Ruckus in the Pod

Last night, Henry was doing OK. His saturation levels were all over the place again. Jenny (again his evening nurse) turned him on his tummy, which seemed to stabilize his saturation levels a bit.

The noise level of the NICU was high. I was pretty upset over it. The people in the area to the left of Henry's isolette were very noisy. Given the size of the baby next to Henry, she should be in another pod. Henry's pod originally had the real little ones in it (i.e., the micropreemies). As babies grow, they get louder. And "Johnnay," the baby next to Henry, is no micropreemie and screams a lot. In addition, Johnnay's family is quite loud. One of the nurses screened off their area to give them privacy, but they talked so loudly that you could hear everything they said. And tonight, they were having an argument about whether the mother should give the father a haircut (mind you, this guy's hair is as short as Jeff's). We did talk to one of the nurses to see if they could move Johnnay to a more appropriate pod (e.g., where there are babies her size who make similar amounts of noise). The problem is that the NICU is almost at capacity right now.

To add to the problem, the nurses at the end of the pod started gabbing about vacation spots or something, and they were loud. These are people who should know better. The literature that the staff have handed us states over and over the importance of peace and quiet for preemies, since they can't handle and shouldn't have to handle the auditory stimulation.

Here is what the literature says...

"Within the womb, noise is filtered and muffled by muscle, fluid, and bone. Outside the womb, your premie's ears enjoy none of that protection. The noise level in the intensive care nursery is 10 to 22 decibels louder than that in the newborn nursery, ranging around 60 to 70 decibels at all times. (Normal speech is at 65 decibels.) At 70 decibels, sleep disturbances may begin to occur. If the sound level exceeds 84 decibels repeatedly over time, your child can experience a hearing loss from the sound's cumulative effects.

The din in the NICU has a wide variety of sources. The infant is assailed by the incessant beeping of other babies' monitor alarms, the excited voices of parents visiting neighboring incubators, the jangle of the phones, the grating of the addressograph, and the rattle of trash cans.

These sounds are quite loud. For example, the sound of shutting incubator portholes runs from 111 to 124 decibels. Setting a milk bottle down softly on top of an incubator measures from 84 to 100 decibels, closing the cabinet doors under the incubator from 104 to 119 decibels. The ambient noise level has been measured at between 50 to 68 decibels inside incubators even when the portholes are closed. When open, it's 60 to 68 decibels.

With this continuous racket, it should be no surprise that a number of babies suffer from hearing impairment when they leave the neonatal intensive care unit. To be certain that hearing loss is detected, most babies are given a hearing test before discharge. Most hearing loss is temporary." (Ludington-Hoe & Golant, 1993, pp. 42-43)

I have repeatedly told the nurses that his saturation levels go down when the room is noisy. But a few of them don't seem to make the connection. Also, when a nurse is taking care of an older baby, s/he tends to talk at a level appropriate for that baby, failing to realize that there are smaller babies (that s/he isn't taking care of that day) who shouldn't have to handle that level of noise.

I feel like I need to keep watch 24-7 to monitor the noise level around his isolette, which is difficult. I'm there a lot, but realistically, I can't be there at all times.


REFERENCE
Ludington-Hoe, S. M., & Golant, S. K. (1993). Kangaroo care: The best you can do to help your preterm infant. New York: Bantam.