CHRISTUS ST. MICHAEL
EXPANDING NICU
SERVICES FOR THE AREA’S
YOUNGEST PATIENTS
by Jane Bouterse
“T
he Vision of CHRISTUS Health,
a Catholic, faith-based ministry,
is to be a leader and advocate in
creating exemplary health care services,
processes, and structures that improve the
health of individuals and of local and global
communities so all may experience God’s
healing presence and love.”
That Vision is nowhere more
apparent in the CHRISTUS St. Michael
environment than in its attention to the
youngest among us. February 2009 marked
the opening of the Special Care Nursery,
an expanded service of an already-busy
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well- baby nursery at the hospital. Dr.
Susan Keeney, a Texarkana native, was
able to return to her hometown to practice
her medical specialty—neonatology.
Neonatologists specialize in the care of
newborn babies, sick babies and premature
babies. Typically, their efforts require
not only a sophisticated space but also
staff dedicated to the care of newborns
with medical challenges. According to
Francine Francis, Director of Marketing and
Communications for CHRISTUS St. Michael,
over 80 babies have been cared for in the
Special Care Nursery since its opening, 45
of whom would have been transferred to
other facilities. That means 45 families have
been able to stay near home rather than
dealing with the trauma not only of their
babies’ health issues but also being away
from families, friends, jobs. “CHRISTUS
St. Michael established the nursery,” Chris
Karam, President/CEO stated, “to address
a community need and allow babies born
before they are ready to face the world to
thrive close to home.” This is “exemplary
health care,” that just keeps getting better.
CHRISTUS St. Michael recently launched
a $1.3 million expansion for their Neonatal
Intensive Care Unit—a new name for the
Special Care Nursery. “The expanded NICU
is scheduled to open the end of October
2009.”
With the expansion, 16 well-baby
beds will remain in the current nursery. Wellbabies are usually full-term (born after 37
weeks). The NICU will add 8 beds to the
current 4 to care for babies with problems
or premature infants (born before 37 weeks
gestation). Premature babies are often not
“sick” at the time of their birth; however,
because their development has not been
completed problems may develop. According
to Dr. Keeney, respiratory problems occur
frequently because the lungs are not fully
developed, so premature babies may need
extra oxygen and/or assistance with their
breathing from a ventilator (“respirator”).
Other problems, according to a CedarsSinai website, may include keeping the baby
warm. Since premature babies have so little
body fat, they get cold easily. Incubators or
radiant warmers may be required to maintain
a stable body temperature. Immature
liver development may result in jaundice;
immature immune systems may mean a
vulnerability to infection; immature stomach
or intestines may mean babies cannot
handle breast milk or formula adequately,
so an IV must deliver some or all of their
nutrition for a while. In some cases, the
brain of premature infants may not be fully
developed, so they must be assisted in
swallowing or breathing in a coordinated
fashion. Dr. Keeney, a board certified
neonatologist, and the NICU staff: nurse
practitioners as well as specially trained
neonatal nurses provide care 24 hours a
day, seven days a week. Kathy Beaman, RN
manages Labor and Delivery, the nursery
and will oversee the NICU. The NICU team
has the equipment and knowledge to handle
the challenges.
Walking through their shining,
wired world, Dr. Keeney and Kathy beam
as they show off their state-of-the-art
incubators. Other specialized equipment
available to them include overhead warmers,
respiratory equipment (fancy neonatal
ventilators); CPAP equipment which provides
continuous extra air flow (similar to adults
with sleep disorders) which protects the
lungs. Today, the NICU utilizes cardiac
monitors, expanded lab facilities which can
provide blood/gas measurements right away
and radiological tools with
specialized echo capabilities
to identify infant heart
problems. Specialized IV
pumps deliver small amounts
of nutrition or medicine. The
world of this neonatologist is
a well equipped, miniature
world prepared to identify and
treat “big folks’ problems” for
the newest among us. Few
hospitals are able to offer the
kind of care available through
this CHRISTUS St. Michael
NICU.
For that reason,
doctors and hospitals
throughout the area depend
on Dr. Keeney and the NICU
over which she presides. In
fact, such a facility was not even possible
until the Texarkana Metropolitan Area and
the Four States Region began to grow. The
numbers now indicate close to 900,000
people in the hospital’s service area;
therefore, CHRISTUS St. Michael Health
System and LifeNet recently purchased an
incubator which will enable babies to be
safely transported to the NICU at CHRISTUS
St. Michael.
