Neonatal nurses care for infants during the first 28 days of life. They not only assist in delivery, they might also help new mothers with breastfeeding or care for newborns who require hospitalization. Their duties can vary drastically from day to day, depending on the health of the mothers and babies they care for. Some neonatal nurses, for example, work in neonatal intensive care units, where they monitor medically fragile newborns.
Levels of Neonatal Care
Traditionally, healthy newborns with no complications stayed in Level I nurseries. Most hospitals now allow mothers to keep healthy babies in their hospital rooms, where neonatal nurses provide care to both mother and child. Level II nurseries cater to newborns who need extra care, such as intravenous therapy, but are not in imminent danger. Level III nurseries are designated for severely ill babies who need constant monitoring. Babies born prematurely or with an illness or birth defect may stay in a Level III nursery.
During and After Delivery
Neonatal nurses assist in the delivery process, both for normal births and high-risk deliveries such as those requiring a cesarean section. After the delivery, they weigh and measure the baby, bathe the newborn and provide extra care as needed. In addition, they sometimes teach new parents to change diapers and breastfeed. They answer questions from parents and watch for signs of postpartum depression or other forms of emotional stress in new mothers.
When caring for healthy newborns, neonatal nurses primarily provide wellness care, such as taking temperatures, monitoring vital signs and evaluating overall health. Nurses working in Level II and III nurseries, however, provide much more intensive care. They might use ventilators for babies with breathing problems, insert and monitor IV lines, administer medication and draw blood. They might also provide specialized feedings, possibly using a feeding pump, to ensure that babies receive adequate nutrition. In addition, they use equipment such as baby warmers and incubators to keep sick newborns comfortable.
Work Environment and Challenges
Caring for newborns and new mothers can be a high-stress situation, even during a seemingly routine delivery. In the delivery room, neonatal nurses must vigilantly monitor the vital signs of both mother and child; be alert to potential complications; and be prepared to intervene if either mother or baby are in distress. They need both compassion and the ability to remain calm in case they encounter an emergency situation. In addition, they witness babies born with a diverse array of health conditions, including potentially life-threatening ones such as HIV, respiratory problems or drug addiction. Neonatal nurses frequently work long hours, including on holidays and overnight. This can make it difficult for them to balance family obligations and other demands. It can also cause shiftwork sleep disorder, which can lead to physical and emotional ailments.
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