Joana Mendes, São Francisco Xavier Hospital, Lisbon, Portugal

I am a NICU nurse since I left nursing school. It was my big and only passion. I work now for about 18 years with babies and families. My main areas of expertise are ethics and palliative care. When Covid-19 was spreading quickly in Europe, I was doing a pediatric palliative care clinical practice in Cardiff. One of the first challenges, was returned home safely, when boarders where closing, all over the world. I got to Portugal 2 days just before the lockdown. The news, papers and social posts on internet, arriving from China, Italy and Spain, were really scary. Portuguese boards (medical, nursing and even veterinary’s) asked for health care professionals, from all backgrounds and scenarios, to come and help in human medicine, especially in adult emergency department and intensive care, if needed.
They even asked the retired ones to volunteer. And they came. Neonatal nurses knew in advance, one could be mobilized anywhere, anytime. If the situation turned really bad, some would have to go and work in adult department. It sounded very unreal. Some of us when to the pediatric emergency department, when a lot of nurses were home due to quarantine needs. How would we help in adults? The second challenge faced, was the decision to left my sons (2- and 7-years old) with my husband and fathers in law. I felt heartbroken with all the uncertainty. I experienced strong and mixed feelings. Like never before, I listened the silence shouting and felt time passing in a very painful slow-motion way.
In the hospital I work, one building was converted in a Covid-19 area. The other, the maternity, neonatal and pediatric building, was considered the non-Covid-19. NICU would admit babies that where born from mothers that tested positive or babies, during neonatal period, suspected to be or tested positive. Since, labor and delivery unit started testing all women, some, with no symptoms or risk factors, tested positive. Evidence was lacking, but the risk of vertical transmission seemed to be low (hopefully).
Neonatal health care team were daily, adapting, adjusting and reframing institutional guidelines. Would using CPAP would increase the risk for professionals’ transmission as suggested in adult literature? Was it possible to do the test properly to smaller babies, if the swab used is the same size in adults and newborns? Planning was very dynamic and all we were learning from one another, around the globe.
When the time came, NICU nurses, that had previous working experience in adult ICU and had with no risk factors for Covid-19, went to work full time there. NICU also admitted a nurse from ICU that had a chronic condition. The others non-risk nurses, like me, would be the first to take care of Covid-19 babies. First admissions came in Easter time. NICU nurses were committed to promote mother-baby bonding, holding concept and family centered care. Even before the first baby was born, were all brainstorming. A mobile phone or a tablet was identified as a good option to send video, photo or promote face time with the mother, if possible. Nurses phone called mother’s, each shift, to update about baby’s situation, lactation advices and other areas of counselling and promote emotional support.
Full protection equipment use was hard. No possibility to eat, drink or use toilets to optimize the deficiency in the number of equipment’s available. Even for a couple of hours, makes you feel hot, dehydrated, sometimes dizzy, with fogged glasses and with a sort of shortness of breath. After you remove it bruises and pressure zones in your face can remains for hours or days. All babies that were born during this pandemic time, not only Covid-19, suffered touch and human face interaction deprivation. Parents stayed in the NICU for short periods of time, because they were afraid. Professional were all wearing masks and gloves. The
noxious sensory hyper stimulation seemed to gain preponderance to Kangaroo care, holding or breastfeeding. Difficult balance: health safety or human healthy development? What will be the consequences of this new crazy reality for next generation? What lessons do we have to learn, in order to elevate the quality of nursing care in the near future? This would be, the huge, third challenge. It was really inspired to feel that neonatal and pediatric palliative care were supporting one another in the globe. I felt we were really as one, sharing emotions and difficulties and being inspired to move forward.

I’m Lora Alexander, one of the Quality Improvement coaches in a busy Level 3 NICU. QI is all about understanding problems, thinking of solutions, implementing ideas and analysing the results.
My name is Adedoyin Yissau, also known as Dee. I am the Education and Workforce Lead for the London Operational Delivery Network. I came into post as a Network Educator in 2019 and have since developed nursing education region wide, with the current focus on developing a nursing career pathway for London.
