Synapse Spotlight: Charla Parkinson talks building a Neuro-intensive Care Nursery (NICN)
Welcome to Synapse Spotlight where we feature an interview with an inspiring NICU healthcare professional.
Today we are sharing an interview with Charla Parkinson, RNC-NIC, MS, about her work building the Neuro-intensive Care Nursery (NICN) at The Johns Hopkins Hospital in Baltimore, Maryland, which recently celebrated its 10th Anniversary!
Tell us a little bit about you, your training, and what first inspired you to work in the NICU?
I am a mom of 5 with children in preschool, elementary school, middle school, high school and college this year. I grew up traveling with my military family and we retired in Maryland, which I love. During my senior year of high school, I volunteered at Johns Hopkins Hospital, which allowed me to fall in love with working with children. I earned my first Bachelor of Science from Eastern Nazarene College. During those 4 years I discovered that my dream of becoming a pediatrician was really not what I wanted to do. I had worked in a National Institute on Drug Abuse (NIDA) lab each summer while I was in college and decided to work in the lab for Johns Hopkins University. While working in the lab, I earned my Masters Of Science in Biotechnology from Johns Hopkins and my Bachelor of Science in nursing from Villa Julie College. I ended my studies with a practicum in the Greater Baltimore Medical Center NICU. After graduating, I began working for Johns Hopkins Hospital in their NICU. I have been at Hopkins for almost 15 years.
What was it like celebrating the 10th anniversary the NICN in May?
Celebrating 10 years running a program was amazing. We work everyday to improve the quality of care our neonates receive, trying to provide the parents with the best information about what to expect and the days and years just flew by. Taking time to look back at where we started and how far we have come was just overwhelming. The best part was talking with parents both prior to the celebration and at the celebration about the program. Not only did they tell us what they loved but also where they would recommend improvements.
Can you tell us more about your role (personally) over the past 10 years in your NICN Program? How did you first get started? High Points and Accomplishments? Future goals?
Looking back over the past 10 years and what I personally have done for the program seems so small, when considering it took so many people to make the program a success and run as smoothly as it has. In 2009, Dr. Frances Northington took a leap and hired me to be the coordinator for her dream of a neuro-focused program in the NICU. The first task she gave me was to read. I read so many articles, and textbooks so that when I ran our very first NICN meeting I would not be left in the dark. We started with small goals. We wanted to streamline a few things such as our hypothermia protocol, and transporting neonates to MRI. We also started weekly multidisciplinary meetings to discuss our NICN patients. Our NICN meetings, which are currently held every Friday afternoon, is one that we are extremely proud of. On Fridays in one room we have people from maternal fetal medicine, fetal therapy, neonatology, pediatric neurology, pediatric neuro-imaging, neurodevelopmental specialist, PT and OT, pediatric neuropyschologist, social work, chaplaincy, nursing, pediatric neurosurgery, neuroscientists from the labs, genetics and infectious disease. If there is a specialty in the hospital that might add a new perspective to our complicated babies, we invite them to join us.
Our goals for the program are always changing as we are advancing and learning how to provide the best care for the neurologically injured neonates. A personal goal is to recruit as many nurses to find their passion for neurological care in the NICU. As a bedside nurse, this patient population is challenging, but anyone who is around someone who has a passion for neurological care will soon find themselves loving it.
When we first started our program we had educational days for neurological care and I would love to see them recur in our yearly schedule. Education is not a one and done activity in the NICU, when it comes to neurological care and providing a neurodevelopmentally friendly environment we are always continuing to learn. When we talk about education, it is not just the nurses but the respiratory therapists, the residents and fellows; anyone who comes into contact with the baby or the family.
How has the role of the NICN nurse changed during these last 10 years?
The role of the NICN nurse in our unit has changed over the past 10 years organically as each of the team members have grown in their knowledge and comfort level. We initially trained 20 nurses to be the “go-to” nurses if a baby were on the unit with a neurological issue. Over the years that role has truly become the resource nurse to all the nurses. All the nurses in our NICU are trained to place aEEG leads but the NICN nurse knows how to troubleshoot an aEEG. All the nurses are trained to be able to say there has been a change in the EEG or aEEG background but the NICN nurses know what that means.
What is the most rewarding part of your job?