Increased population figures
also made it possible for Susan Keeney,
a Texas High School graduate, to return
to Texarkana. Susan had her eye on a
medical career long before she chose
neonatology, which kind of sneaked up
on her. After her graduation from The
University of Texas, she enrolled in UT
Medical Branch in Galveston. In her third
year of medical school, she completed her
well baby rotation which included staying
very busy in the 40 community outreach
clinics credited with some 7,000 deliveries
annually. Susan soon left pediatrics to do
neonatology. “This is it. It is so much fun to
take care of babies.” Only after CHRISTUS
St. Michael opened their Special Care Unit
was there a job for Dr. Keeney in Texarkana.
“It’s wonderful to be back in Texarkana.
Some things are the same, but there are
also lots of changes. I am so honored and
excited to be able to provide this service. I
anticipate a growing level of
service and expanding and
increasing our level of care.”
… And she’s right. According
to Francine Francis, “The
NICU will include specialized
beds called Giraffe Omni
beds, which are state-ofthe-art beds that convert for
the different needs of the
newborn.”
This revelation and
choice on Dr. Keeney’s
part, according to several
studies, deserves lots
of credit for physicians
choosing to add at least
three years of neonatology
fellowship to their already
extended medical studies.
Many responses sound like this report from
Cedars-Sinai Medical Center in Southern
California: “Neonatology is fun because the
babies are so resilient! Given the right kind
of support, they can snap back from almost
anything in an amazingly short time. They
are so much smarter and more complicated
than most people give them credit for, too.
Even a premature baby already has a
distinct personality and style when they are
born. Some babies are ‘easy,’ some are
‘irritable,’ some are ‘social,’ and this is easily
recognized as still being their style years
later.” One of the greatest rewards of this
practice, both Keeney and Beaman admit,
occurs when once-sick babies return to say
a healthy “Hi” and “Thank-you.”
Another plus to the practice of
neonatology is that it is one of the few areas
of medicine which allows the physician to
handle nearly all aspects of the patient’s
care and to become well acquainted with
the patient’s family. Sick babies often remain
hospitalized for months, and parents are
included in the treatment of their babies. As
Dr. Keeney showed ALT staff around the
Special Care Unit, she introduced us to a
mother rocking her little one. The baby and
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mom had become familiar to all the hospital
personnel as the little one added pounds
and worked on breathing. In recent months,
the well-baby and NICU nurseries were
crowded by newborn triplets and two sets of
twins as well as single babies
and their loved ones. “You get
connected to these families,”
Kathy admits. (The smallest
baby cared for in CHRISTUS
St. Michael’s Special Care Unit
had a birth weight of less than
2 lbs. and was not much larger
than a 20 ounce coke bottle.)
“And last but not least,
neonatology is fun because all
the other people in an NICU
are so great to be around.”
The people for whom this
environment is a fit tend to
be even-tempered, kind, and
friendly; they are also smart,
quick thinking and work well
as a team. As Dr.Keeney and
Kathy agree. “It is truly an
honor to work with everybody.”
As one can well imagine, a
Neonatologist faces many issues familiar
to older patients: end of life issues (the
ultimate decision always rests with the
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family) or the very high cost of intensive
care (“What you get is a baby who has a
whole life ahead,” Dr. Keeney emphasizes.)
The “million dollar baby” issue (as Business
Week calls it) is becoming more substantial
with the concerns about
rising health care costs and
the rise in the number of
premature infants. Fertility
drugs appear to be a major
cause of this rise which
can be addressed through
effective and less-expensive
pre-natal care. Dr. Keeney
praises the cooperation
among OB/Gyn physicians,
pediatricians and support
services like respiratory,
radiology, laboratory,
physical medicine and
pharmacy in making such
specialized care available to
the people of the Texarkana
region.
“The NICU is a substantial
investment,” Francis notes,
“but it is addressing a community need.
Our unit helps families reduce their costs,
especially out of town expenses as well as
the emotional toll.” Certainly improving local
communities is a goal of the CHRISTUS St.
Michael Health System.
The community has the opportunity
not only to benefit from the services of
the NICU but also to contribute to them.
Francis provides this reminder, “Funds
from CHRISTUS St. Michael Friends of the
Foundation’s 20th annual duck event, which
will be called the Great Texarkana Duck
Paddle this year, will benefit the NICU. The
Great Texarkana Duck Paddle will be held on
Saturday, October 3, 2009, at Spring Lake
Park.” Everyone can adopt a duck, enjoy
the race, and support the NICU—truly a
worthwhile investment.
For now, citizens of Texarkana
and the surrounding area can join with the
many new parents benefiting from the expert
attentions of Dr. Susan Keeney and her
NICU team. Indeed, the Four States Area
can be grateful to CHRISTUS St. Michael
for their determination to live up to their
Vision. They ARE “creating exemplary health
care services, processes, and structures
that improve the health of individuals and of
local and global communities…” and they
do continue to attract talented doctors and
nurses and technical folks—all of whom
contribute to an improved quality of life for
the area’s citizens—older and younger.
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