The day begins early for Stephanie Sykes, a neonatal nurse practitioner for Akron Children’s Hospital.
When she walks into the neonatal intensive care unit (NICU) at Akron General Medical Center at 6 a.m., there is just the sound of quietly beeping monitors. But with 14 of the 17 isolettes filled with tiny patients, Sykes knows today will be busy.
Sykes splits her time between Children’s NICU and the NICUs at Akron General and Summa Akron City Hospital. Children’s provides neonatal nurse practitioners for the NICUs at both of Akron’s adult hospitals.
First up for Sykes is pre-rounding, or performing a head-to-toe assessment of the babies, and reviewing the patient’s chart for any changes in the past 24 hours.
“I look at all of the vital signs and the recent readings and, if I see any problems, I put together a plan to address the situation, which we discuss during rounds,” she said. “We do interdisciplinary rounds every morning with a neonatologist, nurse practitioner and bedside nurse.”
Sykes and the others move from patient to patient, reviewing each patient’s care plan.
“Our goal is to get the babies well enough to go home as soon as possible,” she said. “Each baby is an individual, so it’s impossible to predict when a child will be ready to go home, but we continually keep the parents updated on their baby’s progress.”
Nearly 15 miles away, nurse practitioner Carole Mantz is heading into work at Akron Children’s Hospital Pediatrics in Kent. Mantz’s day will be filled with up to 20 appointments with children from infants to teens.
“You never know what you’ll see working in a primary care office,” Mantz said. “One appointment may be a well-child visit with a month-old baby and the next appointment is a sports physical for a 16 year old. I really enjoy the variety of patients I see.”
Mantz takes a moment to check the day’s schedule before her first patient. As usual, it’s a busy day with nearly every minute filled with appointments.
“Good morning! How is everyone today?” asks Mantz as she opens the exam room door to find 9-year-old Dylan and her mother.
Mom explains that Dylan fell down the stairs and twisted her knee.
Mantz thoroughly examines Dylan’s knee and, after finding nothing seriously wrong, offers some advice to Dylan’s mom on how to treat the sore knee. Dylan and her mom are visibly relieved to find out it’s nothing serious.
After updating the patient’s chart, Mantz heads into another exam room to see 2-year-old Jozseph for his well-child visit.
She takes a minute to talk to mom and dad about Jozesph and then bends down so she’s eye level with the toddler.
“How are you today, buddy?” Mantz asks. She takes a few minutes to examine the little boy.
“Where is your knee? Can you point to it? How about your hair? Show me where your hair is,” she says to the towheaded toddler.
Throughout the day, Mantz answers questions about eating, potty training and other concerns. Despite her full schedule, she doesn’t rush the parents and answers each question fully.
“Especially for first-time parents, a well-child visit is just as much for the parents as it is for the child,” Mantz said. “I want to make sure our parents know that they can come to me with whatever questions they have.”
Back at Akron General, Sykes has just returned to the NICU after attending a high-risk delivery.
It’s not unusual for her to be called into labor and delivery to consult on a newborn or be asked to assist with premature and high-risk deliveries. Sometimes these babies are admitted to the NICU for further care.
Sykes spends a few minutes talking to a social worker regarding a family who’s concerned about the cost of the specialized formula their baby requires.
“I try to help out the families in any way I can,” Sykes said. “I may not be the person with the answer to their problems but I can usually find the person who can help them.”
After she finishes consulting with the social worker, Sykes speaks to the parents of Brandon, a week-old baby.
“Much of my day is spent interacting with the parents,” she said. “I know this is a very stressful time for families and I try to do everything I can to help minimize the stress. I explain to them in layman’s terms what is going on and help them understand the situation.”
Sykes moves onto the next patient and checks in with the family while reviewing the baby’s chart and consulting with a nurse about the baby’s care.
“We have wonderful bedside nurses in our NICUs,” said Sykes. “They are an exceptional group of people and we rely on them as part of the team to help care for the babies. And we are all fortunate to work with a wonderful group of collaborating physicians.”
Sykes began her career as a NICU nurse at Akron Children’s in 2001 and then became a neonatal nurse practitioner in 2008 when she received her master’s degree in nursing from Ohio State University.
In addition to paying for her master’s degree program, Children’s offered Sykes a reduced work schedule while keeping her pay and benefits at a full-time level to give her time to complete her studies.
This flexibility benefits both the employee and the hospital.
“As medicine advances, we are able to successfully treat smaller and more critically ill babies in the NICU,” said Sykes. “Children’s recognizes the importance of neonatal nurse practitioners to the expanding role of the NICU and helps provide the means to receive advanced degrees. The hospital really values its ‘homegrown’ neonatal nurses.”
In Kent, Mantz’s next appointment is with 12-day-old Elinia. The squirming newborn is wrapped in a pink blanket in her mother’s arms.
“Good afternoon! Oh what a sweet baby,” says Mantz, as she carefully takes Elinia from her mom and gently sets her on the exam table.
She examines the baby while talking to her mom about the importance of “tummy time,” the practice of letting babies lie on their stomachs to help strengthen their neck muscles.
Elinia’s mom listens to the advice, then asks some questions about breastfeeding. As a certified lactation specialist, Mantz knows the tremendous health benefits of breastfeeding and does whatever she can to help moms succeed with what can sometimes be a difficult situation.
In between appointments, Mantz takes calls from parents asking for advice on anything from feeding to sleep issues. She also reviews lab reports from the day before and calls in prescriptions
“Hey sweetie. How are you today?” says Mantz to her next patient, 4-year old Isabella, who has a fever and sore throat.
“Let’s take a look in those ears. Oh my, you have birdies in your ears!” she says to the little girl. Mantz talks with Isabella’s mom about how to treat the ear infection and asks if she has any other questions.
“Working here has been such a wonderful experience,” said Mantz. “You really get to know the children and the families when you’re working in a primary care office. Also, the pediatricians I work with are fantastic. They value my role, and we have a very collaborative relationship.”
Over at Akron General, the NICU is bustling with people as Sykes moves from patient to patient.
“I am continually assessing and reassessing the patients,” she said. “With babies, their systems are immature and the situation can change at any time.”
After a review of her patient’s chart, Sykes responds to a page to the well-child nursery.
“I love taking care of the babies. It’s very rewarding to see them get better and go home − and know that I had a little part in making that happen.”