One of life’s cardinal rules is that things don’t always go according to plan. Sometimes life has a way of throwing you the occasional curve ball, but you learn it’s what you make of those situations that can help carve a new path. Neonatal Intensive Care Unit (NICU) nurse Amanda Ellis knows this lesson firsthand.
As a high school student she took part in a health science technologies program, a college tech prep program that sparked her initial interest in a nursing career. Typically, she would have pursued a college degree post-graduation, but life threw Amanda one of those curve balls. Pregnant at 17, college would have to wait while she focused on family.
“I obtained my State Tested Nursing Assistant (STNA) certification shortly after turning 18 and worked in that capacity for a few years,” she said. “I fell into a routine and a few years passed before the thought of returning to school crept into my thoughts.”
Back to school
It was actually Amanda’s mom, back in school herself pursuing a degree in nursing, who challenged her daughter to follow in her footsteps.
“I’m type A and extremely competitive by nature, so it was the motivation I needed,” Amanda said.
It wasn’t an easy road. Amanda became a single mom to 3 young children while in school, but she persevered. In 2006, after completing her senior practicum at Akron Children’s, she was hired as a staff nurse in the NICU.
“I’ve been here 10 years, and I don’t have 2 days that are ever the same,” she said. “Nursing is a lifelong learning project, and there’s rarely a day that goes by that I’m not still learning.”
Caring for Ellie
Today Amanda is responsible for 19-day-old Ellie, who was transferred from St. Elizabeth Boardman Hospital yesterday morning. Ellie was born at 27 weeks, weighing just 1 lb., 11 oz.
“Ellie has pneumatosis or gas in the bowel wall, which we’re closely watching to make sure it doesn’t develop into necrotizing enterocolitis, which can cause the bowel to become inflamed and infected,” Amanda explains. “Part of the reason Ellie was transferred to Akron is because we’re a high-level NICU and can provide surgery should she not respond to antibiotics.”
Ellie’s mom, Sarah, is no stranger to premature babies. Her 3-year-old son was born 6 weeks early.
“My son was 5 lbs, 9 oz. at birth,” said Sarah. “I could hold him and feed him. It’s very different having a baby 6 weeks premature versus 3 months premature. Today, I got to hold Ellie for 1.5 hours doing kangaroo care (skin-to-skin) –which the longest period of time I’ve gotten to hold her.”
Sarah explains that the priority is letting Ellie’s healthcare team take care of her so she needs to spend a lot of time in her isolette. Amanda provides Sarah with a Snoedel(R) doll to place inside her shirt. The doll collects and retains her scent – important because sense of smell is one of the things that bonds babies to their parents.
“We place the doll in the isolette as a comfort aid for the babies,” said Amanda. “Mom’s scent is slowly released and has been shown to improve sleep and soothes them when they’re distressed.”
In addition to belly issues, Ellie has patent ductus arteriosus (PDA), which is an open valve issue in the heart that usually closes shortly after birth in full-term infants. Since Ellie was born prematurely, her PDA has yet to close.
A day’s work
After arriving for her regular 3 a.m. shift, Amanda got the report from the nurse who was handing off to her.
“I take note of all the medications my patients are on and when they last received them,” she said. “I’ll double check orders and go in and see my patients and make sure all IV fluid and ventilator settings are correct.”
The NICU operates on a strict schedule for feedings, diaper changes and checking vital signs.
“The goal is to minimize the time we’re disrupting the babies and getting into their isolettes,” said Amanda. “In order for them to grow, it takes time, and that includes making sure they stay in a neutral-thermal environment and get the right amount of nutrition.”
Part of the challenge of Amanda’s job is trying to figure out what’s wrong when her tiny patients have spikes in their heart rates.
“They could be in pain or they could need to change positions,” she said. “The challenge is they may like a certain position one day and not so much the next.”
Sarah has anxiously been awaiting a visit from the surgeon to hear about Ellie’s latest status. She is greeted by Dr. Tim Pittinger who tells her the fact that Ellie had a green mucousy stool is a good thing because it means her bowels are working.
“We don’t want to put a baby through the stress of surgery if we don’t have to,” he says. “If she’s responding to treatment, we’re going to sit tight.”
Working with the PIPS team
In addition to her bedside duties, Amanda serves as the NICU clinical practice council chair and is a member of the NICU transport team. She is also part of the on-call Pressure Injury Prevention and Support (PIPS) team. As a Wound Care Certified (WCC) nurse she can be called upon to assess and treat inpatients’ wounds.
“I stage pressure injuries and try to figure out ways to help the body fix them,” she says. “Babies don’t have elasticity in their skin, so wounds can happen quickly from something as simple as IV tubing or a wrinkled sheet. Part of my job is educating staff and parents to help prevent the same injuries from happening again.”
Most people don’t envy her 3 a.m. start time, but Amanda swears it’s the secret to her work-life balance.
“My shift finishes at 3:30 p.m. which allows me to be home for my husband and 5 children,” she says. “I never miss dinner or swim or cheer practice. My kids don’t miss me because they’re either asleep or at school.”
Amanda cites learning more about the disease processes that affect her patients and using her critical thinking skills as what keeps her inspired and challenged in her job.
“In the spring 2016 I enrolled in the University of Phoenix’s Masters in Nursing Education program and am set to graduate this fall,” she said. “Teaching is such a large part of what every nurse does, and I truly enjoy making nursing care understandable and relatable.”
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