Neonatal Intensive Care Unit - About us
Dr. Douglas Campbell, medical director, Neonatal Intensive Care Unit
The St. Michael's Hospital Neonatal Intensive Care Unit is a 20-bed Level 2 academic NICU providing care to a high-risk inner-city population. As the most recent Level 2 unit to develop in the city, it has become a preferred site for transfers of newborns requiring advanced Level 2 care in the city. Our multidisciplinary team includes neonatologists, pediatricians, nurse practitioners, a registered dietitian, social worker, lactation consultant, pharmacist, neonatal nursing staff and respiratory therapists. The NICU provides ventilatory and nutritional support for term and preterm newborns.
The St. Michael's Hospital NICU is an important piece of our critical care centres. As a trauma centre with complex medical surgical patients, neurotrauma patients, and cardiac patients, we are ready to serve the most critically ill of the Greater Toronto Area. That includes pregnant patients in motor vehicle accidents and their unborn babies.
The St. Michael’s Hospital NICU has well established links with the tri-hospital tertiary neonatal centres of Mount Sinai Hospital, Sunnybrook Hospital and The Hospital for Sick Children. The relationship includes the retro-transferring of critically ill patients from their centre to ours for continued care, as well as the provision of care of newborns transferred or via the HSC transport team from other hospitals in the city until they are stable enough to return to their local hospital. We are also the lead site of the recently established NICU component of the Better Outcomes Registry and Network database, allowing us to benchmark our centre with other Level 2 and Level 2 advanced centres across the province in terms of patient care.
We are the leaders in neonatal resuscitation with presence on the Canadian Paediatric Society Neonatal Resuscitation Program executive hosting the National NRP Launch and running a novel Code Pink quality improvement simulation program. Annually, trainees from all levels and health care fields rotate through the NICU to learn about caring for this fragile population including but not limited to newborns exposed to drugs, HIV or high risk social circumstances antenatally. University of Toronto residents in pediatrics, obstetrics and family medicine all rotate through the NICU as part of their core curriculum to experience the care involved in caring for sick babies in the context of urban health.
The NICU staff is dedicated to providing the best evidence-based care. Many research studies have stemmed from the goal of providing the best possible care for these babies. Current studies include the Family Integrated Care in the Level 2 NICU, an innovative program that supports the integration of parents into the care of their infant in the NICU. Parents provide the majority of care once their infant is medically stable with the exception of providing intravenous medications and fluid administration, insertion of nasogastric catheters and adjustment of oxygen concentrations. Nurses provide parents with education and support.
Other studies include multi-centre studies based at St. Michael's Hospital, the Retinopathy of Prematurity Care Study and Establishing Methods for Assessing Hyperbilirubinemia in Preterm Infants. Others studies include the Cuddler study for infants in withdrawal and Probiotics in the preterm infant, HIV in the newborn and neonatal nutritional supplementation.
When will my baby go home?
We don’t give a specific date; however we like to aim for your due date. But be prepared, it could be a couple of weeks earlier or later.
Why can’t I hold my baby whenever I want?
If it is safe to do so, we encourage you to hold your baby anytime you like. Your nurse will let you know when you cannot.
Why is there a limit to the number of visitors?
We are an open concept unit with 20 beds. We try to minimize noise and limit visitors so other babies and their families are not disturbed.
Why can’t other children besides my own come in to see the baby?
Babies are at high risk of catching an infection. We try to limit visits from children due to this. We want siblings to bond with baby as well are parents so only siblings can visit.
Will my baby always be in the bed space he/she is in now? Why does it change?
We may need to move your baby to accommodate other admissions, for safety, for nursing workflow or for unforeseen circumstances. It may not be possible to stay in the same bed spot your entire admission.
Why are there scheduled care times? Why do they change? Can I request a special care time?
We encourage family members to participate in the care of their baby. Scheduled care times are done to promote developmental care for your baby. We cluster activities to minimize disturbances while they rest; this is part of developmental care. You can make a request for a special time and we can try to accommodate it. Changes in care times are based on the individual needs of your baby.
Can I use my cell phone while visiting my baby?
Why are there so many alarms? Why don’t the care team members respond to them quickly?
Nurses and allied health team members are aware when alarms beep. They also know when an alarm requires urgent attention or when it is safe to let it beep briefly while they deal with a more urgent issue.
Why is it important for us to wash our hands before visiting and after changing a diaper or using the bathroom?
It is important to wash hands during these times to prevent the spread of infection.
Who is my baby’s nurse and why isn’t she at my baby’s bedside all the time?
Your baby’s nurse should have his/her name on the white board next to your bedside. Your baby’s nurse will likely have other babies as part of their assignment for their shift. This means they are also doing work to help another baby.
Why does it take so long for someone to answer the phone when I call?
Staff are usually busy tending to the needs of babies and their families. Please be patient.
Will you notify me if my baby’s condition worsens?
Yes. Please make sure to give your nurse the best phone number where you can be reached. This will be placed in your baby’s medical chart.
Who can I talk to about problems I have with transportation, housing, etc.?
You can tell your nurse and she will let our social worker know.
Can I still visit if I’m sick?
No. Many babies in the NICU have weakened immune systems. If you are not sure if you should visit call the NICU and speak to your nurse.
Should I still pump my breast milk if I am on medication or if I am sick?
It is important to continue to pump milk despite being unwell or on medication.
Can my baby be moved to a hospital closer to my home?
Yes. Once your baby is stable, your baby can be moved to another hospital as long as they have a NICU that can accommodate your baby’s needs and have space available.
How will I know if my baby is doing well? When will a doctor or neonatal nurse practitioner call me?
We discuss each baby at morning rounds daily at 8 a.m. You are invited to participate. If you are unable to attend, you are welcome to call at any time and someone can provide you an update over the phone. Otherwise, you can speak with someone when you arrive.
Can I have a meeting with medical staff or nurses in private?
What decisions can I make about my baby’s care?
You can make decisions about every aspect of your baby’s care.
How often can I or should I visit? How long can I or should I stay?
There are no restrictions. You can visit any time for as long as you feel comfortable. Closer to discharge we will ask you to be here more frequently to work on oral feeds with your baby and learn how to provide care.
What special needs will my baby most likely have when he or she goes home?
We will discuss any special requirements prior to your discharge. These needs are individual and based solely on your baby.
What kind of support is available for my family now and when my baby goes home and has special needs?
A care plan will be developed prior to your discharge home. We will discuss individual needs based on your baby’s condition. Our whole team is involved in determining the supports required and needed for your baby.
Getting to the NICU
Dr. Douglas Campbell, medical director, Neonatal Intensive Care Unit, shows you the way to the NICU, from Queen St. all the way up to the 15th floor.
St. Michael's offers public parking in a convenient location across from the hospital. The entrance is located at 209 Victoria St. on the western side of the Li Ka Shing Knowledge Institute (the Keenan Research Centre). The lot is open 24 hours, seven days a week. Alternately, there are several other options close by, including a Green P lot across from the hospital’s Queen St. entrance, behind Metropolitan United Church on the east side of Bond St., the Eaton Centre, located one block west on Yonge St. at Shuter St. (enter from Shuter St.)