By: Jenny Walters RN, BSN
In being a nurse, I have come across numerous ethical dilemmas. However, not until I began my career as a neonatal intensive case nurse, did I truly come face to face with such dilemmas.
Neonatal intensive care nursing involves the care of critically ill neonates. The majority of neonatal intensive care patients are premature neonates (those born less than 37 weeks gestation).[1] Caring for premature neonates was far from typical nursing. It involved dealing with the family as whole, not just the patient.
During my nursing career in the Neonatal Intensive Care Unit (NICU), many of the physicians and nurses would state: “We can save virtually every baby that is born, but should we be saving virtually every baby born.” When I was working in the NICU, we cared for premature neonates that were as young as 21 weeks gestations. Full term neonates are between 37-40 weeks gestation.1 However, the gestational age of the neonates is just an estimate. Therefore, the premature neonates we took care off could have been as young as 20 weeks gestation.
According to the March of Dimes: “Premature babies…who weigh less than 3 1/3 pounds are between 20 and 80 times more likely to develop cerebral palsy than full-term babies.”1 Cerebral palsy in a premature neonate develops from bleeding in the brain, which can damage the baby’s brain tissue; or from the development of periventricular leukomalacia, which is: “the destruction of nerves around the fluid-filled cavities (ventricles) in the brain.”1
Although, there is a high incidence of cerebral palsy in premature neonates, there is also a high incidence that premature neonates will grow up to live healthy lives. Knowing that my patients could plausibly go on to have healthy lives was what kept me doing what I loved; caring for critically ill neonates.
As my career progressed, I became accustom to dealing with highly sensitive and difficult ethical dilemmas. My patients were the children of loving parents; children whom these parents would have given their lives for. For that fact alone, my duty as a neonatal intensive care nurse was to care for my patients to my best of my abilities and to respect the wishes of their parents.
In being a nurse, I have come across numerous ethical dilemmas. However, not until I began my career as a neonatal intensive case nurse, did I truly come face to face with such dilemmas.
Neonatal intensive care nursing involves the care of critically ill neonates. The majority of neonatal intensive care patients are premature neonates (those born less than 37 weeks gestation).[1] Caring for premature neonates was far from typical nursing. It involved dealing with the family as whole, not just the patient.
During my nursing career in the Neonatal Intensive Care Unit (NICU), many of the physicians and nurses would state: “We can save virtually every baby that is born, but should we be saving virtually every baby born.” When I was working in the NICU, we cared for premature neonates that were as young as 21 weeks gestations. Full term neonates are between 37-40 weeks gestation.1 However, the gestational age of the neonates is just an estimate. Therefore, the premature neonates we took care off could have been as young as 20 weeks gestation.
According to the March of Dimes: “Premature babies…who weigh less than 3 1/3 pounds are between 20 and 80 times more likely to develop cerebral palsy than full-term babies.”1 Cerebral palsy in a premature neonate develops from bleeding in the brain, which can damage the baby’s brain tissue; or from the development of periventricular leukomalacia, which is: “the destruction of nerves around the fluid-filled cavities (ventricles) in the brain.”1
Although, there is a high incidence of cerebral palsy in premature neonates, there is also a high incidence that premature neonates will grow up to live healthy lives. Knowing that my patients could plausibly go on to have healthy lives was what kept me doing what I loved; caring for critically ill neonates.
As my career progressed, I became accustom to dealing with highly sensitive and difficult ethical dilemmas. My patients were the children of loving parents; children whom these parents would have given their lives for. For that fact alone, my duty as a neonatal intensive care nurse was to care for my patients to my best of my abilities and to respect the wishes of their parents.
[1] March of Dimes. Cerebral palsy: quick reference: fact sheet. Available at: http://www.marchofdimes.com/professionals/14332_1208.asp. Accessed on 11 May 2008.
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