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Parents
Stories
Twins
- a father's perspective
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Bradley
and Sebastian
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Naomi
gave birth to our twin boys, Sebastian and Bradley, on
29 October 2004. Delighted as I was to finally meet the
reasons for my rapidly expanding wife, the boys were 9
weeks premature. They were very small and were moved immediately
to the NICU. I’d read about NICU, but the reality
of intensive care can be daunting. Room A is a hive of
medical activity, with a small army of dedicated professionals
whose job it is to tend to their tiny incubator charges,
whilst reassuring parents who are often in a minor state
of shock.
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I
must confess at this point to feeling like a bit of a charlatan
in writing about the NICU experience. Our boys spent over
a month there, but they had a relatively easy time of it – just
some of the routine prem-baby complaints; jaundice, excess
red blood cells, periodic oxygen, etc. For parents, however,
it is always going to be a stressful episode, regardless
of the duration. When you’re not worrying about the
conditions your newborn has, it’s difficult not to
worry about conditions that they might develop. Instead,
it helps to turn what feels like a morbid curiosity about
the other NICU incumbents into some common ground with
the other NICU parents - about how the babies arrived there,
about their daily progress and about how they are coping.
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Seb & Brad
spent 7 days in Room A, with its flashing lights, pinging
alarms, clicking monitors and occasional flurries of activity.
Room A slams home the meaning of ‘intensive’ care.
As a ‘newborn’ parent, I cycled through an
array of emotions – fear for the babies’ health;
intimidation in the face of seasoned medical expertise;
confusion over the equipment and the daily routine, uncertainty
about my own role, and even guilt – was this somehow
my fault? These are normal reactions. Proof can be found
on the face of every parent who attends NICU. Like many
men, I like to kid myself that I exercise some control
in my life.
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Bradley
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Experiences
like Room A, where, quite literally, lives are at stake
every day, can do serious damage to such illusions. The
nurses will assure you that as a parent your mere presence
is important for your babies. This may well be true, but
overlooks a significant point – we men feel distinctly
uncomfortable unless we can contribute by ‘doing’ something.
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Steve
and the boys
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So,
after 7 months of escalating anticipation, 2 days of private
panic and a 36 hour labour, here they were - my sons – and
me with no role to play! In Room A, at least, my presence
seemed superfluous. Medics calmly and efficiently went
about their duties; Naomi was recovering from her C-section
on the ward upstairs, leaving me to get on with the job
of fretting quietly around the incubator during lulls in
treatment. I felt sometimes that I might actually be getting
in the way. NICU can seem quite cramped until Room C, where
there is less dependence on machinery.
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The
truth, however, is that there is a critical parental role
to fulfil from the day of the birth onward. The medical
team is there to keep your baby alive and as physically
well as possible. Parents are there to assist, to support,
to participate when possible – in essence to bring
meaning to all that professional medical treatment. Medics
are people too – how much easier must the job be
for them if they know their charges are going on to loving
homes and caring parents.
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Our
boys were moved to Room B, passing from intensive to high
dependency care – not out of the woods, but definitely
a move in the right direction. Room B is slightly smaller
but equally cramped and usually busy. It is notably quieter
than A and therefore less stressful. Parents are encouraged
to be present for regular ‘cares’ - the politically
correct nursing term for gastro-nasal tube-feeding & excavating
nappies. Some babies oscillate between rooms A & B,
if their welfare requires it, but our boys had 10 reasonably
peaceful days before being moved again, to Room C, or low
dependency care, where they would spend another couple
of weeks. C is the place to be. It is quiet, spacious and
with fewer, friendlier machines. The nurses in C are quick
to encourage parent participation, and willing to assist
with ‘on-the-job’ training in how to look after
squawking, hungry infants. There is also a physical sense
of relief as one nears the Holy Grail of the NICU experience – moving
to Ward 76!
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Naomi
and Sebastian
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With
Sister
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As
soon as Seb & Brad were off oxygen and able to maintain
their own temperature without a ‘hot cot’ (literally
a heated cot), they (& 2 eternally grateful parents)
were transferred up to Ward 76, where they stay until they
are bottle or breast feeding and free from medical complications.
76 is a very different environment to NICU. The transition
is not an easy one, because although one is glad to be
out of NICU, it signifies a distinct change of responsibility.
In NICU, we picked our 3 slots per day to attend for cares,
but otherwise life went on pretty much as usual. Naomi
came home when the boys were in B, and for a few weeks,
parenthood was a surreal series of daily trips to the hospital,
interspersed with long periods of parental thumb-twiddling.
It’s like being a parent, but with no hard evidence!
In Ward 76, suddenly, they were our babies and the evidence
is ever present, no breaks, not even to let Mum catch up
on some sleep …
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Reflecting
on the whole experience, NICU is not a place I could ever
voluntarily spend time. I marvel at the fortitude and generosity
of the people who work there. More than any other aspect
of the experience, it is the doctors and nurses and supporting
admin staff I will remember when I’m an old man,
grumbling about how it was ‘in my day’. I’m
not talking about their skills as medics, which are generally
beyond question - NICU is, after all, a regional centre
of excellence.
