A first step to understanding the NICU is learning the lay of the land. Be patient with yourself – you are getting adjusted to a strange and foreign terrain – but it is important to know where and why your baby is in a given NICU. NICUs are generally classified as either Level II or Level III reflecting the level of care these specialized units can provide for babies who need extra medical help.
Level II nurseries can care for babies born at 32 weeks or older and like all NICUs are staffed by specially trained physicians and nurses. Level II nurseries, however, do not provide respiratory support for more than 24 hours – a common need in preemies as their lungs and other vital organs are not fully developed at delivery. If your baby needs respiratory support – like a ventilator – a Level II NICU’s primary objective will be to stabilize your infant to transfer to a more acute, Level III facility.
Level III NICUs care for the sickest and most premature babies who may need a wide range of medical intervention and support. Level III NICUs provide many different types of respiratory support as well as different levels of on-site surgeries. The most advanced Level III NICUs provide the most advanced surgical interventions including open-heart surgery. It is actually safer to provide surgery on site within the NICU setting then to risk the disruption of transferring fragile infants to an operating room.
NICUs may differ in physical design. Some NICUs are set up to assign each baby to an individual room that can enable the parents to stay. Larger NICUs may have several large rooms with an open floor plan with a central nurses’ station in each. Incubators or isolettes as they are now often called will ring this central station so babies are always in the staff’s sightlines. In this design, babies are “triaged” according to the level of medical care they need. The babies who need the closest monitoring will be in one room and those who may be transitioning to being able to do more on their own in another, for example.
Because NICUs are very complex, technology driven units the medical staff understands that an important aspect of their job is to answer the many questions you may have about tests, treatments, equipment and therapies. Tomorrow’s post will introduce some of the many highly trained specialist medical personnel you may encounter if your baby needs to be in the NICU.
I would love to hear from readers how they learned to navigate the NICU itself.