This is what my attending told me on my very first day of nursery week. During our 7-week rotation in pediatrics, we have 1 week devoted to working in the newborn nursery clinic. Since it was only a week long, I hadn’t expected us to do more than shadowing the clinic. It takes a week just to learn the flow of a department. But when my attending told us: “Newborns. They’re small but mighty,” I knew that we would be expected to do a lot.
In the newborn nursery, every number matters. Temperature above 38? Act now. Central trunk seems a little blue, check respiratory drive.
But at the same time, there is a lot of concern by parents for typically benign features. Erythema toxicum, a deadly-sounding rash, is completely benign. Blue fingers and toes? Normal. Some swelling on the skull with some bruising. A cephalohematoma- again benign. There is a lot of time spent on reassuring parents that everything is fine.
Unlike in much of the rest of medicine, there is a lot of subjective language in nursery week. We use terms like–normal and perfect, for newborns. We throw away terms like unremarkable or benign. We’re taught to use 6th-grade terminology with our patients, even those who are in the healthcare profession itself.
It was an absolutely incredible experience working with the newborn nursery team. I learned a lot about communication strategies, as well as how to change a diaper.