Carmichael’s Mercy San Juan hospital will open $38M neonatal intensive care unit
A new $3 8 million neonatal intensive care unit will open by early November at Mercy San Juan Medical Center in Carmichael and with nearly 15 times the space of the current unit, many parents will be able to sleep in with their preemies.
Dr. Carolyn Getman, who leads the Mercy San Juan NICU, said in 1990, when she arrived at the hospital, she never dreamed of having such sophisticated equipment or so much space — nearly 18,000 square feet with dozens of monitors. ventilators that administer “teeny-tiny breaths” and incubators that can be rolled into the NICU from the delivery room.
“Even 10 years ago, I couldn’t have dreamed of having a place (like this),” Getman said. “I dreamed about it, but I never thought it would come to fruition.”
She and the NICU team will be moving from a space where they had 26 beds packed into 1,200 square feet, along with a small station where physicians and staff had to do charting.
The 40-bed NICU bears the name of local philanthropists Robert and Star Pepper, who contributed $1 million of $3.08 million in community funding to help acquire the equipment and furnishings for the new unit. Dignity Health, which owns Mercy San Juan, provided $35 million for construction.
New features allow for more ‘skin-to-skin’ care
A signature aspect of the unit are chairs and couches in each room that convert into beds, allowing one parent to remain with each preemie at all times.
“That was very important to us when we started planning the new NICU,” Getman said, “the ability to have a parent (stay) here at any time from the beginning of the hospital stay to the end.”
Getman’s colleague, Dr. Robert Kahle, said this allows parents to practice what many neonatologists call kangaroo care where a preemie is placed skin-to-skin against a parent’s chest, much like a joey would be in a kangaroo’s pouch.
“It’s been shown that it improves outcomes for babies, both as far as their health as well as their development,” Kahle said. “It helps to actually decrease potential for infection in the babies and it decreases the length of stay. Babies tend to go home faster when there’s more skin-to-skin kangaroo care.”
Both Kahle and Getman contributed their own money toward the new unit. The office for a nursing supervisor bears Getman’s name, and Kahle and wife Janet have their name on the room where technicians will fortify breast milk.
Kahle founded the neonatology department in 1989 and he worked as the sole neonatologist until Getman joined him. He’s now head of pediatrics at the Carmichael hospital.
While giving a tour of the new NICU, he recalled that when he was training at UCLA in the early 1980s, babies under 28 weeks gestation rarely survived. Now, he said, babies at 22-24 weeks gestation can be managed with current technology.
Neonatology is still a relatively young medical field, Kahle and Getman said, and it really didn’t start to blossom until President John F. Kennedy and First Lady Jacqueline Bouvier Kennedy had a son who was born at 34 weeks. He died two days after being born, the doctors said.
“After that point in time, there was a big national effort to improve the care of premature babies, and it led to the development of multiple types of respiratory support that we have today,” Kahle said, “and it has allowed us to take babies that were unable to survive to be able to survive now.”
Preemies are born before their lungs have the ability to produce surfactant, a chemical to expand and stay expanded during breathing. Without it, Kahle said, the lungs collapse on themselves.
A manufactured version of pulmonary surfactant did not become available in the United States until 1990, and Getman said man-made and animal-derived versions of the medication have improved significantly over the last three decades.
So have ventilators, she said, pointing out a high-frequency piece of equipment that breathes like a hummingbird, allowing it to provide the gentle, rapid puffs of air needed by humans so tiny they can fit in the palm of a hand.
In the Pepper NICU, healthier preemies will go into three-bed pods divided by curtains with a station where nurses can monitor the areas. The pods all sit on the periphery of the building, so parents will have windows that allow them to see their babies day or night.
Each window has shades to block the sun since preemies tend to develop better in quiet, dark spaces. Staff have spotlights allowing them to care for one infant without disturbing another one, Getman said, and soffits in the ceiling, shaped like leaves and other natural elements.
The unit also has 16 private rooms for critical care, four of which are isolation rooms with negative-pressure ventilation that allows the air to be vented outside. Those rooms, Getman said, can house babies with communicable diseases such as COVID-19 or influenza.
There’s also room, Korpiel said, to add 10 additional beds.
Even though each room has a space for a parent to sleep, Getman and Kahle said, Mercy San Juan has opted to keep two recreational vehicles provided by the Friends of the NICU as sleeping spaces for couples from outside the region who are alternating care for a preemie.
“One of the hardest things for me when I go out to talk to a brand new family who’s had a baby very early, say at 24 weeks gestation, and (I’m) going through so much medical information, and really the main thing the parents want to know is: Can I stay with my baby?” Getman said. “For me, it’s heartbreaking to have to tell them: ‘I’m sorry. You can come in at any time, but you can’t sleep here. Now we’ll be able to tell them, ‘Yes, you can stay with your baby for the whole hospital course. You can be here.’”
Carmichael unit will help all over Northern California
Michael Korpiel, president of Mercy San Juan, noted that the expanded NICU will continue to serve not only all six Dignity hospitals in the Sacramento region, but patients in Northern and Central California.
Getman noted: “We have specially trained nurses and respiratory therapists who are trained in advance practices and are able to respond any time we have a transport call. We also have the ability for a neonatologist or a nurse practitioner to go as well if the level of care warrants that. We are immediately available to move a baby from an outlying hospital who needs a higher level of care.”
While acknowledging the NICU generates strong revenue for the medical center, Korpiel said the hospital’s main mission is ensuring that children get off to a healthy start in life. That’s been a central mission for Sisters of Mercy, he said, since they founded Mercy San Juan and Sacramento’s Mercy General hospitals.
Because the NICU is expanding to 40 beds from 26, Korpiel said they have positions available for new staff. The current NICU has about 90 nurses and 16 dedicated respiratory therapists, Getman said, noting that nine neonatologists from Mercy Medical Group have privileges in the unit.
“A unit like this is expensive. It’s expensive to staff. It’s expensive to find physicians, “ Korpiel said. “We have centralized this to create a structure so that the most knowledgeable physicians, the most skilled staff are all concentrated here in one facility, so we can deliver the best care to the community. If you spread that out among multiple hospitals, you’re not going to get the quality of care, you’re not going to get the resources, you’re not going to get the expertise that you will here.”
This story was originally published September 24, 2020 at 5:00 AM.
