“Nature will bear the closest inspection. She invites us to lay our eye level with her smallest leaf, and take an insect view of its plain.” – Henry David Thoreau

The March  of Dimes has christened November,  Prematurity Awareness Month.  On November 17th, the MODs is requesting bloggers to post on prematurity to raise awareness, to Fight for Preemies.  In order to Fight for Preemies, you must be aware that a battle actually exists.  Are you aware?  Can you look at the picture above, the picture of the beautiful infant tucked in loving hands, the infant with dark pleading eyes, and be aware of the battle that awaits?  It is easy to pretend that this is just a mini-infant, pint-sized and cute.  It is easy to plead ignorance of the battle ahead for both the beautiful infant, and for the hands cradling him.  How do I know this?  I know because I remained ignorant, and unaware for a long time.

When I first started my career in the NICU, at the ripe old age of 22, I was ignorant beyond belief.  I choose to go into NICU nursing because I thought it would be EASY, yes easy.  I had worked for a year in adult neuro and neurosurgery.  It was back-breaking work.  Working for infants must be a lot easier.  Preemies are small.  It would be fun to hold and rock and feed these little peanuts.  How naive I was, and how naive I feel that the public is of prematurity.

The first time I walked into a NICU I was floored.  It is an alien world of cardiac monitors, alarms, ventilators, glowing lights, IV pumps, radiant warmers and isolettes.  I had a science degree and four years of nursing school and I was completely overwhelmed by this battlefield.  Imagine how the parents feel.  Imagine what the babies feel.  One of my first patients was a tiny 28 weeker with umbilical lines, multiple IV drips and on a ventilator.  I was terrified to touch and handle this baby.  So tiny and vulnerable.  How could my hands help to heal this infant?  Is it possible to be gentle enough?  It took my preceptor much support and coercion to get me to handle this fragile preemie.  I was unaware.

It took me many months of hard-core, war zone, NICU nursing to become aware.  To be come aware of the extreme efforts, resources, intelligence, compassion, faith, and teamwork it takes to care for a premature infant.  I honestly thought that premature babies just needed a little warmth, and food and they would grow and be discharged as if they were now a term baby.  This is what I wanted to believe.  After 16 plus years of NICU nursing, I am certainly not unaware anymore, or am I?

I am still unaware of what the parents of preemies must endure, to fight this battle for preemies.  The everyday struggles for their children.  The time spent in the war zone of the NICU.  We all hear the miracle stories, and these stories are important, and we should hear them.  But we should not ignore the struggles of the families who are not so lucky.  These are the battles we must not ignore.  Saving a preemie’s life in the NICU is a tremendously important and noble battle.  But this is only one fight.  It is a mistake to focus on winning one battle, while losing the WAR.

We must Fight for Preemies not only in prevention and NICU care, but in the long haul.  It can seem to the lay public that the high-tech world of the NICU is glamorous and heroic, and discharging a baby from the NICU is where the story ends.  But it is only the beginning.  We must open our eyes to the long-term care and support an ex-preemie will need.  It can mean a life-time of care.  These preemies and their familes need our support and awareness more than ever.  Let’s not abandon them in this fight.

Supporting preemies and their families means more than prevention and high-tech NICU care.  It means lobbying for support and research beyond the “golden” age of two.  The conventional wisdom that preemies will “catch-up” to their peers by the age of two, so bye-bye.  Nice knowing you.  There needs to be more long-term research to help these infants and families in directing care, development and education.

Let’s promote awareness.  Let’s open our eyes, even if it is difficult to look.  Let’s Fight for our Preemies!

RR