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I
work in a specialist field and it seems to me that anyone
with sufficient incentive can be taught the ‘doing’ of
nursing, just as they can in my own field of expertise.
What can’t be taught, however, is attitude – a
positive outlook, saintly patience and a genuine human
concern for the well-being of others. Naomi and I were
consistently and unashamedly grateful for that. It went
way beyond simply being a job. They seemed aware at all
times that their charges were tiny human beings, and that
parents are also human beings, ones with a sudden, dramatic
and often difficult adaptation to make. It may not seem
much, but in an age where basic respect for other people
at an individual level is a dying quality, it was refreshing
and rewarding to find it in abundance in an organisation
that is regularly clubbed for its perceived dehumanising
approach to health. Suffice to say, it has left me with
very different views on paying tax.
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Soon
going home
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I’m
a firm believer that the worst vice is advice, but for
what it is worth, here’s my two cents:
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NICU
knows best! One knee-jerk reaction to an early birth
is to scour the Internet or devour a book or 6, on
everything from prem babies to raising boys. Reading
does not make experts. What makes an expert is experience
- doing the job day in, day out, year on year, witnessing
things that most of us couldn’t summon up in
our worst nightmares. The psychological impact of a
struggling newborn can be devastating. Multiply that
feeling by the number of other babies you see in NICU,
add in all the electronic beeps, bells and whistles,
plus a 24-hour shift roster to cover every single day & night
of the year… its an understatement to say that
the NICU team has a tough job. A parent’s first
role, then, is to make things as easy as possible for
them. That means respecting their expertise, letting
them do their thing and being grateful for it. Easy!
Hopefully I’ll get it right next time.
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Get
involved! One ‘mistake’ I made was to wait
to be invited to participate at each stage, for fear
of interfering. Fear is a natural human defensive response
to an unknown situation. Asking questions reduces fear,
by converting the unknown into known. What does this
injection do? What is that tube for? Why the UV lights?
What’s the weight today? Can I change a nappy?
Can I do a feed? Can I get one of those uniforms for
my wife?
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With
newborns, there are many, many, many unknowns, so ask
questions from the start, and keep asking until you
get home, where you will be the resident expert. The
answers won’t always be what you want to hear,
but they are not as important as showing willing – it
strengthens the bonding process with the babies, and
it helps construct a positive working relationship
with the NICU team. Beware Point One though; voluntary
participation is valuable so long as it is under-pinned
by respect for the experts.
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Relax!
We were lucky - our boys are healthy little tykes.
Some babies in NICU are very seriously ill, and some
will not survive. Whatever your particular circumstances,
panicking simply makes things worse; not just for you
and the nurses (who generally have a surplus of distraught
parents) - babies are devils for picking up on parental
mood. Make a conscious effort to be calm, positive
and friendly when in the NICU. Make time to attend
the parent-craft classes (which are excellent), and
make an effort to get to know some of the other NICU
parents – it pays huge dividends in terms of
maintaining perspective, sharing the burden and making
new friends.
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Expect
the Unexpected! NICU staff are not clairvoyant; despite
their expertise you will find them generally reticent
about committing to transition dates between Rooms,
or the likely course of action for next week. The reason
for this can be surprising – they don’t
know. They may have an opinion, which, if you took
it to a bookies, may well pay out most of the time.
However accurate it might prove, opinions set expectations,
which drive mood and motivation – ultimately
this means you’ll sit at home bawling if moves
are even a day late. Nurses know this. They also know
first-hand, that babies are not wont to do adult bidding
on demand – they have their own little agendas,
advantages and disadvantages, and they will not be
held to yours, NICU’s or the waiting family’s
time-table. Be patient, watch and learn, and expect
the unexpected now, before it descends on your home!
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Visitors!
NICU is cramped, busy, scary & never stops. Babies
in NICU do not look like term babies. Family & friends
are probably expecting to see ‘a baby’,
not something off a bad Star Trek set. They may react
with anything from tears to terror when confronted
by snaking cables, C-PAP rigs, gastro-nasal tubes and
a wrinkly, helpless blob of flesh at the centre of
it all. Prepare your visitors with photos and if possible,
make them wait until you are out of intensive care
altogether. It sounds mean but it could save them considerable
emotional discomfort, as well as keeping non-medical
activity in the NICU to a minimum.
Bear
in mind also that NICU is an operational critical care
facility; even if your own babies are relatively healthy,
others may not be so fortunate. After Seb & Brad’s
first few days in NICU, we set up a website and kept it
regularly updated with information & photos, for family,
friends & colleagues. It kept everyone at bay until
the boys were fit enough to move to the last stage of NICU – Ward
76, which is much better able to deal with visitors.
All
that’s left to say, from the bottom of our hearts …
THANK
YOU
NICU!
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