1. Tell us about the various roles that people play in the Neonatal Intensive Care Unit. Can you see yourself in any of these positions? Why or why not? Why do you think these providers choose to dedicate their lives to taking care of the sickest and smallest children?
2. Many of the sick children come from families with lots of other problems - difficult living situations, divorce, parents who are addicted to drugs, low socioeconomic status, etc. How did you see the social factors affecting the work and the decisions of the doctors taking care of these patients? How do you feel about allowing social factors to influence patient care decisions?
3. For those infants who do survive, how does being premature potentially affect the rest of their lives
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These children need more help than anyone else I could possibly imagine. Not only are they limited by immobility and the inability to speak but many of their organs don't work at all. Some can't breathe, some can't urinate, and some can't eat. I cannot imagine anything more noble or completely selfless than dedicating yourself to these, the sickest, most helpless people imaginable.
I don't think that the various problems would negatively affect the doctors and nurses decision making. I didn't see many of these social problems affecting their decision making, although I am sure it could. I personally would not willingly give a child to a poor family that would have difficulty feeding and clothing it let alone providing proper education. These babies have so much potential despite their small size! Why let it go to waste? I know the parents have their rights but it would break my heart to send the children I took care of into destitute, lonely, or dangerous situations. These infants are so tiny that many will always be small and their brains would not have had enough time to fully develop before birth so I imagine the ones below 3-4 pounds will have difficulty in school and finding a job that will provide sufficient income. I am sure, however, that quite a few of them go on to be much smarter than I am!
1. although my personal interests do not lie in this area, i very much appreciated the opportunity to observe the various roles involved in the neonatal intensive care unit. i gathered a great sense of respect for these doctors and nurses in caring for the sickest and smallest babies, so that they would be provided the chance to survive and progress beyond their premature state.
2. social factors should not influence patient care decisions. however, the doctors in charge of the patients from lower socio-economic classes would also be somewhat responsible for the education of the patients' families, to promote better care for premature babies.
3. i would imagine that premature infants would be more susceptible to later dysfunction (cognitive developmental disorders, behavioral disorders, an overall decrease in intellectual abilities).
The NICU was so advanced in its treatment. I had never imagined the amount of care each baby requires. The technology required measures everything from O2 levels to heartbeat and breathing.
The social aspect of patient care was not really evident. The doctors made sure that parents had lodging at the Ronald McDonald house, but, otherwise, treatment was congruent for all babies, regardless of socioeconomic status.
The NICU was a difficult place to tour. Primarily because you KNOW that there is a lot of suffering both in the patients/families and in the doctors trying their best to treat them and sometimes falling short. Probably the biggest issue that one can get wrapped up in as a doctor is the unfairness of certain lifestyles and how they can effect even the smallest of people. What it is difficult to keep in mind is the depth of your job--that is, as a doctor, they are paid to treat a patient TO THE THE BEST OF THEIR ABILITIES. When it comes to family life, abuse, drugs, socioeconomic status, etc, one must remember that there is only so much that can be done. Yes, it is unfair, it is sometimes, cruel, unjust, and so many other adjectives--but there is only so much that can be done. Beyond one's best, there is nothing more one can do.
Every role in the NICU is extremely important to the well-beings of both the child and mother. I found it remarkable that while the doctors and nurses were attending to the baby's needs, they were also aware of the mother's needs- like housing, transportation, etc. Seeing how much the doctors in the NICU cared about the babies made me more interested in playing a part in that component of the hospital. I can't even imagine the difficulties that lie within the job, since the patients cannot talk, move around, or feed themselves. It's amazing how much time these doctor's sacrifice for the smallest children and I think that everything they do for the babies is incredible.
I could possibly see myself in the role of a physician making rounds in the NICU, for I can appreciate the appeal of helping such adorable, innocent babies everyday in their first vulnerable moments of life. I did not personally see the social factors affect the work and decisions of the doctors, which I think is very important to ensuring that each patient is taken care of with the same mixture of compassion and objectivity. Being born prematurely may cause a greater risk for various developmental problems in early life as well as problems later on.
It is an incredible feat to sustain life where life should not, but it is also an incredible responsibilty. The moment we have control of life, we are in essence also in control of death and I cannot come up with any other task that bears as much responsibility. The people that work at the NICU must carry an enormous weight and I do not believe that I could do something as important as sustaining someone's life.
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