DuBOIS – Thirty years, approximately 6,000 babies and a national Five-Star Rating from HealthGrades. Those are the numbers that DuBois Regional Medical Center’s Neonatal Intensive Care Unit can celebrate this year.
DRMC’s NICU first opened Aug. 1, 1977, at the former Maple Avenue Hospital, now DRMC East, according to Robin McKenrick, nurse manager of the NICU.
The specialized skills of the physicians and nurses are used to save the smallest of patients, even as small as the tiniest baby born at DRMC (1 pound, 1 ounce) or the largest baby (13 pounds).
There are 16 “beds” or incubator cribs in the unit and on average; 10 are filled every day. During the busiest of times, there have been up to 22 babies in the NICU using the extra equipment always kept on hand.
On staff, there are 28 nurses plus three neonatologists and other specialty doctors, such as pediatricians and perinatologists, who work side by side on babies who are born prematurely or with complications. Many others on staff at DRMC work to save tiny lives including unit secretaries, respiratory therapists, laboratory staff, radiological technicians, social workers, nutritionists and pharmacists.
Today, the unit has modern equipment to help babies breathe, monitor their oxygen levels and their small heart beats. Modern medicines are given to replace proteins in the lungs essential for babies’ lungs to develop and function.
But, it didn’t start off that way.
The NICU started as a small 12-by-12-foot room in the far end of the first floor of the Maple Avenue Hospital. It had one big glass window and an area for a nurse.
Dr. John Siar, a neonatologist, was then-chief of pediatrics at West Penn Hospital when he came to DuBois. Outcomes were not as good for babies born in the hospitals far away from NICUs, Siar said.
Some babies were too small to be transferred. Their veins were too small for intervenous lines. Equipment that could help was just being developed, and it was mostly developed for adult sizes. It wasn’t until the late 1960s that there was a breathing machine for a baby, Siar said. Until then, adult ventilators were first used on babies.
Dr. George Fatula, a pediatrician, agreed that the equipment needed locally wasn’t available. In DuBois since 1973, many people called upon Fatula and his partner, the late Dr. Donald Orris, to care of their premature babies even before the NICU opened. They worked hard to get those babies ready for trips to Pittsburgh hospitals because they had the necessary equipment in their NICUs.
The lack of premie-sized equipment was hardest, Fatula said. But he and the staff improvised. For example, the need for smaller forceps led him to borrow forceps used for eye surgeries from Dr. William Hill. Other equipment was shared between DuBois Hospital and Maple Avenue, so many items made cross-town trips.
As neonatal care grew in the larger hospitals, people saw there could be a better chance for their babies if they could get them to an NICU in time.
The number of babies from DuBois and the surrounding area was growing, and Siar said he thought that a NICU in a rural area would be a viable program. It would cut the time for a baby to reach care in a critical situation.
Siar said he approached both DuBois Hospital and Maple Avenue Hospital about setting something up. DuBois Hospital said that they couldn’t afford it at the time. Maple Avenue said they couldn’t afford not to do it, Siar said. That is how the location was first selected.
So, Siar, a Brookville native, came to DuBois with the plans to stay a year to get things started. It was an experiment and unheard of at the time. His colleagues thought it was a mid-life crisis, he said, especially when he traded in his sports car for a truck.
Shelby Smith, LPN, started at the NICU on Sept. 5, 1977. She was very interested in the job because she had worked in maternity and watched with fascination when the teams came from Pittsburgh to pick up the premies.
The NICU started with two patients, and by the end of the week, it had three, Smith said. Siar joked that when they reached 10 patients, they would have a party to mark the milestone. It was not long before Siar had to pay up, Smith said.
“As the census grew,” Smith said, “we got to learn so much.”
Babies came from throughout the area — Brookville, Punxsutawney and Clearfield. Then, Kane, Coudersport and Bradford started sending babies to DuBois instead of Buffalo, N.Y.
“DuBois is the right spot on the map,” Siar said. DuBois is in the middle of all the other neonatal units. The highway system is such that it was the right spot for something to grow. Parents could visit their babies – who sometimes stay for days, weeks or months – even after they had to work all day.
The 10-bed unit grew to 15 beds by 1980, Siar said. The unit moved to the third floor of the east unit which Smith recalled was so nice with so much more room and privacy.
Lucille Loomis, LPN, agreed that privacy was needed. An NICU nurse for about 28 years, she said because of the location next to the gift shop, people would watch the babies all the time.
