Samantha Alessi, MSN, chose to pursue a career in nursing after her sister was diagnosed with Type I diabetes in 2003. After witnessing the compassionate care her sibling received in the Pediatric Intensive Care Unit (PICU), she knew she had found her calling and decided to follow it at the University of Arizona Health Sciences.
Alessi will join the College of Nursing this fall as a part-time PhD student, drawn to the program because of its reputation, as well as the opportunity to work with Sheila Gephart, PhD, RN, as her mentor.
Dr. Gephart is nationally recognized for her research into technical and parent-engaged solutions to reduce the burden of necrotizing enterocolitis (NEC) – a devastating disease that can infect the intestines of premature infants. Because of their coinciding research interests, it was immediately clear to Alessi that Dr. Gephart would be her ideal advisor. Alessi has already been studying the unique health needs of patients in the Neonatal Intensive Care Unit (NICU).
In April, as part of a team of nursing students at New York University Langone Health, Alessi published a paper in Current Problems in Pediatric and Adolescent Health Care, a monthly peer-reviewed medical review journal covering pediatric and adolescent medicine. Alessi and her peers were driven to examine the problem of COVID-19 in relation to NICUs in the New York City area.
The introduction to their paper states, “One of the most vulnerable pediatric patient populations is cared for in the neonatal intensive care unit. There is limited data on the effect of COVID-19 in fetal life and among neonates after birth. Therefore there is an urgent need for proactive preparation, and planning to combat COVID-19, as well as to safeguard patients, their families, and healthcare personnel.”
The team’s aim was to consolidate recommendations from the Centers for Disease Control and Prevention (CDC) and local resources to provide guidance to clinicians in the NICU in key aspects of preparation needed to counter exposure or infection with COVID-19.
Alessi recently shared insight on her experience, including the challenges she has faced as a nurse researcher in her efforts to protect some of the most vulnerable patients from the dangers of COVID-19.
Can you share your perspective on the challenges nurses and nurse researchers face during this crisis?
It has been hard going into work every day with so many unknowns. Not knowing when the crisis will end, will I bring it home to my family, how do I keep myself safe? The other piece that has been most challenging has been the influx of information and the rapid pace of changes in recommendations of care. New information was released daily. On the flip side, the fluidity of the care teams, embracing the change and coming to work giving their all, demonstrated how resilient nurses can be.
What was the inspiration for your study on neonatal intensive care preparedness?
I fell in love with the NICU after floating there when I was a mother/baby nurse. I love watching the babies grow and how resilient they are. Babies can do amazing things!
What particular vulnerabilities do neonatal nurses and patients face?
There are so many. I think neonates are vulnerable recently due to the unknown effects of COVID-19 on their population. Although vertical transmission has only been described in case reports to date, we do not know the ramifications of being in utero when a mother has been critically ill.
Can you describe the need for the guidelines you have developed?
I was part of an amazing multidisciplinary group who met and spoke almost daily to discuss best care practices as information came out daily. Using clear communication and discussion of risk/benefit, we were able to institute and change care recommendations. Our recent publications reflect our experience and recommendations regarding COVID-19 and neonates in the original epicenter, New York City.
How do you hope to see these guidelines implemented in neonatal intensive care units?
I hope that this is a baseline for other organizations to see what we were able to recommend for practice with the current information that we had and ways that we were able to convey it to staff as it changed. Information regarding COVID-19 care in mothers and infants will continue to evolve as we continue to learn more but this document may serve as a place to start.