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Deborah Howell: What is a NICU and what conditions are treated there? Today, we'll explore these questions and more with two experts in the field.   This is the podcast series from Deaconess The Women's Hospital, a place for all your life. I'm Deborah Howell. And our guests today are Dr. Pushkaraj Jadhav, a board-certified neonatologist and Terri Lynn Nunn, clinical nurse manager here at Deaconess Henderson. Thank you both for being with us today.

Dr. Pushkaraj Jadhav: Thanks for having us.

Deborah Howell: Our pleasure. So I guess my first question is pretty basic. Dr. Raj, what is the NICU?

Dr. Pushkaraj Jadhav: The NICU stands for neonatal intensive care unit. It is a department in the hospital designed to provide specialist care for critically ill babies.

Deborah Howell: Okay. That's pretty straightforward. And what conditions are treated in the NICU?

Dr. Pushkaraj Jadhav: We take care of premature babies as well as babies born to term moms who may suffer from respiratory issues, cardiac problems or serious infections. We provide ventilator care when needed in addition to performing procedures necessary for the wellbeing and survival of these babies.

Deborah Howell: is it also a place for just underweight babies as well?

Dr. Pushkaraj Jadhav: Yes, premature as well as underweight babies.

Deborah Howell: Okay. And who can visit baby in the NICU?

Dr. Pushkaraj Jadhav: In order to ensure the utmost safety of our babies, we restrict visitation to parents and grandparents. However, to uphold our goal of providing family-centered care, we also have a viewing room set aside where other friends and family members can see the baby on a screen.

Deborah Howell: That's so nice. It's such special moments at the very beginning of life. And how long is baby in the NICU?

Dr. Pushkaraj Jadhav: So every baby is different and therefore each one requires a unique care. Depending upon the severity of his or her condition, the baby could stay in the NICU from only a few days up to a couple of months. Most of our premature babies are ready to go home at least two to three weeks before the mom's due date.

Deborah Howell: Wow. That's interesting. Terry Lynn, now to you, do you offer a place for parents to stay while their baby is in the NICU?

Terri Lynn Nunn: Well, it's important for us to have our patients involved in the baby's care at all times. The patients obviously can visit and spend time with their baby anytime they're in the NICU. We do offer the parents to stay when the baby is critical. We make those accommodations for those rooms based on that baby's condition.

Deborah Howell: Now you say, spend time with the baby. Can they touch the baby? What are the limitations?

Terri Lynn Nunn: Those all depend on each baby. So if the baby very early and there's no simulation that would be ordered by Dr. Raj to say, "We're going to keep this baby quiet and, you know, hands-off for right now," for the most part, we have the parents in there at the bedside, helping with the bath, bringing in changes of clothes, really being in there with that baby, so that they can provide the best care that they can because, you know, they're ultimately going to be taking the baby home. So we want them to be as educated as possible.

Deborah Howell: And to begin that bonding.

Terri Lynn Nunn: Absolutely.

Deborah Howell: So, what should I expect when my baby is sent home from the NICU?

Terri Lynn Nunn: Well, as you know, they've waited sometimes days, weeks, or even months to take their baby home. But when that day comes, there's been lots of preparation, planning from the healthcare team. So they'll be ready. We'll give them education. We'll give them the tools they need and provide them the very best care when they return home.

So to do that, we offer a parent care room here at the hospital. It allows the parents and their preemie to kind of room in. And it's just like a little brief stay here at the hospital to just kind of get an experience of taking care of the baby while having that little bit of a security of knowing that help is just down the hall. So each parent is given the NICU phone number that they can call at any hour and they can speak to the nurse if they have any questions after the baby has been discharged.

Deborah Howell: Sure. And can babies come back to the NICU once they're sent home?

Terri Lynn Nunn: Yes. We do have two isolation rooms that can be used for infants less than one month of age that has to be readmitted. Typically, we use those rooms for infants that are re-emitted for jaundice, maybe dehydration, poor feeding skills or maybe just to rule out infection. And these rooms are separate from the NICU, so that they're in an isolation.

Deborah Howell: I can imagine it's been quite a year with COVID. Has anything been changed?

Terri Lynn Nunn: It definitely has. Our visitation policy is a lot stricter, but what I have seen with that is it's really made the mom and the father both bond together. And even doing interviews with the parents, they have really enjoyed that time that they've been able to spend, you know, with the baby alone. So overall, it has been a great experience.

Deborah Howell: Yeah. Dr. Raj, back to you. What's the overall goal of the NICU?

Dr. Pushkaraj Jadhav: Our goal is to administer a standardized and a specialist care that is unique to the needs of each baby. In addition to providing the best possible care for the babies, we also support parents in a safe transitioning from the hospital to homes, and that's what Dr. Lynn was talking about the parent care. And lastly, we also provide the family with emotional support during the difficult time in the NICU.

Deborah Howell: Do doctors spend much time in the NICU? You usually only see nurses, nurse managers, et cetera.

Dr. Pushkaraj Jadhav: No, we actually try to get involved in the parents and the babies at the same time. So we spend a lot of time educating the parents, being around the babies, how to take care of the baby, how to handle the baby, what to expect, what the overall course of life is going to look like for these babies. So we try to spend a lot of time with the parents and the babies together. Also, you getting the nurses around, that helps in overall performance of the NICU.

Deborah Howell: It's such a precious time to families with their newborns. And especially in NICU, it must seem so fragile and so frightening. What's the best part about your job, Dr. Raj?

Dr. Pushkaraj Jadhav: Oh, wow. It's every morning you come with a new challenge, not knowing what to expect and then going home, knowing that you have achieved something, you have saved a life. That means a lot. Every single day, I come to this hospital.

Deborah Howell: Yeah. And have you seen outcomes improve over the years?

Dr. Pushkaraj Jadhav: Yes. We have achieved a lot. In last 15 to 20 years of my practice, I've seen that much and much smaller and sicker babies, we have been able to send them home and get them connected with their families. We have changed the practices overtime involving parents during the management, that has helped us a lot and are overall tremendous. We fall in the top tier of the Vermont Oxford Network and our outcome has been really good.

Deborah Howell: Oh, my goodness. Congratulations. Terry Lynn, any final thoughts from you?

Terri Lynn Nunn: Well, we've always been known as a little hidden jewel here at Deaconess Henderson Hospital NICU. Our patient scores have been a hundred percent. Would you recommend us over the last nine months? So come see us. Get a tour.

Deborah Howell: Can't get better than perfect.

Terri Lynn Nunn: Yeah, can't get better.

Deborah Howell: Well, thank you so much, Dr. Raj and Terry Lynn for taking us inside the special world of the NICU and giving us a true picture of how parents and their newborns can benefit from their vital services. Thank you so much.

Terri Lynn Nunn: Thank you so much.

Dr. Pushkaraj Jadhav: Yeah, thanks for having us.

Deborah Howell: And that wraps up this episode of the podcast series from Deaconess The Women's Hospital, a place for all your life. For more information or to set up an appointment with one of our providers, please call (270) 827-4000. And for more health tips and updates, follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.