From the third floor of DRMC East, the NICU moved to DRMC West in 2005. “It is very nice,” Loomis said. The unit is divided into “pods” where each baby has a special section, much like a room without walls.
Today, Siar is pleased about how everything worked out. “Our quality and the survival rate match the upper tier in the nation,” Siar said. “Most people don’t think about the overall quality,” Siar said. “It’s just the quality for their child that matters.”
Siar attributes the NICUs success to the dedication of the nurses at DRMC. “They are not clock watchers,” he said. They call from home when they are off to see how a baby is doing.
DRMC has a low turn-over rate for nurses in the NICU. Statistics show that the average length for nurses to work in an NICU is two or three years because of stress. But many of the DRMC nurses have been in the unit for 15-20 years or more. Few transfer out once they start.
“You have to love it or not like it at all,” Smith said. She was going to retire eight years ago, but she didn’t. She works as she is needed on the schedule. “I wouldn’t be able to not have it in my tomorrow,” she said.
Loomis did retire in 2002, but she continues to work as the NICU needs her. “I just love the work,” she said. There are always new challenges, camaraderie among the staff and “we continue to see results.”
There are always new ways of doing things, Loomis said. Many people see the staff feeding bottles to the babies, but there is more to the work than that.
It’s not easy to be an NICU nurse. The first NICU nurses spent weeks in Pittsburgh training, Siar said.
Today, according to Judi Withers, director of Women’s and Children’s Services, the NICU nurses go through a comprehensive orientation and training at DRMC.
“After the nurse has completed their basic education and passed nursing ‘boards’ to become registered, their NICU education begins,” Withers said. “Paired with a preceptor, the new nurse has a combination of study, classroom time and clinical experience under supervision.
“After mastering all of the basics, NICU nurses continue to take classes and programs of study are offered at DRMC such as flight training to be able to fly in a helicopter to transfer a baby from another hospital to the DRMC NICU,” Withers said. “The nurses at DRMC’s NICU are true professionals and expert in all they do.”
“Helping the babies gives such a wonderful feeling that I can’t even explain,” Smith said. “It can be stressful,” she said of the job, “but I love the fact that a sick baby can be admitted, cared for and, then, we see him in his mother’s arms, again.”
Loomis agreed that the job is satisfying. “New parents live by the babies’ bedsides,” Loomis said. When parents feel comfortable enough to go home and get a good night’s sleep, she said, the staff knows that they’ve gained the parents’ trust.
There are bonds created between the doctors, nurses, the social workers and families. “It’s a trusting relationship,” according to Smith.
Seeing the babies grow into toddlers, children or teenagers is really rewarding, she said. Some of the premies are now mothers themselves, and their children are being cared for in the NICU.
Many of the NICU families send photos of their children or “graduates,” as the staff calls them. The bulletin boards in the hall to the NICU are covered with these pictures.
Through the years, parents recognize the workers and still express thanks. Everyone who has worked in the NICU has a story about running into someone – at the grocery store, restaurant or the mall- who is thankful for their work. Siar’s family even ran into a grandfather at the Canadian border who recognized him for saving his granddaughter’s life.
Fatula remembers a time when he was called after a woman came to the hospital with abdominal pain. It was thought to be a kidney stone, but it turned out to be a 3-pound baby. Today, the mother still thanks Fatula for saving her daughter’s life.
But the stories that the physicians and staff often reflect on most are the sad ones. “Not every case is a success. You remember those more than the ones you are successful with. You can try so hard and no matter what you do, you are not successful,” Fatula said. “People expect every baby to do well, but sometimes babies are born before they are ready.”
“Today, at DRMC, we are learning from the past and looking to the future with hope and optimism,” Dr. Mohamed Hassan, DRMC’s newest neonatologist, said.
“Hard work, hope and optimism describe the journey of DuBois Regional Medical Center’s NICU through its establishment over the past 30 years. From its modest beginnings to its current position, our NICU is appreciated as one of the well-respected NICUs in Pennsylvania.”
“Over the years, many things have changed, from the buildings and staff to the medical technology and procedures. But something important has remained consistent, which is caring for sick neonates with love.”
DRMC will host a picnic for all its graduates and their families and friends to mark the 30th anniversary. It will be held from noon to 5 p.m. Saturday on the lawn at DRMC West.
For more information, call the NICU at 375-NICU (6428).