An Interview with Neonatal Intensive Care Unit Nurse, Emma


Following on from Interantional Nurses Day, we wanted to introduce Emma so supporters can gain a bit of a better understanding about what we do in Lancashire Teaching Hospital’s maternity units. Emma works at Royal Preston Hospital and helps babies and mothers alike, whilst juggling a full workload too! Learn more about her in our Q&A session:

What is your job?

Coordinator on the Neonatal Intensive Care Unit

Tell us what that means you do for mums and babies and families?

In a nutshell, a lot of hand-holding, tear mopping, laughing and hugging (although social distancing is making that a no-no at the moment).  We refer to ourselves as a NICU family and that extends to the parents and babies too.

Recent research has shown that having a NICU admission is one of the most stressful things a family can go through and many parents suffer from PTSD afterwards.  The thought of leaving your sick and/or preterm baby to be cared for by strangers must be petrifying so it is vital that we build good relationships with families from the very beginning.  We become family and they trust us with the most precious thing in their lives, it is a relationship like no other I have ever experienced in my nursing career.  We laugh with them, we cry with them and together we watch their miracles grow.

What made you want to become a midwife/nicu co-ordinator

Originally I trained as an adult nurse and when I qualified I worked for 3 years on the Gynaecology ward.  I loved my job there but I always struggled when women came in having miscarriages.  At that time women up to 20 weeks of pregnancy came to gynaecology with any problems in pregnancy and it was really hard to support them to give birth but not be able to help their babies.  Babies are only classed as viable from 23 weeks gestation (sometimes slightly earlier if the consultant thinks there is a good chance of survival).  When I saw a job come up on NICU I jumped at the chance to be able to help babies to survive.

How long have you been in midwifery? And how long at RPH.

I qualified in 2006, spent 3 years on Gynaecology and came to NICU in 2009 as a staff nurse.  I got my sisters post in 2014 and my coordinator post in 2017.  This is definitely the place for me!

How long did your training last?

Neonatology is such a highly specialised area that training takes place after staff have already qualified as either a midwife, adult or paediatric nurse.  Initially, a lot of the training is on the job, learning first hand from experienced NICU nurses, then there are 2 UCLan courses which you need to complete to gain your neonatal diploma.  The first is the Neonates Northwest course which covers special care and high dependency care skills, and the second is your 405 course, which covers intensive care skills and includes a 2-week intensive care placement in a unit of your choice.  We have a wonderful education team and everyone is committed to supporting learners in practice at any stage in their career.

What’s your usual shift like?

The coordinator role has evolved over the past few years and is gradually becoming more and more diverse but to sum it up I would say that I am a troubleshooter.  There is only ever one coordinator on shift and we are basically the first point of contact for anything and everything.  We need to be able to set up that specific piece of equipment that hasn’t been used for months or locate that last box of dressings or order that drug that we’re running out of, the list goes on.

While we are problem-solving we must also be prepared for every eventuality; we are NICU Girl Scouts! NICU admissions can be unpredictable so it is important to have admission spaces and equipment prepared along with a plan for moving babies and staff according to skill mix and workload.  We liaise with delivery suite to try and prepare for potential admissions and speak with the MDT about specific care plans for infants or safeguarding concerns.

We are part of the Northwest Neonatal Network which includes neonatal units from Blackpool right up to Barrow and we accept transfers from all over the country to ensure that infants receive appropriate and consistent care.  We are involved in governance, performing regular audits, utilising the datix system and supporting staff who may have been involved in an error.  We perform ward manager duties including risk assessments, off duty problems and return to work interviews.  We also all have our own individual roles to ensure a smooth service.

I am the lead for newborn screening, we also have a lead for breastfeeding, infection control, developmental care, bereavement etc.  Sometimes we manage all of these and have our own clinical workload too, but more often than not we are able to remain supernumerary to help support the staff and families in our care for that particular shift.  It is busy, demanding and unpredictable, and I love it.

Tell us something interesting or funny or heartwarming that has happened at work…

Whenever I tell people what I do for a living the response is always “Oh I couldn’t do your job, it must be so sad!” and it is true that neonatal death is an inevitable part of our role.  It is both a privilege and an emotionally exhausting experience supporting these families to create beautiful memories at such a painful time.  However, for each neonatal death that occurs there are at least 50 sick or preterm infants that we are able to support to grow, and thrive and ultimately take their first journey home to sleep in a room that isn’t full of beeping monitors and hushed conversations.

Every single milestone is celebrated, first cuddle, first milk feed, first time off respiratory support.  These moments are massive for the parents and for our NICU family.  We play a huge part in the lives of the families admitted to the NICU, for however long or short a time that maybe, and the relationships we build mean that families come back to see us time and time again.  We have walls of photographs of children who are 5, 8, 12 years old, we get letters and cards on anniversaries of babies being admitted to the NICU at “The Old Sharoe Green”, we have parents who return every Christmas with a box of chocolates for the staff because their baby was on the NICU over 20 years ago.

The staff may have retired, but the relationship and the desire to give something back is still so strong. Oh, and every baby that reaches 100 days of age as an inpatient with us gets a cake because, well you know… cake.

Approximately, how many babies do you look after in a normal shift?

We have the capacity to take up to 28 babies, a mixture of intensive, high dependency and special care infants.

How have Baby Beat helped/supported babies and mums in your area of work?

Charitable donations make a massive difference to the experiences of families experiencing a NICU admission.  We have many parents and families who feel that they want to give back in some way and they often fundraise for Baby Beat once they have been discharged.  These parents tend to ask us what we need on NICU and my response is always “Think of something that would have made your NICU journey easier because you know that will help another family in your position”.

We have 2 double ensuite bedrooms on the unit for parents to stay if their baby is very sick, for end of life privacy, and for parents to stay with their baby prior to discharge.  Previously these rooms looked like bland hospital bedrooms, clinical and unappealing, but thanks to some parents who fundraised on behalf of Baby Beat, these rooms have been transformed into beautiful, calm, homely spaces.  They are like hotel rooms and so much more comfortable and relaxing for parents staying in them, I could move in myself (and have been tempted after a tough shift with a short turn around).

Baby Beat also helped us to purchase the VCreate system, which is an iPad and App that allows us to photograph and video babies and send the links securely to their parents.  This supports our “Zero-Separation” initiative and helps to reduce anxiety and build vital bonding relationships between parents and infants who cannot be together.  This had been especially helpful during the pandemic with strict guidelines in place about visiting and infection control.

Tell us a bit about you – your hobbies, likes/dislikes etc.

I’m a mum to a thoughtful 6-year-old and a mischievous 2-year-old and that doesn’t really leave much time for anything else.  A lot of people say I should have been a primary school teacher, as I’m quite creative and enjoy making things and coming up with new activities to do with my children.  Home-schooling during lockdown has proved to me that I much prefer babies who can’t back-chat though!