How would you describe the philosophy of care in the NICU?
We tend to be a very collaborative group in the neonatal intensive care unit. We have incredibly dedicated nurses and staff who are very open to team work. We make a point of incorporating many people into a baby’s care, including nutrition and pharmacy, in addition to our nurses and intensivists. In addition, we now have a permanent chaplain in the NICU, Kat Kowalski, who has been a great source for families and parents of babies born with severe anomalies. We also collaborate with colleagues in genetics, obstetrics, palliative care, radiology and fetal medicine, which has improved outcomes and given us a whole new population of patients.
Where is the NICU’s focus on research today?
It is an exciting time to do lots of rediscovery in neonatology. Currently, we are trying to balance doing new things that not only help in the moment of care but also influence the long-term health of the baby. We are still pioneering many treatments through a diverse group of researchers who continue to build both basic science and clinical research and push the field forward in a variety of areas.
Can you give us some examples?
I can give many. Marilee Allen, a member of our neuroscience intensive care nursery team, continues to focus on neurodevelopment in premature infants. Renee Boss is conducting research in the area of neonatal bioethics and decision making for high-risk newborns. Raul Chavez-Valdez has a great interest in the mechanisms of delayed injury and repair and regeneration in the developing neonatal brain following hypoxic-ischemic encephalopathy. Similarly, Frances Northington’s laboratory continues to concentrate on the mechanization of neurodegeneration following neonatal hypoxic-ischemia brain injury. Pam Donohue is engaged in the study of infant growth and the blinding eye disease retinopathy of prematurity. Maureen Gilmore’s research focuses on clinical translational work to bring brain protection strategies to the bedside, including the use of erythropoientin for neuroprotection in extreme low-gestational age neonates. Chris Golden is the site principal investigator for the SMART study, an NIH sponsored multicenter trial evaluating interventions to promote safe sleep practices in neonates. In addition, Lawrence Nogee’s research continues to enhance our understanding of genetic mechanisms leading to neonatal respiratory failure and diffuse and interstitial lung diseases in older infants and children. Amaris Keiser is investigating racial disparity in preterm birth and Julia Johnson is working with the CDC in preventing hospital infections both here and abroad.
What are the biggest challenges facing the NICU today?
Limited space is probably our biggest challenge today, in part because the acuity of patients is higher and they tend to stay longer. Recruitment is another issue. We have been able to continue to recruit neonatal specialists but the need seems to be growing.
What do you like best about working in the NICU?
The variety of the challenges—no two days are ever alike. The NICU is always an exciting place to be—it can be very intense and sometimes emotionally draining, but it is very rewarding to be a part of the families and see the children grow and thrive during the course of their stay. In addition, you are surrounded by people who are all intellectually curious, incredibly caring and compassionate. It makes for days that are very fulfilling.