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Sunday, July 19, 2015

Saving Our Youngest Characters: Neonatal Information for Writers with Meredith Pritchard

Jaap Vermeulen, Jacoplane in a Neonatal intens...
 (Photo credit: Wikipedia)
It is heart wrenching to watch a tiny infant struggle for life.

The vulnerability of the new parents, the impuissant position they find themselves creates strong emotions for an author to grapple with. Written well, this is a wonderful place to twist a plot and pull up the deepest, most basic desire to survive and to continue into a new generation.

If you are attempting this in your work, I thought you might like some information from a neonatal nurse, my friend and fellow Kindle Scout winner, Meredith Pritchard.

Fiona - 
Can you tell my readers why I turn to you for information about neonatal scenes?

Meredith - 
I have been a NICU nurse for over five years, and I still have a lot to learn. I don't think I'm 'expert' level, yet, but I definitely feel like my clinical expertise falls under proficient right now. It's an ever changing specialty where the technology continues to get more advanced and the babies we care for come to us with greater morbidities. 

Fiona -  
Meredith, if I was writing a scene that included a baby being placed in NICU can you give us some parameters? What age child and under what circumstances would they receive that level of care?

Meredith - 
In the neonatal ICU we care for babies that are 30 days old and younger. We care for infants born as early as 24 weeks who are frequently on life support for weeks, infants who are simply premature and need some more support with growing until they can go home, and also term infants who could be ill for a variety of reasons (cardiac defects, sepsis, dehydration, etc).

Fiona - 
Nurses go on rotations to see where their skillsets and personalities fit best. What kind of personality would it take to be a successful NICU nurse and what kinds of personalities have you seen make things more difficult (not thrived) in that particular position.

Meredith - 
Author, Meredith Pritchard
Compassion is the number one trait a NICU nurse needs. We are dealing with sick infants and mothers who are stressed, and who just had a baby. Add in the hormones and illnesses of some mothers (Gestational Diabetes, Hypertension, etc) a twelve-hour shift can be an emotional rollercoaster for some.

An RN is rarely assigned one baby, a single nurse cares for 2-4 babies and their families. So organization, attention to detail, and quick critical thinking are a must-haves. 

The nurse also needs to have excellent interpersonal skills since we communicate with various members of the healthcare team
  • co-workers
  • charge nurse
  • Practitioners
  • Doctors
  • Residents
  •  Surgeons
The nurse needs to be able to speak up. We care for the tiniest patients that have no voice of their own, so we are their voice at the bedside. 

Every now and then we'll have a nurse pass through the NICU who just isn't emotionally ready to deal with sick babies. It's not for everyone. It's very stressful some days and relaxing others. No shift is ever the same.

Fiona - 
What can a parent expect to see when their child is in the NICU and what role can they play? Are parents allowed to touch/hold their babies?

Meredith - 
I can say from experience that seeing your baby in the NICU setting is a shock. My daughter was born 7 weeks early and the experience still boggles my mind. 

It also depends on why the child is there. Some babies are in cribs and just feeding and growing, other babies are on warmers or in isolettes (think an incubator for baby humans instead of chicks) and have IVs and respiratory support. So there is no quick answer to this question, it all depends on why the baby is there. But they will definitely have cardiac leads on and oximetry probes. All of our babies are monitored throughout their time there. 

We try to have parents participate in care as much as they can and as much as their baby will allow. Some babies, their parents care for them all day long as though they were a normal newborn-diaper changes, breastfeeding, baths, holding. Other infants are more critical and something as small as being stroked on the back or being held can send their body into stressed-out shutdown mode. These kids are working so hard at keeping their own body systems going that noise, touching, or even increasing their feedings by 5 milliliters can stress them out. So again, it depends on why the baby is there and what kind of a day their having that lets us decide if a parent can hold or touch their baby. We let the babies run the show in the NICU.

Fiona - 
I'm wondering about security. What safety mechanism are put in place for the babies?

Meredith - 
In the NICU where I work the door is locked all the time and visitors must be let in for visitation. The nurses at the bedside check the paren't hospital bracelets to verify who they are and if they're at the right bedside. Once a baby goes into an open crib, those babies have a HUGS tag placed around their ankle. The HUGS tag alerts security and shuts down the hospital if it is tampered with or if someone takes the baby past the doors to the unit.

Fiona - 
Let's talk about coping mechanisms for nurses when things don't go well and a baby doesn't survive or even if there's just been a lot of close calls. It seems the stress levels would be enormous.

Meredith - 
Some days are good and some days are bad. 

I've had a lot of crazy stressful days. Usually it's during the summer when census ( number of patients) is high. I remember one night when babies just kept coming; and then when we thought there was no more room left at the inn, there was a set of 28 week triplets born. 

On the subject of loss, we nurses tend to support ourselves on the unit during a tragedy. The death of a baby creates a somber setting for the entire unit. Depending on the situation, sometimes we are supporting the family during a death, and we can't allow ourselves to deal with it until hours later. That's when we turn to our co-workers, and our friends and family. Most hospitals also offer support services for coping.

Fiona -
What kinds of programs are there to support a parent?

Meredith - 
I think every hospital has different programs in place. Where I work we have a support person who runs a weekly support group for parents to attend. It's a safe place where they can discuss their situation and give each other tips on dealing with their stay in the NICU.

Fiona - 
I got stuck on one of your details from an earlier question. Your census is higher in the summer? So the heat creates a more difficult environment for carrying to full term?

