Wards of tiny charges
Anne O’Sullivan, an advanced nurse practitioner in neonatology at the Coombe hospital, cares for some of the tiniest and sickest babies in the State
THE NEONATAL Centre at the Coombe Women and Infants University Hospital in Dublin cares for some of the tiniest and sickest babies in the State. Some are born at just 24 weeks and can weigh less than 500g, the equivalent of just half a bag of sugar.
On the day I visited I was brought on a tour of the unit. Holding my breath for the entire time, afraid that even the slightest sound would disturb the tiny patients, I had to look twice into some of the incubators as tubes and wires dwarfed their precious inhabitants.
Anne O’Sullivan is one of just four advanced nurse practitioners in neonatology in the State and coupled with caring for tiny patients her role encompasses education, practice development and research. As an advanced nurse practitioner, O’Sullivan works closely with both medical and nursing staff and also promotes multidisciplinary teamwork within the unit.
With a capacity for 40 babies the neonatal centre in the Coombe is divided across two floors with the neonatal intensive care (NICU) and high dependency (HDU) on one floor and the special care baby unit (SCBU) on the other. The NICU is for babies who are critically ill and need intensive care.
“Intensive care is where babies have huge needs in relation to their respiratory management, their cardiovascular management. They are sick babies. They might have infections and they need a lot of supervision,” O’Sullivan explains.
As their condition improves, babies move from the NICU to high dependency and then upstairs to the SCBU from where, months after their birth, parents can finally prepare for their new baby’s homecoming.
Last year, 1,023 babies were cared for in the centre of which 125 were admitted weighing less than 1,500g or just over 3lbs.
O’Sullivan joined the neonatal centre in the early 1990s and has witnessed a number of advances in neonatal medicine and technology over the years. For example, medicines which help develop a premature baby’s lungs means that more babies are surviving today that sadly may not have done in the past.
“When I started in neonates if you had a 26-week [baby] everybody was on high alert. Now babies are living from 23 plus, 24 weeks . . . not every baby who is born at those gestations obviously survives but it can depend on lots of factors.”
O’Sullivan also says that advances in antenatal medicine mean that serious abnormalities or conditions can now be diagnosed in utero. This allows for the careful planning of the delivery of these babies and those with serious heart conditions, for example, are transferred immediately to Crumlin children’s hospital where a team of experts is on standby.
The Coombe accepts high-risk premature babies from all over the State with the help of its neonatal transport team which retrieves very sick babies by air or by road at all times of the day and night.
“If the baby moves to us obviously it is horrendous for the mother but as soon as she is stable the obstetric and midwifery staff here will try to facilitate the mother to move here as soon as she can,” O’Sullivan says.