Caring for tiny lives
When babies need extra care, they go to the Special Care Nursery at the St. Catharines hospital
The lights are dimmed in Room 8. Casting rectangular shadows along the lavender-painted walls is a collection of medical machinery. A cardiac monitor, an IV pump, oxygen monitor, a glasssided incubator. And a cot.
In the midst of it all, a tiny life. A little girl so new, she does not yet have an official name. She was born a day and a half ago; one week early, with a mop of black hair and plump, crabapple cheeks.
Her parents are from northern Saskatchewan. They came to
Fort Erie for a family emergency and ended up staying longer than they’d hoped. When mom, Jessica Vance, started having contractions that became stronger and more frequent, they cast disbelief aside (and speculation that maybe it was just too many Freezies) and drove to St. Catharines.
Baby was born a half hour after their arrival.
Mom sits in a large beige arm chair, her back turned away from the glass wall that separates them from a hallway, and more rooms. In her arms, a swaddled, sleeping bundle.
She carefully draws back the blanket. On the infant’s chest and abdomen, are three small square white pads with wires leading back to equipment that monitors her breathing and heart rate. An intravenous line in one foot delivers a sugar solution, and a monitor on her other foot tracks the oxygen saturation of her blood.
It’s just past 11 a.m. in the Special Care Nursery, a 12-bed unit in the St. Catharines hospital where babies stay when they need a more intense level of care. Rooms here are almost always filled.
Babies might be facing any number of medical challenges: breathing and feeding difficulties often a result of being born premature; blood sugar problems; even babies experiencing withdrawal symptoms, born to drug addicted mothers. More serious – such as being born earlier than 32 weeks, or needing a ventilator – they are transferred to McMaster Children’s Hospital, Sick Kids or beyond.
In the Special Care Nursery, parents stay with babies in private rooms. A team of registered nurses are specially trained to care for sick newborns, and have expertise in life-saving procedures including neonatal resuscitation. Babies could be here for a few hours, or weeks at a time. Some are transferred from McMaster once their condition has improved, to bring them closer to home. The blueprint for their care is a combined effort between a pediatrician, the family, and Amanda Symington, the unit’s only nurse practitioner.
She spent more than 25 years in the neonatal intensive care unit at McMaster, immersed in the fragilities and joys of life, before coming to St. Catharines in 2016.
All that time with sick babies has offered her a certain view on life. “You just relish every moment you have,” she says. “It puts everything in perspective, really. You see families go through so much.
“I have tremendous admiration for them.”
Indeed, there’s a soft spot in her heart for anything tiny and vulnerable.
While there is not the same life-and-death intensity in St. Catharines, her day can turn in a heartbeat, requiring in-the-moment crisis leadership with a team trained to manage very sick babies until a transport team arrives.
She can intubate a baby and insert arterial and venous lines into a baby’s umbilical cord to provide IV fluids, or draw blood for testing. She can perform a lumbar puncture to extract spinal fluid for tests to rule out meningitis.
During her morning rounds, she meets Jessica and her baby girl for the first time. A big baby at 9 pounds, one ounce, her blood sugar level was low and wouldn’t stabilize. They discuss a treatment plan.
“I’ve never had to deal with anything like this before,” says Jessica, afterwards.
Jessica is 43 and has two other daughters, a three-year-old and a 23-year-old. She is a dental therapist from the Peter Ballantyne Cree Nation, on Reindeer Lake, a community that fills her spirit and empowers her passion for helping children. She works in a health care centre 37 steps (she has counted) from her front door.
Doctors are flown in by float plane, or on planes with skis for landing gear in the winter. During her pregnancy, she was cared for by a registered nurse. A month before her due date she had planned to drive more than five hours – the first three hours or so by dirt road – to Prince Albert, where she would deliver her baby at a hospital.
Those plans changed when she was needed in Fort Erie.
And then baby came early. A room of their own, just steps from the nursing station, offered peace of mind.
“I don’t want her away from me. She’s so newly out of me. I just want her near me,” she says.
“I want her to hear my voice. I want to hold her.”
On another day in Room 8, a baby boy born seven weeks too early gets a head-to-toe examination by Symington.
If he passes, he could be going home. His twin brother was officially discharged several days ago.
A final eye exam, prompts an outburst of newborn, red-faced cries.
“He’s all set to go,” she tells first-time mom, Breann Van Roon, 24.
“Do you want to see mom,” she asks the squirming infant. “You’ve got quite the face.”
Mom sits on the edge of the cot; “It’s been quite the adventure,” she says, smiling.
Her boys were born by C-section at 33 weeks when one baby’s water broke, affecting the other’s breathing.
At 3 pounds, 13 ounces, Dylan was the smallest and sickest. His big brother, Lucas, weighed in at 5 pounds. They both had feeding and breathing challenges, but Dylan struggled to keep his liquid food down.
When they were born, the Special Care Nursery was beyond full so, they were transferred to the Credit Valley Hospital in Mississauga until a room opened up in St. Catharines.
He needed time and patience. “I had no idea how stressful this would be,” says Breann, as baby Dylan’s cries escalate. She sets him on the cots and wraps him in a blanket, burrito style. Nurses call him Dill Pickle.
Breann is a nurse in the hospital’s labour and delivery unit and yet, she did not feel confident when she had her own preemies.
“Your emotions take over,” she says.
It’s easy to bring their stories home, says Symington.
“I think about them all day, every day,” she says. “I can’t imagine anyone doing the job we do, not taking it home.”
Nursery staff take time to talk about feelings and critical events. And when she’s home, there’s nothing better than a bike ride through the vineyards.
On her desk, she keeps a poem given to her by her father, a retired oral surgeon.
It begins: Go placidly amid the noise and haste, and remember what peace there may be in silence. And continues: You are a child of the universe, no less than the trees and the stars; you have a right to be here. And whether or not it is clear to you, no doubt the universe is unfolding as it should.
These words, she lives by. Every day.
“No matter who you are, or what life has thrown at you, no matter the circumstances you’re in,” she says, “We all have a right to be here and enjoy the world.”
Cheryl.Clock@niagaradailies.com
905-225-1626 | @Standard_Cheryl