Caring for the tiniest patients: Life in the NICU

About 3.5 million babies are delivered annually in the U.S. Most are born healthy, but 10 to 15% are born with health challenges that require a higher level of care and expertise. That’s where Dr. Samuel Zoucha, who is a neonatologist (a doctor who cares for newborns) and a pediatrician, steps in.

Dr. Zoucha works at Sharp Grossmont Hospital for Women & Newborns in the neonatal intensive care unit (NICU). He specializes in caring for babies who are delivered premature or with high-risk or complex medical conditions.

A pregnancy is full-term at 39 weeks. Babies born prior to 37 weeks are considered premature, or “preemie,” although not all may require an extended stay. “Some of the babies also have congenital anomalies, which requires stabilization in the NICU prior to surgery,” he says.

Dr. Zoucha might also work with families prior to birth when a congenital disorder (a condition present at birth) is diagnosed, for example heart defects, neural tube defects or Down syndrome.

“I introduce myself, explain what the NICU is, and answer any questions they might have,” Dr. Zoucha says. “I am always happy to answer any questions expecting parents might have.”

An extraordinary level of care in an equally extraordinary place

The NICU at Sharp Grossmont is a state-of-the-art unit, where an expert team provides around-the-clock, lifesaving care for newborns and their families. However, it can sometimes be a stressful environment for concerned parents who are worried about their baby’s condition.

“The toughest part of my job is giving bad news to the parents when things don't go according to plan,” says Dr. Zoucha. “The thing about being a NICU doctor is that you get to see people on the happiest day of their lives, but sometimes you have to be there for them on the worst day of their lives.”

Even so, he considers it a privilege to help families through what can be a difficult time. He says he chose the field of neonatology because it offered him a chance to practice critical care medicine and provided continuity with his patients.

“Some of the really premature babies will stay with us for three to six months,” Dr. Zoucha says. “In that time, I have the chance to watch babies grow and develop, and I can establish relationships with the family. It’s incredible to watch a baby go from weighing 1 pound to 7 or 8 pounds at discharge.”

A typical day in the Sharp Grossmont NICU

In the NICU, Dr. Zoucha works alongside a team of specially trained professionals with expertise in neonatology. This includes other physicians, nutritionists, rehabilitation therapists, lactation specialists, respiratory therapists, social workers and research specialists. Together, they help critically ill newborns in their most fragile state to thrive.

Dr. Zoucha’s day starts with rounding, which includes visiting patients, checking on their status and reviewing their care plan. “I review labs and X-rays, examine the babies, talk with the nurses and come up with a plan for the next 24 hours,” he says.

He then meets with parents to discuss how their babies are doing and answers any questions they might have. When other babies are born, he heads to the delivery room. If an emergency arises, he’s there to attend complicated deliveries or assist babies who may need help breathing.

“The majority of my patients are born at term or slightly preterm and need help with breathing or eating," Dr. Zoucha says. "Or they require observation to make sure they don’t have any infections.”

The most rewarding part of his job, Dr. Zoucha says, is when a baby is well enough to go home with their family and live a long, healthy life. “It is really fun to see the joy, excitement and pride that parents feel when they take their baby home for the first time — especially after a particularly long time in the NICU,” he says.

Most of all, Dr. Zoucha says, he is grateful to be in his position. “I am grateful to all of the families and babies I care for — for placing trust in me, for teaching me and for letting me be a part of their journey,” he says.

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