Neonatology

The Neonatal Intensive Care Unit (NICU) at Geisinger Janet Weis Children’s Hospital in Danville, Pa., is a 40-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 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 2 to 3 patients at any 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 faculty 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 
• Care for 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 cosignature
• 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 you choose