Originally written for Donna Ranker on the occasion of her first retirement from the NICU

Neonatal nurses are a difficult group to describe. I have a bird’s eye view of them, working with them yet not being one of them.

I entered their world cautiously, knowing they would eat me for lunch if I so much as looked the wrong way. Forget that I had any knowledge or even a personality. I knew that first I must just exist in their world and do no harm for a very long time, and if that plan worked out, maybe I could start treating some patients. I respected their protectiveness. I couldn’t think of any group of patients in greater need of protection.

And slowly, they allowed me to be.

If you’ve never seen a NICU nurse work it’s quite amazing. They can bundle a baby as tight as any burrito in 3 seconds flat, especially if showing a new resident how to properly perform this task. Seemingly regardless of their age and/or eyesight they can start an I.V. in a vein that’s no wider than a thread or fishing line while blocking out all surrounding distractions.

And don’t kid yourself if you’re a friend of one of these nurses and you visit her with your new baby. You may think she’s just admiring his adorable face when really she’s trying to control her excitement about how good his scalp veins look in case he ever needs an I.V. in his noggin.

I’m telling you, they’re just not right.

They are meticulous about the state of the baby’s bedside and the baby himself, and are so anal that they typically revamp the entire area when they come on shift because the nurse before them wasn’t quite anal enough. This is all in the best interest of the baby of course, and for that nurse’s state of mind for the rest of the shift.

They have the ability to discern when a little 1-pound person just doesn’t seem like herself from a mile away. They will do everything in their power to convince the docs of this and will likely not let them leave for the day unless they get what they want for that baby.

NICU nurses have known forever that these babies feel pain, even though it was difficult to ‘prove’. They think about the babies on their days off, come in from home if they are dying. They provide a baby with lots of love one minute, and run to code another one the next.

They are expert at what they do.

Now that I’ve been working with them for well over a decade and they trust me not to do anything too stupid, I must say I understand them. This little world in the NICU is unique. It is at once a place of celebrating new life and the grasping for it. It has been noted to be a place of intense parental love or at times abandonment; parents sometimes lost in their own set of horrible circumstances. It is mostly happy. It is mostly positive. It can be devastating.

We tuck years of that pain into a place we pretend doesn’t exist in health care. We go home and kiss our children.

I can’t say enough about the dedication of this group of people. They make me laugh hysterically with the sarcasm and humor that comes with the territory. They stun me with the level of skill they take for granted and the patience with which they teach the unending line of new doctors, new nurses, and people like me.

It is an immense responsibility to dedicate your work to a place that never closes, which needs you for its smooth and competent running, where fragile babies living and dying can just be part of your day’s work. All of that for a six figure salary…………

Thank you to the NICU nurses, for your expertise, your example, and your friendship. May there be a place in heaven for you with a coffee pot, good Chinese food, and the perfect schedule!