Kelly Patston is a Neonatal Senior Sister who works for the London Neonatal Transport Service (NTS). In this interview she discusses what it is like to work in the NTS, and some of the highs and lows of the job.
The London Neonatal Transport Service (NTS) transports premature or sick babies who need specialist care to a hospital that can provide it. The transport service has three emergency teams spread across a 24 hour period, as well as a weekday elective service (one that has been planned in advance) for returning babies to local hospitals.
I am a Senior Sister and work on both the emergency and elective teams. As the nurse on the emergency service I work alongside our doctor to ensure the baby is as stable as possible during transfer. This may include initiating breathing support, starting medications and fluids, and taking bloods.
Our nurse-led elective service runs Monday to Friday. With an ambulance technician we take babies to their local area when they are well enough to be cared for in their local hospital.
I have been working with the London NTS since October 2015. To work on the NTS nurses must have neonatal specialist qualifications and have significant experience in tertiary level neonatal care, ideally both medical and surgical. This in-depth knowledge is essential when out on a transfer, as there is only yourself, the doctor, and an ambulance technician to provide everything for the baby.
A lot of training is within the job itself; working in unfamiliar surroundings, and learning to adapt your neonatal skills from the safety and stability of a neonatal unit to the restrictive environment of a small incubator and moving ambulance!
For me caring for premature and sick babies offers a variety of experiences. The preterm period is very unique and most people never get to see this early stage of life. I am constantly amazed by these little humans and how much they cope with, often experiencing very extreme interventions which most adults would struggle with.
Babies born sick are also a big emotional challenge for a lot of nurses. These babies often have an uneventful pregnancy, and then suddenly things change at the last moment, that baby’s world is turned upside down and the families are naturally distraught. We try to visit mum on the labour ward as they often have yet to see their baby. We are only able to be with families briefly – they are expected to trust us with their baby after just a short conversation. It takes real skill to achieve that and I feel privileged to be in that position.
Neonatal nursing is the most rewarding thing I have ever come across, and working in transport just heightens that. We may arrive to a very sick and struggling baby, spend hours getting them stable enough to move, and deliver them safely to the next hospital knowing they are in the best place at that moment in time – then two weeks later our elective service are transferring them back again having recovered enough for step down care. It is very humbling.
There may be a window of opportunity when the baby is ready to move and we have to grab it even if it is not ideal, as it could make the difference in saving that baby’s life. There is a skill to identifying that window for transport as our environment dictates different priorities to being in the safety of a ward.
There are also times it doesn’t matter how much we do it just isn’t enough. We see families at their worst times, and we know there is nothing we can say to make it ok. All we can do is try to make the situation the best it can be in the circumstances, so they come through this time with some reassurance we have done everything possible for their baby. Every one of these babies stays with us after we leave them.
Change is always difficult, particularly if your baby has been in one neonatal unit for several weeks or even months. To move to a local hospital is a positive step – it means your baby is getting better, is stronger, and is closer to that end goal of going home. If your baby is poorly and is moving up a level it means they may need more than their current hospital is able to provide at that time.
While we hope your journey through the neonatal world is brief, if your baby does need to be transferred we are the team who will do our best to get to your baby as quickly as we can.
Kelly also shared with us some of her advice on what to expect when your baby is being transferred.