Nicole Gustafsson Valderrama, New Karolinska University Hospital, Stockholm, Sweden
Since the beginning of Covid-19 the routines about how to approach the parents if they are positive and/or have any related symptoms has changed a lot. Sometimes It feels like we have new routines each and every week which builds up a frustration because there is not always time to learn the new routines. But we all try our best. For the most part, life at the NICU continues a lot like it did before Covid-19. Parents are still encouraged to be with their children as much as possible and be a part of the daily routines that we have (rounds, diaper change etc.). That is if the parents have NOT tested positive or to have shown any symptoms correlating with Covid-19. Other visitors such as grandparents or siblings are not allowed at the ward (nor in the hospital).
About kangaroo care there are no restrictions as long as the parent is tested negative. Today the routine is that if the parent was to be tested positive but does not showcase any symptoms they can still take care of the child but not to kiss or perform kangaroo care, and the health care staff needs to use face shields when caring for the child with the parents.
The child is never seen as infected unless a test is done and comes back positive. We only screen the children if they need surgery (before) or if we have a child that comes from another hospital. This has created a bit of insecurities amongst the staff because we feel that we are not given the chance to fully protect ourselves and also what guarantees us that the parent does not have an active infection and just don’t have any symptoms? Or just in an early stage of the infection? Where should we draw the line between what is ethical for the children and their families and our safety? Since we work with the idea of a family centered care it is normal for us that the parents are a part of the daily routine, but now they can travel from their homes to the hospital, be accompanied with whomever they choose (because we don’t have any restrictions in Sweden, only recommendations) and then coming back to the hospital to be taking care of the children with us standing only centimetres apart from them. So, there are some concerns on how to approach this situation properly since we want to continue the family centered care but still have our health as a priority as well as not risking bringing home the infection to our loved ones.
I have been distancing myself from everyone except my closest family whom I live with because I don’t want to spread the infection to others nor be infected. If I am sick it will affect the whole unit because we already have a lot of staff that are sick (not necessarily in Covid-19). We try to make ends meet but it is taking a toll on our mental health because a lot of Swedish people don’t understand the severity of this infection. We are next to a ward where the sickest people that have been infected are getting treated and we can see the staff with all the protective gear whilst the infected sick people just lay there with all the machines surrounding them. It is scary and it makes me mad that a lot of Swedish people just go along with their lives as if nothing is happening, especially a lot of people my age (I’m 24 y/o) because they don’t believe they can get infected. But we can all get infected and it is my fellow colleagues who work at the frontline that get affected the most. And when they
can’t take it anymore it will probably be our turn to go to the adult units and treat the Covid-19 patients. It takes a toll on my mental health not knowing if I will get my vacation this summer because I want to spend time with my family as well, but I don’t because I need to put the safety of my small patients, my colleagues and the society before my own needs. And we all need to think like that so that we can see the light at the end of the tunnel and hug our loved ones.