Behind The Scenes

When a baby is on the way, parents often spend months preparing for the day they will welcome their little one home from the hospital: gifts are received, nurseries are decorated, clothes and blankets are washed and folded.

Few families plan to spend time in a hospital’s neonatal intensive care unit. But on the third floor of University of Cincinnati Medical Center, this highly specialized care is there for those who find themselves in need of it.

The hospital’s Level III NICU provides the highest level of neonatal care available in Cincinnati, aside from surgical procedures. The physicians and residents are employed by neighboring Cincinnati Children’s Hospital Medical Center and on faculty at the UC College of Medicine, and the unit's highly trained nurses, respiratory therapists and others provide advanced care around the clock to UC Health’s tiniest patients.

On this Friday night, the NICU is surprisingly quiet. That is intentional: a womb-like environment aids in the recovery of babies who are born early or with special medical needs that require extra care.

The medical monitors that track the babies’ every breath, burp and movement hum and beep. Insulated blankets cover many of the incubators, providing both warmth and comfort. Others are outfitted with cameras so that parents and families can feel close to their babies even when they can’t be present. Caregivers speak softly with each other and with the families, careful not to disturb their tiny patients.

The serenity is interrupted every now and then by the wails of an infant. The sound of crying may signify grief elsewhere in the hospital, but in the NICU, it signifies life.

On this night, veteran NICU nurse Deanna Riddle begins her shift around 7 p.m. with a handoff report from Ann, the colleague who has been caring for her two patients all day.

Deanna studies the oxygen levels of Ava, who weighed just 550 grams when she was born at 27 weeks and two days. This day, Ava weighs about 1,500 grams, but her developing lungs require constant aid from a ventilator to breathe.

Deanna also checks in on Giovanni—who goes by a nickname, Henley. Born at 30 weeks and two days, Henley flutters his delicate eyelids and wriggles a bit, since it’s almost feeding time. Soon, his mother will arrive to nurse him.

UC Health uses a primary nursing model in the NICU, which means that nurses provide care to the same patients, day in and day out. Deanna knows what every fluctuation in her patients’ readings means, and what every movement of the head or the eyes might signify.

Tiny Ava is serene as Deanna carefully changes her diaper, the nurse’s expert hands moving steadily but quickly so as not to disturb her intubation. Deanna carefully clears Ava’s mouth and throat of saliva to help ease her breathing. She gently turns Ava to check on the development of her stomach, and then returns her to a position that will best allow her lungs to relax and breathe.

“You wait, and you feed them, and you do all that you can to help them grow,” she said. “And you create this little world for them, and you hope that it’s enough.”

Deanna knows because she’s been there.

Nearly 20 years ago, she and her husband, Mike, who also works at UC Health, successfully conceived after fertility treatments. Pregnant with triplets, she was hospitalized at 18 weeks.

At the time, Deanna was a nurse on the High Risk Antepartum Unit at UC Medical Center—and suddenly, her coworkers became her caregivers.

Her sons arrived at 26 weeks and five days, and they were cared for in the very NICU where she now works.

“It’s such a special thing: when you have people you can depend on to take care of your kids…,” she said as her voice, breaking with emotion, trails off.

One of Deanna’s sons, born prematurely, passed away.

Today, her two adult sons are thriving: both are students at UC, one studying graphic design and the other studying chemistry. Her younger daughter, born at full term, has been accepted to study biology at UC.

“I feel like UC is my home: I met my husband here, we got married, we did fertility (treatments), we had kids—everything is here,” she said. “I’ve always been here, and I wouldn’t go anywhere else.”

The NICU has become a surrogate family, too: Deanna helped care for the twin children of one of her colleagues. And respiratory therapist Diana Stahl helped care for Deanna’s sons in the NICU nearly 20 years ago.

“I made the cake for her boys’ high school graduation,” said Diana, a 22-year veteran of the NICU. “It all comes full circle.”

At Ava’s bedside, Diana provides respiratory care while consulting with Deanna. Meanwhile, Henley grows increasingly vocal in his bassinet across the aisle. It’s almost 8 p.m.—dinnertime. His mother, Jasmine, arrives and begins speaking to her son as she changes his diaper.

She tells him how anxious his 6-year-old sister—also born prematurely—is for him to come home. Deanna brings in curtains to provide privacy for Jasmine to nurse her son, as Diana attends to Ava just a few steps away.

“The great thing about this unit and about this hospital is that we’re one cohesive unit. We’re a team, and we all work together to do what’s best for our babies. It’s a pretty amazing place,” Diana said. “I’ve been here 22 years, and I’m very proud to work here.”

Many babies graduate from the NICU and are able to go home, and the caregivers take joy in keeping in touch with those families and watching their children grow. Deanna’s daughter babysits for a family whose 3-year-old son was once one of her patients.

Other families have a different outcome, however.

“The worst part is when babies don’t make it,” Deanna said. “But your work is still important. You need to help those families move through and hold those babies and know—this life means something. You make a difference, and they made a difference.”

Deanna is always willing to share her own story with those families if she thinks it might help them.

“We do what we do because we love what we do. As we do it, there are good days and there are bad days,” she said. “You’ll have days when your babies aren’t doing so well. And when you have those days, you talk to your fellow nurses about it. But it’s so rewarding, no matter what.”

Editor’s Note: Ava passed away after this story was reported. We send our deepest condolences to her family and to those who cared for her. This story is shared with the permission of her family.