Committed to Care: Coping with COVID-19

By Kailey Rinaldi, MS APRN CPNP-PC

NANN Footprints: Stories from the NICU July 2020

July Footprints

I had waited for this day to come. I looked at the assignment sheet and I only had one baby–usually not a good sign. It's officially here; it's at our hospital. I walk down the hall of the unit to the two negative pressure rooms that have been designated for this. They've sat empty for months, but I knew we would be using them soon. As I peek through the window in the hall, I see him in his isolette, cozied up in a snuggle device, all alone in the room.

He was brought to the NICU straight from the delivery room. His mom only saw him for a few minutes. Moms who test positive for COVID-19 aren't allowed in our NICU. Apparently, dad had tested positive too. After report from the night shift nurse, I called to speak to his mom, but her nurse said she had a high fever and was not feeling well.

Another nurse watched over him as he slept, and I went to change into hospital scrubs. He began to stir while I was reviewing the new policies and procedures to make sure I was doing everything I was supposed to do. These policies seemed to change daily, and this was the first time we had an "exposed" newborn in the unit. As I put on all my required protective equipment (gown, N95 mask, face shield, hat, shoe covers, double gloves) to do my morning assessment, I couldn't stop thinking about what he was missing. This is not the NICU I'm used to. There are no visitors allowed. With his mom unable to be in the unit, no breastfeeding for now. No skin-to-skin care. No learning mom and dad's face or smell. No visits from excited grandparents. Today, it's just him and me.

He can't see my face or my smile, but he can hear my voice. He can hear the soft music I play on the computer in the room. He can feel my touch, even if it's through double gloves.

Instead of charting in the hall on my mobile computer unit, I stayed in his room and talked to him softly while I clicked and typed away. I sang lullabies (poorly) and I made sure to tell him all about the weather outside and the paper I was writing for one of my classes. He wrapped his fingers around mine while I listened to his heartbeat. Alert as could be, his eyes wide open, he seemed to be taking in this big, open room around him. I washed and dried his fine, wispy blonde hair and he fell asleep as I gently combed it to the side.

Without the hustle and bustle of the unit alarms, giving medications, and helping with admissions, I almost didn't know what to do with myself at first. I was only allowed to go into his room. We were isolated in the back corner of the unit. His mom called me at the end of my shift, and I gave her updates on how he was doing. She cried as she told me how much she wished she could physically be with him, and I held back tears.

These are unprecedented times in the NICU for us all. Our flexibility and adaptability are being put to the test. Families and clinicians are facing fear, grief, and uncertainty. With rapidly evolving information, policy changes can seem overwhelming, yet we must persevere. As for me, I'm trying to do my best and provide my patients with the love and attention they need while we have strict visitor limitations. If that's me singing Twinkle, Twinkle Little Star through an N95 mask and a face shield, then so be it.