Neonatology

The Neonatal Intensive Care Unit (NICU) at Geisinger Janet Weis Children’s Hospital in Danville, Pa., is a 41-bed unit that provides comprehensive medical and surgical care to critically ill infants. It’s staffed by board-certified neonatologists, pediatric residents and neonatal nurse practitioners. The NICU also oversees an active neonatal transport team.

The NICU cares for a wide range of clinical conditions commonly observed in the neonatal period. Conditions that you’ll encounter include:

• Prematurity, including very low birthweight infants (VLBWs)
• Neonatal sepsis/infections
• Shock
• Neonatal seizure
• Hyperbilirubinemia
• Congenital heart disease
• Inborn errors of metabolism
• Congenital malformations
• Genetic conditions

The neonatologists, in conjunction with pediatric surgical subspecialties, treat conditions requiring multidisciplinary care, such as gastroschisis, intestinal atresia, myelomeningocele and congenital heart disease. The maternal-fetal medicine service works closely with neonatology in the identification and management of high-risk obstetrics patients.

You’ll be completely and actively integrated into the NICU medical team. Due to the complexity of most NICU patients, you’ll follow two to three patients at any one time with resident supervision. You may have NICU patients in any part of the continuum of care, from critically ill to convalescence.

Goals and objectives

Professional conduct

A commitment to excellence in medical practice, as well as service in the interest and welfare of assigned patients, is required. You’ll be expected to exhibit a respectful approach toward patients and their families, members of the medical team, nursing and ancillary staff. Compassion toward patients and their families is a critical competency required in the NICU. Recognizing your limitations is a valuable requirement when rotating in the NICU. The neonatology staff will be available to you at all times to discuss patient care and guarantee a quality educational experience.

General goals

• Effectively analyze maternal history and identify risk factors for preterm birth.   
• Understand the steps in resuscitation/stabilization of critically ill neonates.   
• Actively participate in the care of critically ill and convalescent neonates.   
• Formulate a case-appropriate, general differential diagnosis and assessment.   
• Initiate basic treatment plans for critically ill and convalescing neonates.
• Understand the complexities associated with discharge planning for the recovering neonate.   

Specific educational objectives

• Gain functional efficiency and effectiveness in neonatology via a systems-based approach.
• Acquire an understanding of current medical management of the ill neonate using evidence-based practice.
• Have a fundamental knowledge of the following processes at the completion of the rotation:
  • Fetal growth and maturation
  • Normal newborn examination
  • Prematurity
  • Birth injuries
  • Transient tachypnea of the newborn
  • Meconium aspiration
  • Respiratory distress syndrome
  • Sepsis and infections in the neonatal period
  • Anemia in the neonatal period
  • Apnea
  • Hyperbilirubinemia
  • Hypoglycemia
  • Neonatal seizures

Patient care objectives

• Pre-rounding and data collection on assigned patients
• Formal presentation of patients on bedside rounds
• Assisting or performing (under direct supervision) invasive procedures
• Writing of daily notes with attending attestations
• Following up on all ordered diagnostics (e.g., imaging, laboratory results)
• Participating in supervised call (once weekly until 10 – 11 p.m.)
• Reviewing the medical literature pertinent to their patients
• Attending and participating in delivery room stabilization/resuscitation
• Providing a short oral presentation (15 minutes) to the NICU team on a neonatal topic of your choosing