurses, and 1 orderly, caring for 20 to 25 babies, sometimes up to 30 at peak times. In severe cases, one nurse prioritizes caring for two babies, or even closely monitors only one baby whose condition is deteriorating.

Dr. Nguyen Thi Khanh Uyen, Deputy Head of the Pediatrics Department, had just finished examining a baby when she received a phone call from Cam Ranh Regional General Hospital informing her to prepare for a newborn transfer. While discussing professional matters over the phone, Dr. Uyen and her team were already getting ready to receive the upcoming transfer. At that moment, a muffled cry came from the milk delivery area. A 42-year-old mother from Vinh Thai commune (Nha Trang City) had given birth two days prior, and her baby was showing symptoms of excessive sleepiness, lethargy, refusal to feed, and rapid breathing, diagnosed with neonatal sepsis. After one day of treatment, the baby had consumed 20ml of milk and was being monitored, but the mother was extremely worried because she hadn't been able to be with her child yet, and was restless… Dr. Uyen gently explained and encouraged the mother to calm down before quickly returning to her work…

This is the treatment area for critically ill newborns.

At night, the workload doesn't decrease at all. The entire process becomes much more stressful if a case takes a turn for the worse. However, not all family members are understanding. Some have even angrily broken glass doors demanding to check on patients because they suspected the nurses were sleeping!

The hearts of these "kind mothers"

Caring for and treating premature infants is always a challenge in neonatal resuscitation, especially for extremely premature infants (under 28 weeks gestational age) and extremely low birth weight (under 1,000g). To care for newborns, doctors and medical staff need not only knowledge and experience, but also the love of parents to detect early changes in the baby, from gestures, skin color, breathing, heartbeat, etc. Holding her baby's tiny hand, Ms. MTHN (32 years old, from Son Hoa district, Phu Yen province) smiled happily: “I gave birth at 29 weeks and 4 days. My baby weighed only 1,000g, tiny, and had to be in an incubator. The whole family was very worried and confused, at times almost losing hope. Thanks to the dedicated care of the doctors and nurses here, after 18 days in the incubator, my baby was able to meet me and receive skin-to-skin care. After nearly two and a half months, she can now breastfeed on her own and weighs 3.6kg. I am very grateful to the doctors and nurses here.”

About three years ago, the neonatal intensive care unit received a baby boy from Khanh Vinh district. He was born via C-section but suffered from effusion, scleroderma, and required lung intervention… After more than two months of round-the-clock care, he gradually responded, recovered, and was discharged to his mother. “Recently, during a check-up, the mother brought the baby to visit. Seeing him happy and alert, the nurses didn’t recognize him; the mother had to remind them,” Nurse Huong recounted excitedly. Doctor Uyen also recalled a premature birth at 30 weeks during the Covid-19 pandemic. After the baby was admitted to the unit and weaned off the ventilator, the mother contracted Covid-19 and transmitted it to the baby, causing the baby's condition to worsen and his platelet count to drop sharply. Doctors had to change medications repeatedly, but after 14 days, the test was still positive. After consulting with higher-level hospitals, the answer received was that the baby was unlikely to survive! But after more than three months of intensive care, the baby overcame the critical condition and returned healthy to his mother’s arms.

The baby looks rosy-cheeked after the bath.

"Bringing a child back to their parents' arms from the brink of death is the greatest happiness for doctors and nurses. But we always remind each other that we not only strive to save the child's life but also make every effort to ensure the child recovers with the fewest possible aftereffects, develops normally, and grows up healthy," shared Dr. Nguyen Thi Khanh Uyen, Deputy Head of the Pediatrics Department.

According to Dr. Nguyen Ngoc Huy, Head of the Pediatrics Department, premature babies are very vulnerable and prone to postnatal risks such as asphyxia, respiratory failure, hypothermia, hemorrhage, neonatal infection, jaundice, hemolysis, and anemia. These conditions often progress rapidly. Thanks to the investment in equipment by the province and hospital leadership, the dedication of doctors, nurses, and other medical staff, and the close cooperation of other departments, many premature and low-birth-weight babies have responded well to treatment and been discharged. Five years ago, the survival rate for premature and low-birth-weight babies in the department was only about 70%, or required transfer to higher-level hospitals; recently, this rate has exceeded 90%. Currently, the department is capable of treating premature babies born after 26 weeks of gestation and nurturing many babies weighing less than 900g. Sharing this joy, nurse Huong told us: They are happy to see the children developing well day by day, weaned off ventilators, able to feed, sleeping soundly... and even happier when, after moments of almost having to accept defeat, the babies miraculously recover. However, we know that the babies' recovery is not due to any miracle, but to the nurturing care and attention of these "mothers" and "fathers" in white coats, every minute and every second.

NGUYEN VU - CAT DAN

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