Issue #5: A love letter to nurses...
Musings from the Neonatal Intensive Care Unit
Taking Care has been sitting on my nightstand for about a year now, but last week, I finally cracked it open. We were on vacation, and my husband (a Cowboys fan) was watching a replay of a 2014 regular season game between the Colts and the Broncos (for anyone outside the US, I cannot emphasize how irrelevant this game is. Even in 2014, the score had little bearing on the teams’ outcomes. Boys.) This worked out well for me though, because once opened, I was utterly captivated by the book. In fact, I didn’t put it down until I’d finished it. (Another notable and convenient aspect of American Football- the games can last up to 4 hours).
DiGregorio is a journalist, author and mother to an ex-preemie infant. In her first book ‘Early’ she talked about pivotal moments in neonatology as well current controversies in the field. Throughout, she weaved in stories of her own experiences in the NICU. It was an absolute beauty. We filmed a video explaining why everyone who works with babies should read the book. Watch it here!
In Taking Care, DiGregorio tackles a wider subject matter: what it is to be a nurse. She covers the history of nursing and shows over and over again how nursing has changed the world both at the level of individuals as well as national policies. The book is extraordinarily well researched (we’re talking 50 pages of references). I learnt so many fascinating tidbits- including that Florence Nightingale (although effective at incorporating women into the medical field) was a bit of a racist snob and that there is a really sad connection between the decorative ferns you find in store-bought bouquets and end-stage renal disease.
In the introduction, DiGregorio wrote:
This book is a love letter to nursing’s vast possibilities. I have been on the receiving end of nursing care so expert and compassionate that it altered my life. I know that this kind of care is possible and that it should be possible for all of us.
I’m not sure what else to say, except you’ll enjoy reading it! Taking Care, by Sarah DiGregorio.
Recent PICC line video
Last week we published a video on PICC (Peripherally Inserted Central Catheter) placement on X-rays. Click on this link if you missed it: PICC line X-rays
Here is the PDF summary of the video (some facts you have to learn, but obviously not as helpful as actually inspecting a million X-rays!)
And some multiple choice questions related to PICC lines:
And The Rest:
If anyone is interested in the logistics of filming and publishing YouTube videos, let us know and we’ll happily dedicate a newsletter to it. But for now, I think this quote sums up ‘YouTubing’ the best: It is simple, just not that easy.
So what has really, really kept us going are all the absolutely delightful comments we receive from viewers. We love hearing how the videos have helped people pass exams, trigger A-ha! moments, or simply enjoy the NICU more.
For example, check out this motivating message we received from a viewer:
That’s an immediate dopamine hit when a comment like that pings half-way through a busy day. What struck me, though, was the word ‘effortless’. So flattering! But Arianna and I probably spent longer on that video than any other video we have made. Maybe in the vicinity of 20-30 hours (including chatting with Bunnell, poring through articles, writing the script, filming, editing etc.). In all, very far from effortless!
It reminded me of the dazzling graduation speech recently delivered by Roger Federer.1 His style of tennis was so smooth and polished that his play was often described as effortless. And per his speech, the portrayal frustrated him: His strokes took thousands of hours of practice, a lot of effort.
So think about that the next time you miss an intubation, or you set up the suction catheter wrongly. It only looks effortless when other people do it because they’ve done it hundreds or thousands of times more than you! Everything is practice.
In sadder news about brilliant people, Dr. Mildred Thornton Stahlman, a true pioneer in neonatal care, died at 101 on June 29th. DiGregorio (in Early) wrote about how Dr. Stahlman changed the world of neonatology, by using negative pressure, and later positive pressure, ventilators, inserting umbilical catheters, resetting limits of viability, establishing a model for neonatal intensive care units, and by believing whole-heartedly in the field. What a woman! May we all have even a little bit of her spirit.
Neonatal Nugget Tip: If you want to check whether an infant has a urinary tract infection (UTI), obtain the urine in a sterile way. You can either straight ‘cath’ the baby (insert a catheter up the urethra into the bladder), or perform a supra-pubic tap. If you are checking the urine for CMV or for a drug test, then bagged urine is sufficient.
We hope you’re enjoying this newsletter as much as we enjoy writing it. We’d love to hear your thoughts either way….And if you’re interested in featuring in the 5 questions with… then let us know!
Stay healthy, and we’ll be back in your inboxes in 2 weeks,
Tala and Arianna
P.S If you make a purchase using links on this page, Neonatal Nuggets may earn an affiliate commission. Thank you for your support!
We are in NO way comparing ourselves to the greatest tennis player ever, here!
Love your sense of humor interspersed with information! I'll check out the book.