Authored by: Anthony Ogueji
Nurse Gabriel Oluremi is among the heroes providing quality care to small and sick babies in the neonatal unit (NNU) at Lagos University Teaching Hospital. She shared with us a typical day in the NNU:
At the NNU at Lagos University Teaching Hospital, the morning shift runs from 8 am to 4 pm, while the evening shift runs from 4 pm until the following morning. Nurse Oluremi begins her workday at the NNU in the morning.
As I enter the unit, the first thing I do is change into the nursing uniform (scrubs). Following this, I wash my hands with soap and running water.
After handwashing, I sign the daily nursing attendance log and check the functionality of the equipment we use to care for patients. After confirming the equipment’s functionality, the other nurses and I take over the shift from the previous shift’s nurses.
When taking over a new shift, we begin in the intensive bay, moving from one baby to another, checking their charts and making corrections as needed. Next, we go into the intermediate and the infective bays to repeat chart checking.
After all checks are complete, we proceed to work allocation. The allocation is based on the number of nurses on duty and their levels of expertise. Nurses with greater expertise are assigned to the intensive bay, which houses very sick babies requiring the highest level of care.
In the bay I am assigned to, I begin by checking patients’ vital signs and bathing and cleaning those who require it. I also give special attention to those on continuous positive airway pressure (CPAP) and check whether anything needs to be changed, such as the water in the CPAP.
After this, I proceed to feeding – 10 am is for feeding. Patients are fed three-hourly; however, some patients with special needs require feeding two-hourly. Usually, feeding times are at 10 am, 1 pm, 4 pm, 7 pm, and 10 pm, around the clock.
If there are babies on eight-hourly medication, I also take care of that, as well as babies on intravenous fluid so that such babies are not overloaded. Similarly, if there are babies on special electrolytes, I closely monitor them to ensure their electrolytes are not under- or overcorrected.
Caring for sick babies requires skills and commitment. When you are committed, you get recognised even beyond the four walls of the hospital. There was a day I was at the market to buy things, and I heard a woman shout, “Matron, thank you; you were the one who cared for our baby when he was sick, and you are the one who encouraged me to stop crying when he was on admission months ago.” This recognition makes me happy and fulfilled that my work is appreciated beyond the hospital setting.
I know that being admitted to the neonatal unit comes with feelings of anxiety and uncertainty in the parents. So, I ensure that I support parents not only clinically but also emotionally. I do this by involving the parents in the care of their babies. I explain the baby’s condition to the parents in simple terms and instill hope in them.
In delivering quality neonatal care, my main challenge is a shortage of workers. Sometimes, we have 20 babies to two nurses. It takes a lot of commitment to deliver quality care to such babies in the context of 20 babies to two nurses. When you are supposed to close by 4 pm but are still working in the NNU by 6 pm, it shows you are committed. What drives my daily commitment on the job is my passion for caring for babies.
The message I would like the public to know about neonatal nurses is that they do their best to care for babies. If I could change something to improve the care of sick babies, it would be to recommend that pregnant women register early for antenatal care, the medical care provided to mothers before the baby arrives. I encourage pregnant women to present early to the facility when they observe any changes, such as bleeding, which can result in positive health outcomes for both mother and baby. I also call on the labour and theatre wards to perform their work well before transferring babies to the neonatal unit.
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