Neonatal Network Nurse Educator
My name is Dr. Julia Petty, and I am a nurse lecturer specialising in children’s nursing with a particular interest in neonatal care. My nursing career in paediatric and neonatal clinical nursing practice began after a BSc Hons degree in Psychology at Warwick University, when I moved to Great Ormond Street Hospital, London. Here, I trained in children’s and adult nursing before working there for many years in children’s and neonatal surgical care. I then gained my neonatal nursing qualification at St George’s NHS Trust London and worked at the Whittington NHS Trust NICU before moving back to Great Ormond Street for a senior education role on NICU where I worked until 2001. I then worked as Senior Lecturer at City University, London for 12 years leading the neonatal nursing education portfolio. I studied for a MSc, a PGCE and MA in academic practice during this time, In 2013, I moved to the University of Hertfordshire where my role is Associate Professor (learning and teaching) and Senior lecturer child nursing. I teach on the BSc Hons nursing and master’s degree programmes including leadership of modules, face-to-face/online teaching, assessing and supervision of students at all levels up to doctorate level. I am also research active and have completed a Doctorate in Education. As a nurse, educator and post-doctorate researcher, my interests focus on parents’ premature birth experiences, supporting parents in the transition home from NICU, exploring communication needs of neonates and their carers and studying the educational value of digital storytelling. This combination and variety of roles enriches my working life and brings together my experience as a child / neonatal nurse, educator and researcher. My role and related activities enable me to engage in both education and research while supporting students on their nursing career and education pathway, which is a privilege to be part of.
Hello my name is Claire Richards and I’m the Lead Nurse for the Wales Maternity and Neonatal Strategic Network. This covers nursing leadership but also Neonatal transport. I also have a clinical honorary contract in one Health Board.
Hello, my name is Kim Edwards, and I am a Neonatal Nurse. I am currently the Lead Nurse and Workforce, Education Lead for the Thames Valley and Wessex Neonatal Operational Delivery Network (ODN)
Hello, my name is Jean and I am a registered children’s nurse with 27 years experience. I qualified with a DipHE after struggling academically due to dyslexia. Over my career I have worked mainly in PICU, NICU and children’s cardiac critical care. I am dual qualified in speciality (QIS) for both Neonatal and Paediatrics. The QIS program is a post graduate modular course completed at level 6/7. To be considered QIS you must successfully complete 4 separate modules, each have an academic and practical component. Only on completion of the QIS course can you apply for a band 6 role. In addition to the above qualifications it is expected you would have several years proven experience in speciality at Band 6 and 7 prior to applying for a Matron’s role.
My name is Lisa Baker, I’m a Ward Manager on a Level 2 Special Care Baby Unit in South Wales and I’ve been in this role since 2020.
Hello, my name is Wesell, and I am currently a trainee Advanced Neonatal Nurse Practitioner (ANNP) at Great Western Hospital, which is a Local Neonatal Unit (LNU). Prior to this, I gained substantial experience in a tertiary neonatal unit where I completed my QIS course at master’s level. This course, alongside my role as a senior nurse, provided me with the expertise required to develop my career further in neonatal care.
My name is Hannah Wells, and I am a Neonatal Surgical Clinical Nurse Specialist (CNS).
Hi, I am Amanda and work as the Neonatal Infant Feeding Coordinator for a NICU and a SCBU within one service. While the role is not standardised, many neonatal units now have dedicated posts.
Hello, my name is Daniela Machado, and I am proud to be a Developmental Care Specialist/Lead Nurse and a sister/charge nurse, working across two different trusts. I am originally from Porto, Portugal, and have spent 14 years building my nursing career in the UK. My role involves applying and advancing neuroprotective/developmental care practices for our preterm and neonatal patients/families.
Hello! I am Renjita Raju , a Neonatal Junior Sister working in London. After completing my BSc nursing degree in India, I moved to UK, and completed NMC OSCE to get registered and QIS course to become specialised in neonatal care. I recently qualified as an NLS instructor with the support from NNA scholarship programme. My role involves caring for premature and critically ill newborns, ensuring their safety and health with a highly collaborative multidisciplinary team. I also teach in NLS courses as an instructor following my passion in neonatal resuscitation. I love witnessing infants grow stronger each day and supporting their families through this journey. I’m grateful for the opportunity to provide meaningful compassionate care to the tiniest, most vulnerable patients.