Harold with the Hair
By Megan Watts, BSN RNC-NIC
NANN Footprints: Stories from the NICU November 2020
It was December 2018, and I was ready for the matchmaker to make me a match. I was 3 years into my career as a neonatal intensive care (NICU) nurse and I had learned that primary nursing – signing up and following one baby through their entire stay – was good for babies and good for me. Caring for a baby day-by-day would let me know them intimately and teach me their needs and quirks, and I could provide consistent, individualized care... and get to see my special little one grow from admit to discharge. I'd get to know their family well, sharing their pains and triumphs on the NICU roller coaster ride. I let the charge nurses know: I was a free agent looking for a new primary, find me a good one!
"Alright I've got one for you," said my charge nurse at shift change a week later. "He's in the admitting nursery." A baby boy! My excitement grew. Entering the six-bed admitting nursery, where our newest and sickest babies stayed, I took my seat for report on two baby boys. Hmm...which could be my intended match? One was a tiny 27 weeker – tucked in, on a vent, and enjoying his early honeymoon days of what was sure to be a long stay in our NICU. But what was this? The other little boy across from him, a shock of black hair across his head.
Harold. Little boy, sleeping deeply, 39 weeks, Downs Syndrome, needing oxygen support, possible congenital heart defect. What was it about this one? How did I know immediately? His long eyelashes, pink button nose, and round belly were beautiful. He had an outrageous amount of jet-black hair plopped on his little head. He was perfect. I've never fallen so hard or so quickly. Looking back, there wasn't a minute from knowing him that Harold wasn't mine. This was my baby, my next primary; this one was special.
I love educating families about primary nursing and seeing their eyes light up when thinking of their favorite nurses but offering to primary myself feels like asking someone out on a date. What if they don't like me? What if they reject me? How awkward! I approached Harold's parents on my second shift with him, heart thumping and hands sweaty with nerves that turned out to be unwarranted. Of course, I could primary Harold. "We were grateful that you taught us about primarying and then asked to primary Harold right away; it was like oh good that's taken care of for us!" says Sara, his mother, now two years later.
Harold and I spent the following days and weeks getting to know one another. He was a hard sleeper, as was I, so we had that in common. He strongly preferred to be held between cares and made that preference known with a squeaky but mighty little wail. Early morning lab draws were a nightmare, and I remember asking for forgiveness again and again, "Harold what are we going to do?" His oxygen saturation would drop, and I'd stand sentinel at his bedside telling staff "give him a minute, he likes to take his time, but he'll come back up." We'd work on his pacifier skills. We spent Christmas together, and I walked him to the nursery window to see the fireworks on New Year's. "Blow on his head!" I hollered to a charge nurse during a procedure, "It's the only thing that will settle him." "Hah! That's magic!" she marveled. Only a primary nurse would know this.
To say that we had a special bond was an understatement. Soon he'd transition home, to gain weight and prepare for his heart repair. Our hospital recovered these patients in the pediatric intensive care unit (PICU), a floor and a world away, and even a floating NICU nurse wouldn't take a fresh heart patient up there. Did I visit him every shift? Of course. "He's a hard stick so don't lose access. Blow on his hair when he gets mad. Sing to him." The PICU nurses must've been ready to wring my neck. And then, a small miracle, a primary's longing wish – I was blessed with a float shift to PICU on Harold with the Hair's last day.
In the NICU, crying can be a team sport. Tears fall for our wins as well as our losses, and it is no shame for a nurse to share tissues with a mother or father in joy or pain. I let tears wet my cheeks sitting alone and holding Harold in the PICU that day, tears of sadness that I'd no longer have him in my care, tears of joy and wonder at the amazing strength he held in that tiny body. Tears of gratitude. How did I get so lucky? So, so lucky...