ReadingRoom

“I watched the Covid-19 update and coated everything in bleach”: life at neonatal care

A report from Auckland neonatal nurse and novelist Amy McDaid, filed after coming off two 12-hour shifts at Auckland hospital.

I’ve just finished two busy 12-hour shifts in Auckland’s Newborn Intensive Care Unit. The first shift, I was the so-called resource nurse for the day. There's another term for this role that circulates around the unit, but it’s unpublishable. Let’s just say it has something to do with getting around and giving a lot.

The resource nurse helps where needed, checks emergency equipment, and attends deliveries. I ran from room to room, helping the busiest nurses. I helped transport a ventilated infant to radiology, and assisted with the resuscitation of baby born several months early. Very standard all-in-a-days-work. On my second shift, I was allocated a room, caring for two extremely preterm infants in incubators. I actually had time to sit down. I watched the Covid-19 update and coated everything in bleach. There are signs everywhere alerting the sick, and the recently travelled, to stay away. Our unit now only allows parents to visit: no family, friends, siblings.

Our babies are precious. Some are surprises, some are the result of years of trying. Some are no bigger than a block of butter; their skin as thin as tissue paper, chests sucking in for each breath as a result of their underdeveloped lungs. Our earliest are 23 weeks gestation — 17 weeks before their due date. Their immune systems are poor, and they often battle infection after infection. They need ventilators and constant monitoring and complex medications. They like to stop breathing. We give them a gentle tickle to remind them it’s not optional as well as a generous wallop of caffeine with their morning milk — it’s as essential to them as it is to their nurses.

And though the worst days are achingly slow for their parents, they grow and their skin matures and they transfer from incubators to cots and stop terrifying their family with breath-holds and learn to feed without a tube. After months of hospital care, the majority are bundled up in their car seats like overdressed sausages and whisked out our double doors by relieved, smiling parents.

Right now, it’s hard to assess the impact of Covid-19 on a neonatal intensive care. We are still learning what it means for pregnant women and vulnerable infants. But we have always been extremely cautious about infection control. Our hygiene standards are the best in the hospital, if not the world —our reddened, alcohol-rubbed hands and the colourful graph in the corridor, representing the sneaky observations of lingerers with clipboards, attests to this.

But one of the big concerns is not about our infants catching Covid-19 (as we know, it mostly affects older people) but for the nurses and doctors, because they're needed to run the space station technology that keeps these children alive; to insert needle-thin intravenous lines into needle-thin veins, to administer life-saving medications, and to teach an anxious dad how to change a nappy, and an exhausted mum how to breastfeed. It's why social distancing and self-isolation is so important. Not just for those vulnerable to the illness, but for those who rely on well, highly-skilled professionals for their next breath.

Let’s say we’re lucky here in New Zealand and we’ve caught this early and the government’s measures keep spread down. Our hospital systems will not be overrun, and medical teams will not be forced to chose between saving 50-year-old Margaret with two teenage kids, or 67-year-old Bob with five cats and an errant wife, or 16-year-old Luke because as bad luck has it, he’s just been in a car accident. Our neonatal unit will remain well-staffed. Even then, we know life will be different.

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I’m not an economist, I’m not an epidemiologist. I’m a nurse, and I’m a writer, and as such can only comment on a personal level about the impact of this and my concern for those whose work will dry up, and for those who were already struggling, either mentally or financially, before this hit. For small businesses, and big ones, and our self-employed creatives; our musicians, our comedians, our performers, who are already some of our country’s poorest, who rely on public gatherings and contract work.

Our government’s rescue package sent a collective sigh of relief across the nation. But those of us who have the means must still do what we can to support local businesses and creatives. If you have to self-isolate, don’t waste your time watching too much Netflix and freaking yourself out on social media, and don’t order from Amazon. Instead, brighten your home with a painting from Janet down the road, because the local market where she sets up her table every Sunday has closed. Use the money refunded from the cancelled Auckland Writers Festival to order books from your local bookshop. Many deliver; most will run books out to your car if needed. And check on your neighbours. People are going to be sad and lonely. Above all, be kind.

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I laughed out loud when Wellington writer Eamonn Marra tweeted seven weeks before his brilliantly funny book, 2000ft Above Worry Level, was due out: "I hope humanity survives that long." It was early January. I was still editing my novel Fake Baby. But I could taste that fear — I might die, or the book industry implode, or something really really terrible could happen to the world before I got to hold my book in my hands. The book that’s taken four years, a Master’s degree, baked-beans dinners and the input and advice of countless kind and intelligent people. My laugh came from the knowledge of my ego and the ego of other writers — that despite battling imposter syndrome and crippling anxiety that we are really quite stupid and everyone will hate our books, we also believe at the same time that what we’ve written is vital and deserves an audience.

And then that moment arrived last Monday. And I held my novel and it was more beautiful than I imagined and I should have wanted to jump up and down, call up all my friends and shout the news from my rusty balustrade overlooking Crum Park.

Though I never expected Fake Baby to be welcomed into the world with a fanfare. I expected some shit and blood and maybe some tears and maybe a laugh and maybe it to be simultaneously the most underwhelming and overwhelming thing I’ve ever done. I expected a small window of promotion where the bookshop would put my book out the front on the stand, and maybe it’s cool bright blue and neon pink cover would grab someone’s attention and maybe they’d buy it. I expected to be able to annoy my friends by reposting every single small (and nice) mention of my book from columns and bookstagram, as well as photos of it in every conceivable location while feigning surprise: (OMG! HERE’S MY NOVEL! IN POPPIES HAMILTON!).

Fake Baby is due out in five weeks, and all those things I thought were crucial to get my book out to an audience: my launch party, writers festivals, busy shopping malls, have evaporated. My publisher, Penguin Random House, are looking at virtual means of promotion. Kind people from the writing community have come forward to offer help. I’ve been blown away by the generosity of ideas.

I don’t drink a lot these days, so I’m unsure what to do with the several dozen unopened bottles of wine earmarked for my book launch party. Perhaps when this is all over, I’ll hold a party to celebrate. Or perhaps I’ll distribute them among our hardworking hospital staff for secret swigs. (For once they get home, of course). The only thing that’s certain for all of us, is life is going to be different, and we’re going to need to adapt. Writing is my life, but I’m prepared to do less of it over the coming months and help at the hospital — and some extra quality time with little babies and my incredible NICU colleagues isn’t such a bad thing.

ReadingRoom will host a virtual launch for Fake Baby by Amy McDaid when Penguin Random House publish it in April. Everybody welcome! In the meantime, pre-orders for her excellent book are available here.

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