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Nicole Haim
Dr. Bragg
British Literature
24 February 2015
Career Link
Neonatology isn’t a field for everyone. A neonatologist is a pediatrician who
specializes in treating newborn infants. Physicians refer their patients to a neonatologist
for complex and high-risk births. When babies are born prematurely, with a birth defect
or serious illness, a neonatologist may assist with the delivery and attend to the newborns
medical needs. Neonatologists consult with obstetricians if pre-natal sonograms suggest
the possibility of a birth defect or disease
Neonatologists diagnose and treat newborns. They also provide preventive care,
such as making sure parents are adequately feeding and attending to their newborn’s
needs. Neonatologists focus their services on infants four weeks old and younger, but
may extend care if they are following a patient in an intensive care unit or pediatric
nursery. They routinely provide longer-term care for premature infants, who suffer from a
host of complications such as underdeveloped organs, low birth weight or lack of
responsiveness. They coordinate care and consult with other specialists, including
primary care physicians, pediatricians and obstetricians.
In order to become a neonatologist you must go through 14 years of schooling;
four years for undergraduate, four years for medical school, three years of residency in
general pediatrics, and another three years in neonatal fellowship. You must get your
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license from the American Board of Pediatrics and the Sub-Board neonatal-periratal
medicine.
All neonatologists need to get a license to practice medicine in their states. They
must also be board-certified as a pediatrician by the American Board of Pediatrics. They
then apply for a subspecialty in one or more areas of neonatal medicine, including
developmental-behavioral pediatrics, pediatric emergency medicine, neurodevelopmental
disabilities and neonatal-perinatal medicine. Each subspecialty has its own requirements
in terms of testing and experience. To keep their licenses and certifications current,
neonatologists must complete the number of continuing educations hours dictated by
their state licensing boards.
There are three branches of neonatology. The first branch is service. In order to
advance in service an individual will specialize in a certain type of patient population.
The Second Branch is teaching. In order to advance in teaching an individual must return
to school and get an award in residential teaching. The third branch is research. In order
to advance in research you must gain funding.
Neonatologists primarily work in the NICU at hospitals. The NICU is the
neonatal intensive care unit. However, some neonatologists choose to work in private
practice. The work in a private practice is divided up between different hospitals. A
neonatal doctor must tend to their patient no matter where she is. A very small percentage
of neonatologists run their own private practices separate from a hospital.
The hours a neonatologist must work are brutal. It usually consists of a 12-hour
shift that can change from nights to days. It is hard to predicate the amount of hours a
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neonatal doctor actually works because it fluctuates. A major factor for this fluctuation is
the patients. There is no way to predict how many babies will be born on a given day.
The U.S. Bureau of Labor Statistics groups neonatologists with the more general
category of pediatricians, reporting a median annual income of $168,650 as of May 2010.
The website Medscape reported that pediatricians reported a 5 percent increase in pay
during 2011. Demand for neonatologists is high. The American Medical Association's
website cites a study by the Children’s Hospital Association that found that the current
shortage of pediatricians, including neonatologists, is resulting in parents having to wait
for weeks for their newborns to be seen.
In order to relate neonatology on a personal level I interview Susan Bjerke.
However, Susan is not a neonatologist. Susan Bjerke is a neonatal nurse who has worked
in the NICU for 7 years. I asked her a serious of questions to figure out what inspired her
to become a doctor. As well as what has kept her going this long.
The first question I asked was, “what inspired you to go into medicine?” She said,
“ I have always wanted to go into medicine for as long as I can remember. The thought of
neonatology came to me after my first child was born. I wanted to be able to help other
moms and save babies lives. It is very complex though because my patients can’t tell me
what is wrong with them. I have to a look at what is going on and asses the situation.”
The second question I asked was, “ what can a parent expect if a baby is born a 28
weeks or less?” Her response was very intriguing she said, “Those babies tend to require
a lot more care in terms of the technological support. Most babies born within that
gestational age will need some help breathing. A lot of those babies will end up on some
sort of respiratory support. All babies born that early will need help not just with feeding
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but their weight gain and growth. We put central lines in and give them all their proteins
and sugars through an IV. Overall, babies born this early have a very long NICU stay. I
often tell parents to picture (the baby's) due date, and that's the goal. This little person
may surprise you and go (home) a little bit sooner than that, or, more likely than not,
you'll be here a little bit past your due date. Each baby is different, and we can try to
prepare (parents) for every scenario, but in the end it's just going to be what it's meant to
be. My best advice to the families is to be very patient, ask a lot of questions and really
be a part of the medical team.
I then asked her, “What kind of problems are frequent with babies?” “Most babies
admitted to the neonatal intensive care unit, are full term babies and the other half are
premature babies. Premature babies require the most help because their internal organs
aren’t fully developed. For example:
• The lungs are not fully developed; so premature babies may need extra oxygen and/or
may need assistance with their breathing from a ventilator ("respirator").
• The surface area of a premature infant's body is large compared to its volume and there
is very little body fat, so premature babies get cold easily and must be kept in an
incubator or radiant warmer.
• The liver is not fully developed; so premature babies have a tendency to become much
more jaundiced than a full-term baby. If the jaundice is too severe, it can cause
brain damage.
• The immune system is not fully developed; so premature babies are very susceptible to
infections.
• The stomach and intestines are not fully developed, so many premature babies'
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digestive systems cannot handle breast milk or formula adequately, and must get
part or all of their nutrition through an IV for a while.
• The brain is not fully developed; so many premature babies don't breath regularly and
reliably without assistance, or can't suck, swallow, and breathe in a coordinated
fashion without choking.
I started to broaden my questions and preceded to ask her, “What do you like most about
your job?” She responded with, “Neonatology is fun because the babies are so resilient!
Given the right kind of support, they can snap back from almost anything in an amazingly
short time. They are so much smarter and more complicated than most people give them
credit for, too. Even a premature baby already has a distinct personality and style when
they are born. Some babies are "easy," some are "irritable," some are "social," and this is
easily recognized as still being their style years later.”
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Works Cited
"Bibliography." Neonatologist. N.p., n.d. Web. 24 Feb. 2015.
“Neonatology on the Web: Neonatology as a Career." Neonatology on the Web:
Neonatology as a Career. N.p., n.d. Web. 23 Feb. 2015.
"What Are Some Disadvantages of Being a Neonatologist?" Work. N.p., n.d.
Web. 24 Feb. 2015.
Susan Bejerke