NICU Nurses and The Polarizing Emotions of a Twelve Hour Shift

By Jacquelyn Wallis, RN BSN RNC-NIC

NANN Footprints: Stories from the NICU June 2019

Each shift ends the same. I clock out and walk to the employee garage, always wondering why I feel so suddenly drained of energy. After all, it wasn’t that long ago I was able to pull all-nighters in college, completely unfazed by the lack of sleep. Yet here I am after another twelve-hour shift, slowly walking to my car thinking about the babies and the families I just left behind and the sudden lack of energy I’m now feeling. No matter what the shift brings, or my energy level, I still feel a sense of accomplishment and pride. I often spend the drive home contemplating the day, what I did right, what I could have done better, and the emotional highs and lows of the day.

Upon entering my house, I sit down at the kitchen table deciding on whether I have the strength or desire to eat dinner at 9 o’clock at night. One by one, my children filter through and each in turn asks me how my day was. I always answer the same… “It was a good day.” They’re teenagers, when they come into the kitchen to ask how my day was, it’s really just another way of saying, “Hi mom, glad you’re home, our family is all together, things are normal”. They don’t really want a long explanation of how my day was, it’s just a formality to acknowledge that they know I’m home. Yet time and again I often ponder how I would ever really answer that question with brutal honesty and truthfulness. How was your day? …it’s a simple question really. Yet for NICU nurses, we know all to well it’s not a simple answer of good, bad or ok. Each twelve-hour shift brings a multitude of emotions, often conflicting. It suddenly occurs to me that the drain of energy I feel on my way out the door is not so much physical as it is emotional. In every twelve-hour shift, a NICU nurse often flips back and forth between emotions that can be at such opposite ends of the spectrum, that when the shift finally ends and we have time to take a deep breath, we can finally feel the weight of all those emotions.

For example, the day might start with learning that overnight an infant that was struggling the day before has turned a corner and your heart beams with joy and gladness. As you’re admiring that infant and breathing a sigh of relief, the Brady alarm goes off and your heartbeat plummets too as you look to the monitor for the source and run to the room. With that crisis averted and the infant now stable, you walk over to check on your other patient and you see mom is standing at the isolette, giving her precious baby hand hugs with tears streaming down her face. Now you’re the cheerleader, offering comfort and looking for positive, yet realistic words to comfort her. The overhead pager goes off signaling for NICU nurses to rush to a delivery. You anxiously wait to see if the charge nurse appears in your neighborhood letting you know you’re getting an admission, so better hurry to get a room ready and supplies on hand. And on it goes…

I vividly recall a night shift I worked right after coming off orientation. In huddle, while choking back tears, the outgoing charge nurse announced the sudden passing of an infant that day who had been in our care for nearly three months. With a heavy sigh, we all moved forward to our respective neighborhoods to start our shift. The parents of the little boy were still sitting in his room, grief stricken and sobbing. You didn’t have to know the baby to be moved to tears just from the sheer, raw emotion coming from that now empty room. To this day, over three years later, I still think of that little boy every time I pass by the room that he occupied. Yet just as I was walking away that night, dabbing my eyes and desperately trying to remain composed, I see a family across the way loading their infant into their car seat, radiant and beaming with joy as they are about to head home with their baby after a few months in our NICU. How quickly I went from tears of pain to tears of joy as this little one got to finally go home with her family.

Time and again it has occurred to me the vast number of emotions NICU nurses switch to and from with each twelve hour shift. It’s no wonder we leave the floor each shift weary. No doubt nurses that work on other units must feel the same from time to time but for NICU nurses, the emotions can be so polarizing each shift as we care for the most fragile human beings that are only just beginning their journey on earth. We can’t help ourselves from immersing our whole beings into the vast variety of emotions we encounter each shift. There is something about a new life that offers hope and a fresh start that allows us to find strength we never knew we had for each and every one of twelve hours we work. It is that hope in each new life that gets us through the tougher days. It’s no wonder we feel such as sense of accomplishment and pride every time we head home. I wouldn’t trade that emotional roller coaster for anything.