Ms. Nevart Chirinian is the first Advanced Clinical Nurse Specialist in Qatar. She works in the NICU of Women’s Hospital at Hamad Medical Corporation. She holds a master's degree from State University of New York and is a Board Certified Neonatal Nurse Practitioner.
‘Children First’ asked Sister Nevart to provide our readers with a glimpse into the hectic, daily grind of a NICU Advance Nurse Specialist at HMC and, luckily, she obliged.
"Hello, ‘Children First’ readers. Well, my day starts with inter-disciplinary morning sit-down rounds where admissions and potential problems and complicated cases are discussed, after which I conduct my own rounds. I use my rounds as an opportunity to check on the infants' conditions and ensure safe practice, which include double-checking the appropriate alarm limits for oxygen saturations and humidification that are dependent on the patients’ age, and ensuring the patient is handled and positioned in a developmentally conducive manner. Concurrently I use this time to engage with nurses on a personal level and offer one-to-one guidance and education. If parents are keeping vigil, I encourage them to hold their child, either inside or outside the incubator. Once the doctors arrive at the NICU, I join them on their medical rounds, all the while determining that management plans are sound and follow best evidence-based practice. I follow-up with mail and paper-work necessary for registering of courses, CNE applications, special NICU program developments, and exploring research opportunities. Finally, I update and review NICU policies and guidelines to ensure that they are updated and evidence-based – which means I conduct a lot of systematic reviews. Currently, I have been conducting systematic reviews of literature to ensure that all care provided in the NICU is safe and evidence-based.
My more atypical days occur once a week when I am assisted by a very enthusiastic team of allied health professionals to conduct education classes for parents. Simultaneously, I conduct classes to update the nursing staff on the latest developments in neonatology. For instance, I have lead classes regarding the use of the cerebral function monitoring. Along with the nurse educator, we have educated the staff on the novelty of therapeutic hypothermia for the treatment of hypoxicischemic encephalopathy. I have worked hard to raise awareness in the prevention of SIDS and developmentally appropriate care. In conjunction with my allied health colleagues, we have begun to educate parents on how to provide care in a more organized and professional manner. My involvement outside of NICU lends itself to keeping my day quite busy. I act as Chair the Neonatal Clinic Practice Committee and the Developmental Care Task Force. Aside from attending meetings, the real work is following through with achieving tasks and implementing certain initiatives. I constantly review NICU practice in an effort to provide better streamlined care, efficiency of process, and ensuring equipment is used safely and according to best-practice guidelines.
I know it may seem overwhelming, but in all the rounds and one-to-ones and reviews, my main objective is to provide knowledge and confidence to the nurses so they learn to advocate for the best care of the infants. I would like to inspire, motivate, and open nurses to the various career opportunities within the field. Ultimately, I would like to witness a more collegial attitude within the unit, supported through inter-professional collaboration. Being a part of the medical rounds is a good step forward towards achieving it. It also provides an opportunity to address any concerns. The establishment of the Neonatal Clinical Practice Committee is another forum that we can use. As it has been quite active in reviewing our practices, we receive encouragement, positive feedback and constructive criticisms. Our last project, the ‘Golden Hour’, is very much in line with the concerns of the neonatology community worldwide and helps raise the overall standard of care the unit provides. At the end of the day, we are all working together to provide the best possible care to our charges. Every day is a rewarding day at work when you are confident that you provided the best possible care to an infant. It is a bittersweet moment when we see the infant go home to their family, but we are encouraged and focus on the next infant.”
