Alison Thomson knows all too well how scary it feels to take your baby home from a Neonatal Intensive Care Unit (NICU) for the first time.
Having worked in Starship’s NICU for several years, she gave birth to her twin girls in 2018 at just 27 weeks gestation – three months earlier than expected – and found herself back on the ward as a parent just after she went on maternity leave.
“I finished work on the Wednesday and they arrived on the Friday. So I’ve done the NICU journey on both sides – from a parent’s point of view and also from a nurse’s.”
Now her daughters are busy preschoolers, Alison has resumed working with Starship’s neonatal homecare team where she helps families transition from NICU back to their home environment.
This is where Alison’s role provides support for new parents. Her charge nurse, Dale Garton, describes the 33-year-old as an ‘unsung hero’ of the last two years. “She goes beyond 110% to ensure that babies going home from NICU get the support and service they need when they transition home,” Dale says. “Her homecare role has been confounded by additional guidelines and PPE associated with the Covid response. Throughout this time, and in adverse conditions, she ran the service to ensure vulnerable babies stay safe.”
Covid did indeed throw a curve-ball at the homecare team but Alison came up with innovative solutions to deliver remote care. “It was a really tough time for us morally as well because we didn’t want to not see families. But we also had to see them in a way that was safe for us as well as safe for them.”
Regular RATs and Zoom calls were instigated, and multiple new sets of scales were purchased so families could weigh their baby at home and report results without nurses having to physically be present. A screening tool was developed which guided how much PPE had to be worn during weekly home visits and social distancing protocols were put in place.
“It has worked quite well,” Alison says. “It’s certainly changed the way we work and showed us how we could be working better and more efficiently. We were able to figure out what sat most comfortably with us, and with parents.”
Feeding issues are the most common problems new parents grapple with when they first return home. Many NICU babies are fed through nasal gastric tubes in hospital, so learning to feed without one tires babies out – and their parents – and throws any semblance of routine out the window.
Alison describes the homecare service as a ‘safety net’ to make sure babies continue to grow and feed well after they leave NICU. “Some extreme pre-term babies that are born at 24 or 25 weeks need to go home on some low flow oxygen. We work with families and their neonatologist to gradually wean that oxygen down so those babies can sometimes be with us for three to six months.”
When the time is right, the homecare team passes that medical oversight over to Well-Child providers such as Plunket or Māori or Pacific health organisations in the community.
Although homecare nurses like Alison see most babies twice a week, their phones are always on to respond to calls and text messages from worried parents.
Alison is one of this year’s deserving Health Hero award winners although she had no idea her charge nurse, Dale, had nominated her. “It was just such a lovely surprise, and really nice to be recognised for a really hard two years. We all have worked hard since Covid arrived to make sure that we’re doing what’s best for our families and supporting them as best we can.”