I love not only interacting with my patients and families while they are in the NICU but I get to see them during their follow-up appointments and to talk to their parents about life after the NICU. This is amazing!!! The personal connection with each of the families in not only rewarding professionally, but is also rewarding personally. I am sure that every NICU nurse feels this way after caring for something so precious during the biggest roller coaster ride of these families’ lives. My job really allows me to follow these families not only in the NICU but for years after.
What is your biggest struggle at work and how are you working through it?
The biggest struggle I have at work is having to walk into a room with a kind and caring smile on my face when I know the long term outcome of the baby will most likely not be the one they want to hear. I know how much parents love their baby and how every ounce of them wants their baby to be “normal”. But in the NICU, what is “normal”? What might seem like a much better outcome to me, is almost always devastating to the families. The difficult conversations is what I struggle with but it does not break me. It doesn’t break me because I view my position is to remind the parents that the outcome is not a definite; it is a spectrum. Their job as a parent is to always remain optimistic and keep hoping for the best outcome instead of waiting for the worst.
How do you stay on top of the latest trends and technology coming to the NICU?
Staying on top of the latest trends and technology is where I think all NICN programs struggle. There is always new information every week about how we should change our practice. I tend to try and read as much as I can, to stay involved in the conversations. There is a neuro special interest group where some of the discussions are not relevant to me, but I stay tuned to see what others are doing, how we can improve our program. Topics come up that I would have never thought to ask about or change. I want to continue to learn. I would never consider myself an expert because there is always room for improvement as we learn every day.
What advice would you give to new nurses just starting their career in the NICU?
To any new nurse starting in the NICU, you have made a great choice. Remember that it never hurts to ask questions. The people working around you did not learn what they now know by not asking. Remember that NICU parents have dreamed their entire life of a “normal” baby and their dreams are now altered. If they seem touchy one day, it’s only because of that dream. Find your niche in the NICU – you may find that you’re passionate about the little itty-bitty babies or that the ones with neurological injury call your name. Everyone has “their” type, find yours and then try to be the primary of that kind of baby. When you are truly passionate about why you are coming to work, you will not be as sad to leave your family for 12 hours on a holiday.
What is one thing you do every day to keep you sane in the midst of NICU chaos?
NICU chaos is something I see less of as the NICN coordinator, but when the stress is high in the NICU I tend to do my best. You simply react and get done what needs to be done as a natural part of being a NICU nurse. I really do not think about it too much. The adrenaline rush from having to be on your toes with a sick patient or a new admission has always been a love of mine. I would tell anyone considering the NICU as your home, embrace the chaos but do not add to it. Don’t let it stress you otherwise you could be a source of the chaos. Breathe!!
Why should nurses attend the ONE Conference or watch the 2019 recordings? What makes the ONE Conference unique??
This conference is definitely “ONE” of a kind. If you have not attended or listened in yet you are truly missing out. This conference is not one that is entirely stats and figures; it breaks down the day-to-day life of a NICU nurse/physician. It talks about everything you do as a caregiver to this vulnerable patient population. Every touch we make, every ounce we feed them, every special thing we do either enhances or hinders their neurodevelopment. The way we communicate with the parents and how we take care of our physical, emotional and spiritual needs all affect these babies. There is always room for improvement and learning, but we can be the ONE who makes the difference to the only brain these babies will ever have. This is what the ONE conference focuses on.
Charlamaine Parkinson attended Easter Nazarene College (ENC) earning a Bachelor of Science, majoring in Biology and minoring in Chemistry. During the summers while in college, Charla worked for National Institutes of Drug Abuse doing research in Baltimore, Maryland. After graduating from ENC, she moved back to Maryland, where she began working as a lab technician for Johns Hopkins University’s HIV/STD lab under Dr. Thomas Quinn. While working in the lab she studied and earned her Masters of Science in Biotechnology (2004) from Johns Hopkins University and her Bachelor of Science in Nursing from Villa Julie College (2005). Her favorite hobbies while working and studying were running and flying at the New York Trapeze School that was located in Baltimore at the time. In 2005, she began working for Johns Hopkins Hospital in the NICU. In 2007, she married her high school sweetheart, Christopher Parkinson. Christopher, Charla and their five children (Amanda, Joshua, Alexis, Jayden and Jaxon) reside in Maryland. Their favorite vacation destination is the Outer banks in North Carolina.
