Reportage NICU - Sint Elisabeth Hospitaal, Curcaco

Recently (November 2018) a local newspaper on Curacao published an article I wrote about the NICU. I was asked to not only take pictures but also write a story about the Neonatal Infant Care Unit, in brief the ICU for infants, at the Sint Elisabeth Hospitaal (Sehos) on Curacao. I tagged a long with one of the nurses, Pamela Waas-Kramer. She showed me the in and outs of this very important section of the hospital.

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At the NICU they work in three shifts. I meet Pamela at the handover from the morning to the midday shift. Pamela, “During the handover we inform eachother about any irregularities from the previous shift and we are informed about the special care each of the babies have had. This helps us to prepare better or our own shift. We meticulously write down which baby has had which care, not only to inform our own staff but also for the parents. They also want to keep a close eye on the well being of their baby.

The NICU (Neonatal Intensive Care Unit) is a special section within the hospital and consist of two seperate sections; the Intensive Care Unit (IC, 8 spots) and the High Care (HC, 6 spots) Unit.

At the IC, premature babies are being admitted from a gestational age from 25 weeks, babies who are seriously ill and/or who have serious birth defects. All of them are put in an incubator. Their heart rate, breathing, blood pressure and the oxygen level (saturation) is monitored. To do this, a band with a red light is attached to the babie’s hand or foot. Adhesives are attached to the abdomen and chest that record heart action and breathing. If necessary, breathing can be supported or taken over, blood pressure is measured with a tape around the leg or via a so-called artery line, infusion therapy can be given and brain functions can be monitored. That is why this department often has a lot of equipment around the little patient’s bed.

“Parents, often suddenly and without preperation or warning end up in a totally unknown world. They are guided by health care providers such as doctors, nurses and social workers. We are development-oriented and rest and comfort for the little one is the most important thing here, ”says Pamela

Babies that no longer need Intensive Care go from the NICU to the High Care section. It can happen that they are still with extra support such as the low-flow oxygen. They are in a crib and can then wear clothes. The heart rate, respiration, blood pressure and oxygen levels are also monitored here via the monitor. The emphasis here is on growth, tranquility, nutrition and comfort. Parents are encouraged to help an are becoming increasingly independent in the care of their baby.

Pamela, “I was born in Curaçao and when I was 18, I went to the Netherlands to study as a nurse. After that I worked in a hospital but Curaçao was always on my mind and three years after obtaining my diploma I returned to Curaçao. First I worked in the maternity ward in Sehos and after a number of other departments I have finally arrived at my dream section, neonatology, already for three years now. Together with five other colleagues I am doing the Neonatology training. ”Why is this department the right one for you? “I have two children, one of whom has been at the NICU. From this experience I understand a lot of the emotions the mothers/parents have. It is very difficult to leave your baby behind, especially on the day that you are discharged but your baby isn’t. I was so sad and at the same time I was very angry. I didn’t understand why this had to happen to my little one I had been waiting for so long. I am very grateful to the nursing staff and the pediatrician for the good care they gave to my baby girl when she was there. Around her birthday I get emotional and especially because I now work there myself and see the place where she was. Fortunately everything went well! ”

After the transfer, the activities are divided. Pamela, “Everyone is assigned to 1 or 2 babies. First thing you do is you go to your assigned patient(s) and  check the checks and visually see how the baby is doing. After this you go and get all the supplies you need, to give the care as carefully as possible without having to stop constantly to get other or more supplies. We try to do the care with two nurses per baby`, which is not only calmer for the baby but also better for their development. The parents can come and see their baby from 9 AM until  7 PM. There is an hour from 2 PM to 3 PM because this is when shifts change and we have to do the handover. ”

Pamela takes me to see one of her patients, “baby A was born at 25 weeks and tat the time she was 32 cm and she only weighed 710 grams. Now she is 31 weeks old and weighs 950 grams. Still  relatively small but she’s getting stringer and bigger. On average, those little ones gain 30 grams a day! ”

Not long after our conversation, the parents of baby A arrive. They come to visit their little one on a daily basis and they try to do as much as possible themselves; changing the diapers, feeding and pouching with the baby.

Pamela continues her work and is caring for a baby in the high care department. “It is now time for his bottle and to pouch a little. Sometimes parents can’t be on time for feeding because of work travel distance. We will gladly step in and take over. It’s not for nothing that I work in the best department ever. ”And with a big smile Pamela says goodbye to me. I have learned a lot about the work that people do at the NICU and I hope that they will be able to welcome many more babies in the future!