Meredith -
Well, it's a combination of that and everyone was making babies during the coldest days of winter. The heat definitely doesn't help. An example of that is while the NYS fair is running we get a lot of dehydrated moms coming into the hospital.

Fiona -
When you are watching movies or reading books and an infant is placed in the NICU, what makes you crazy because it's just so wrong?

Meredith - 
Oh Lord. I can't even watch movies/shows that have NICU stuff in them. I actually don't watch TV anymore, haven't in years. I do like movies, but I try to stay away from medical stuff since the critical nurses eye is always watching closely. But one thing that drives me nuts is when they place a baby in an isolette and say it's ventilated and yet there is no Endotracheal tube present. There was a scene like that in show Jericho - loved the show, hated that episode.

Fiona - 
Can you take us through a quick day in the life? On the job and off - how is your time managed.

Meredith -
Well since I work nights, I always feel like my time is managed poorly. It's always a fight to get enough sleep and try to exist within the strict business hours created by society. 

This past year I've just allowed myself to live a night lifestyle. I go to bed late, I get up late, it helps me stay awake at work. So on a typical day that I have to work: 
  • I'll get up around 9 or 10 and work on house chores, homeschooling, and book business stuff. 
  • Then I shower and leave for work around 5:30pm. I have an hour commute so I like to daydream and work out kinks in any of the books I'm currently working on, and then I'll take notes in the parking garage for a few minutes before clocking in. 
  • I put my lunch in the fridge, fill up my water and clock in.
  • I check the assignment board to see what I'm doing for the night. Since it's rarely the same assignment, overnight is different. But there is a lot of diaper changing, medication administration and teaching parents how to care for their ill infant. 
  • Usually 12 hours passes in a blur, and I'm clocking out at 7:30am and dragging myself to my car, laughing with my co-workers. 
  • Then it's time for the hour-long commute home. I turn the music up as loud as I can stand it and rock out. 
  • Shower. 
  • Then bed. If I have to work the next night, I sleep for 6 hours and then do it all over again. If I don't have to go back to work, I take a nap and then get up and write into the night. That's my day in a nutshell. 
Fiona - 
If an author is trying to portray a NICU nurse as their character, what advice do you have about writing it right? Do you know of any sites where they can get information?

Meredith - 

  • In healthcare, vagueness is your friend. The more technical people try to get, the easier it is to nitpick. 
  • Anyone interested in writing about the NICU should definitely follow around a NICU nurse for a day. It's easy to do, just call a hospital and ask to shadow a nurse or be a volunteer and come in and hold the babies. 
  • has a ton of threads and some for NICU, it's a good place to start. 
Fiona - 
And with all of the pressures from family and job, you still find time to write. Recently you became a Kindle Scout winner. Can you tell me about that book?


Meredith -
A second chance at love is a fight to the very end.

Guys like Alex Sullivan don’t come around every day, but when they do, they aren’t looking for girls like Morgan. She is the unexpected one, the unplanned daughter of parents who don’t want her; she has always stood in the shadow of her beautiful-but-dead twin sister. So when Morgan lands a marriage proposal from the handsome businessman, she pounces on the opportunity.

While Morgan is basking in the joy of feeling wanted for once, Alex’s untimely death sends her life into a downward spiral, and she’s left picking up the pieces while the tabloids, pesky neighbors, and an eight-point buck haunt her.

The only thing keeping Morgan grounded is her new found love of running. And then there’s her newly acquired business partner, stoic MMA fighter Nick “The Strangler” Stacks. Morgan and Nick have never been able to get along, but Alex’s tragic death forces them to interact when he leaves the two as owners of his successful gym.
After years of tepid interactions, Morgan and Nick finally find that they have more in common than they previously thought, and it’s enough to make one of them want to tap out on their disastrous relationship for good.

Fiona -
I always ask our visitors to tell us about their favorite scar.

Meredith - 
I have a lot of scars. I don't think any of them are my favorite. I tend to be a wimp and I don't like pain. I have scars from an emergency appendectomy, c-section, various cuts because I'm a klutz, and a scar on my wrist from falling out of the back of an El Camino when I was a teenager. If I had to choose any of them, I'd have to say the one on my wrist. I cleaned it and bandaged it myself and avoided going to the doctors when I really needed stitches. But it reminds me of a simpler time, when there was more time for fun and less time spent paying bills.

Fiona - 
Thanks so much, Meredith, for sharing this information with us!
Here's how to stay in touch with Meredith:


Thank you so much for stopping by. And thank you for your support. When you buy my books, you make it possible for me to continue to bring you helpful articles and keep ThrillWriting free and accessible to all.



  1. What an original and informative blog idea. I've browsed some and will be back for more. In the meantime, I've nominated you for an award, The Dragon's Loyalty Award. If you want to participate, check out the directions at I'll have them posted by Saturday!

    1. Thank you kindly for your nomination. Right now, though, my blog is working more like a resource library for writers. I'm so glad you stopped by and found some content that you found intriguing. Hopefully it will inspire a plot twist along the way :)

      Happy writing! Fiona

  2. I was an adult ICU nurse for many years and did not even considering creative writing during that time, so my hat is off to Ms. Pritchard. And like her, I really cannot watch hospital shows. I find myself shouting at the TV when I do.

  3. Thank you for sharing such wonderful information! Don't forget to always keep a healthy life!