In Good Hands: The powerful and essential work of a Neonatal Nurse Specialist
BY MIRIAM BURKE
Mum-of-four Karen Prunty tells her inspiring story of how she landed her ‘dream job’ and explains the role of a Neonatal Nurse Specialist.
“It’s kind of like my identity in a weird way. Not to sound cheesy or corny but it’s who I am.”
Karen Prunty is proof that it is well worth pursuing your dream job, even if you have to do it time and time again. After a start in hotel catering, a job on the deli counter in Spar, a sojourn in Portugal working in overseas property development, where, she admits, she ‘lived the life’, and a stint in a nursing home, Karen didn’t take the traditional path to becoming a Neonatal Nurse Specialist. But she got there in the end. And there’s nowhere else she’d rather be.
Karen knew from a young age that she wanted to be a children’s nurse. Always ‘pulling at [her] heartstrings’, she was sure that it was the role for her, but it wasn’t until she was aged 25, with a little baby in tow, when she began training in a Dublin children’s hospital, that it dawned on her that she was ‘home.’
As soon as she walked onto her first ward, the baby ward, she remembers thinking, ‘I’m home. This is where I belong.’
Over the years, she worked as a nurse in the children’s hospital and eventually earned the huge promotion to Neonatal Nurse Specialist, a position held by only four people in the country.
Not quite believing beforehand that nursing was ‘a calling’, once she assumed the position, she changed her mind, telling me she loves it so much she would do it for free.
What is a clinical nurse specialist?
A Neonatal Nurse Specialist is a senior role where the nurse works with consultants and with the family of a very sick baby in a children’s hospital. There are only a few Neonatal Nurse Specialists in the country, one in Temple Street, and three in Crumlin.
In a nutshell, Karen says that a Neonatal Nurse Specialist is the link between the team looking after the baby and the parents.
Karen says, “we’re basically the glue that binds the whole team.” There are so many people involved with these babies because it’s so specialised, from surgeons, to physiotherapists, intensivist in they’re in ICU, social workers, to dieticians.
“There could be so many different people who are connecting all of the pieces of this little baby’s puzzle and we’re kind of the glue of that.”
A huge part of her job is helping the parents at the bedside. She is instrumental in encouraging the parents to attach and bond and feel that connection to their baby, who is separated from them through glass and tubes.
“We get to know the moms, the dads, the families, the siblings really, really well and and that’s the part that I really love.”
The babies they treat are really very sick. Some of them, Karen says, are even there long enough to celebrate their first birthdays.
One of the tasks Karen is passionate about is guiding parents through alternative modes of connection when their baby is in ICU, on a ventilator and hooked up to machines. She promotes things like holding hands and rubbing their feet and talking with and singing to them.
Karen was the nurse behind the introduction of little bags for the babies in the hospital where she works. Each of the little bags has a book in them to encourage the parent to read to their baby, for instance, to help with infant mental health, attachment and bonding.
“All of things are to trying to encourage you to feel that this is your baby, that you are involved, that it’s not out of your control.”
The Story of Me
The bags also contain little dictaphones for the parents to leave messages and recordings that the staff play to the babies “so that they hear the comfort of their parent’s voice.”
“The Story of Me”, Karen’s brainchild that won an Irish Healthcare Award, is about capturing little milestones that we would take for granted in a healthy baby – say a first poo, their first bit of milk, the first time they breathe on their own – but that are huge for a sick baby.
Karen says that it’s so important for the parents to celebrate those moments and be supported when marking them. She says, “when you’re in a haze of having a sick baby in hospital you might forget those moments and five years later, when it’s all behind you, you can reflect and appreciate what you all went through.”
And in the heartbreaking situation if a baby does die, the parents “will have the little memories that they can cherish forever.”
Power of touch
The power of touch and connection, Karen says, can really help with your attachment later on, and building these attachments from the get-go will benefit the baby as they grow. “Later on in life,” she says, “in the teen and adult years…you’ll have a better and healthier relationships later on, leading into adulthood.’
Karen is a huge advocate for baby massage, which she also teaches in classes she runs near her home. In the NICU, she shows parents some ‘strokes that are appropriate for sick babies’. She says that not only does it help with bonding and attachment, it can help with regulating temperature, heart rate and breathing and with weight gain, too.
It can also help the mother’s milk supply if she is breastfeeding and expressing, as it triggers “a powerful hormone, the love hormone, that gives you that lovey fuzzy feeling that builds up in your system as well.”
Meeting a Neonatal Nurse Specialist
You are likely to only encounter a neonatal nurse specialist in two situations: if you find out that your baby has a serious condition that needs specialist care while you are pregnant, or if it transpires that the baby needs specialist treatment after they are born.
For pregnant women who knows their baby will need such care, before the baby is even born, the Neonatal Nurse Specialist will organise a visit to help prepare you for what’s in store, giving you an idea what to expect when you go into the ICU or the ward. If the distance is too far for an in-person visit (babies from all over the country are treated in the children’s hospitals in Dublin), they’ll give you a call.
Karen says, “nothing can prepare you, but we can help you alleviate the stress and the shock and the emotions of what’s going to be happen.”
“Your newborn baby shold be in your arms with you and that can’t happen if your little baby needs special treatment.”
Often, the parents can be very overwhelmed with all of the information. So the Neonatal Nurse Specialist would sit down with them and go through all that with them, as much as they can.
Karen would link in with the parents every day, giving them the support they need. They will offer the milestone cards, and they take footprints and photos when they can “because we want them to know that we’re thinking of them as a mother, as a family – that it’s not the medical or surgical side. That we actually want them to experience something positive to take away from it all.”
Going through the trauma of having a sick baby while recovering from the birth itself is a very tough situation for the mother, especially as they are often separated from each other for a time in different hospitals. Karen says “often it’s numbing, it’s a shock”, but says that for these mothers, “there is huge support within the hospitals and we link them all in with the clinical psychologist if they need it.”
The reality of the situation is that when a baby is sick “it can go either way” which is very scary, says Karen and there are often hard conversations to be had.
The Neonatal Nurse Specialist will also be involved in preparing the babies who need to go abroad for surgery, if it can’t be done in Ireland. But they will also organise everything for the babies who are going home, who will often need a home care package or equipment.
Balancing home life
Karen says that switching off can be hard. It is bound to be, with a job that is part of you. Often, on her days off, Karen will think about the babies under her care and will find herself texting colleagues to ask how they are doing.
“We do think about them. People think we just walk out the door that we forget them but we don’t. There are some babies I still think about ten years later.”
She herself is supported by a “small but mighty team” that are as dedicated and committed to the babies’ care as she is. They all support each other.
Karen wanted to bring her expertise to other mums in her community so she started up baby massage classes, doing even more while on maternity with her fourth child, Robyn, “because she has the extra time!”
She runs three hour-and-a-half-week classes a week, where mothers and babies come for baby massage and get a lot more from it, too, through talking about the pregnancy, birth and motherhood.
Karen’s not afraid to talk about difficult things, since the nature of her job requires her to on a daily basis, and she encourages talking about the tips you’d give other mums (that you should maybe take yourself!) and the biggest surprises that having a baby brought. Basically, she says, she checks in, and “often that can be more than the massage itself.”
Find out more about Karen’s classes here: littleroo.ie
While we hope you never encounter a Neonatal Nurse Specialist in a medicaly capacity, if you do, you can be safe in the knowledge that you and your baby will be in dedicated, nurturing, kind and capable hands.
“To be in any way part of it is an absolute honour. I feel like I’m the lucky one.”
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