Uncertain Trajectories

Abstract

The basic task of the NICU staff is to respond adequately to the frequently changing conditions of its patients. These changes are not always predictable and seldom unambiguous. They are indicative of the simple fact that the children in the NICU are alive. Like all infants they go on growing after birth, and this is of course an essential development. If, however, an infant is too small or too ill to realize this natural growth on his/her own, the baby’s condition will worsen without outside intervention. In such cases change implies no longer growth or development but a deadly threat, and direct intervention is essential. Furthermore, changes may be the effect of treatment and often this will mean recovery. By the same token, not all children in this unit respond to treatment according to the handbooks. This is why NICU efforts also have a more experimental basis: they rather involve attempts to influence the course of events so that a child’s condition will improve. Even if much of this work is routine and experienced staff will not be caught by surprises easily, it is also common that situations recur in which indecision prevails. In this sense, change in a NICU context always comes with an element of uncertainty.