Jocul in Sectia de Terapie Intensiva Neonatala (Apasa aici pentru a citi mai mult)

Jocul poate fi definit ca fiind orice fel de activitate liber aleasa, intrisec motivationala si personal regizata. Acesta este vital pentru dezvoltarea fizica si motorie, dar si pentru dezvoltarea sociala, emotionala si intelectuala.

Jocul in Sectia de Terapie Intensiva Neonatala ar putea sa reprezinte o provocare datorita starii clinice a bebelusului, care s-ar putea sa nu fie potrivita pentru desfasurarea unei activitati; datorita zgomotelor ce distrag atentia, a echipamentelor medicale la care bebelusul este conectat, a procedurilor regulate la care bebelusul este supus sau a spatiului insuficient pentru a pastra jucariile. In cazul nostru, jocul a fost o problema deoarece Aurora si Victoria aveau boala cronica a plamanilor si  isi foloseau majoritatea energiei pentru a respira. Cu toate acestea, noi am incercat sa le stimulam in asa fel, incat sa nu fie foarte solicitant si stresant pentru ele.

Pe langa faptul ca am vorbit si le-am cantat oricand a fost posibil, ne-am asigurat ca aveau jucariile potrivite varstei lor, si care, au fost recomandate si de terapeutul de joaca si de terapeutul ocupational- de exemplu, lumini senzoriale sau instrumente muzicale. Am folosit pana si aplicatii pe telefon pentru stimularea vizuala.

Aurora jucandu-se cu luminile senzoriale puse la dispozitie de catre spital.

Sesiunea noastra de joaca in Sectia de Terapie Intensiva Neonatala a reprezentat o oportunitate de a ne apropia mai mult,  de a observa progresul psihologic al fetelor si de a imparti zambete, ceea ce ne incanta enorm. Daca Aurora si Victoria erau treze in acelasi timp si binedispuse, obisnuiam sa le punem pe un covoras de joaca si sa le observam indeaproape, asigurandu-ne ca apa din tuburile ce apartineau aparatului de respiratie, nu le ajungea in nasuc.

Aurora si Victoria jucandu-se impreuna.

Uneori le puneam in balansoare, una langa cealalta, si le delectam jucandu-ne ‘’de-a v-ati ascunselea’’, citindu-le povesti sau aratandu-le diferite jucarii. Am incercat sa facilitam jocul prin punerea fetelor intr-o pozitie confortabila; de exempu, facand rulou din paturica si punandu-l sub cap, astfel ele se simteau sprijinite, dar totodata si forma capului era corectata. Bebelusii sunt predispusi la plagiocefacie, datorita scalpului relativ moale.

Cand se aflau pe covorasul de joaca, obisnuiam sa punem rulouri din prosop in jurul lor pentru a incuraja miscarea, impreunarea mainilor sau atingerea picioruselor. La bebelus sanatos, nascut la termen, aceste lucruri se intampla natural, iar parintele observa doar ca bebelusul se rostogoleste deja sau isi pune piciorusele in gurita. Spre deosebire de acesta, copilul prematur are nevoie de ajutor cu cele mai simple lucruri pentru a-si  intari mobilitatea, forta si increderea in sine, iar jocul reprezinta cea mai buna cale prin care aceste lucruri pot fi atinse.

Cand Maria avea permisiunea sa isi viziteze surorile, ea le aducea jucariile ei ca sa se joace cu ele, si se prefacea ca este doctor si ca le trateaza.  A fost fascinant sa vedem conexiunile pe care jocul le creeaza si cum ii ajuta pe cei mici sa comunice. Cand Maria era in preajma lor, Aurora si Victoria o urmareau si ii zambeau, aratand ca adora prezenta ei.

Maria jucandu-se cu Victoria.

Este foarte important de stiut ca un copil prematur sau bolnav are propriul ritm de joaca, iar parintii ar trebuie sa il respecte si sa se ghideze dupa acesta, pentru a se asigura ca respectivul copil nu este suprastimulat sau in dificultate. Ori de cate ori copilul arata ca este obosit sau in dureri, acesta trebuie sa primeasca oportunitatea de a se odihni si de a se recupera, pana cand el insusi arata ca este pregatit sa se joace din nou. Aurora si Victoria aveau, de asemenea astfel de momente, cand vroiau doar sa doarma, sa fie tinute in brate, si nefiind atrasi de nicio jucarie sau activitate, iar noi le-am ascultat.

Mai mult decat atat, Aurora avea o perioda cand era hranita incontinuu prin tub NJ, ( metoda de hranire direct in intestinal subtire) deoarece era blocata din punct de vedere respirator, iar doctorii au considerat ca ar fi de ajutor pentru plamani daca stomacul era gol. Astfel posibiliatea de a vomita era redusa, ceea ce prevenea aspiratiile de catre plamani. Inserarea tubului NJ necesita  multa atentie, maiestrie si o radiografie, care sa confirme daca tubul este in locul potrivit. De-a lungul acelei perioade, am fost extrem de atenti la modul in care o miscam pe Aurora, sau o lasam  sa se joace. Totodata, fusesem restrictionati de pompa pentru administrarea laptelui.

Aurora avand tubul NJ.

In concluzie, jocul in Sectia de Terapie Intensiva Neonatala este crucial, desi uneori, este atat de greu de realizat. Pentru mine era foarte suparator si stresant sa am grija de atatea tuburi si cabluri; pentru a nu trage ceva dupa mine, sau mai mult, pentru a nu le rani pe fete. Am visat ziua in care puteam alerga in parc cu ele, lasandu-le sa se rostogoleasca si ridicandu-le catre cer, fara nicio retinere, fara niciun impediment. Imi doream cu disperare acea libertate, iar cand am abtinut-o, a insemnat o reala descatusare.

Multumesc ca ai citit!

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Play in NICU (click here to read more)

The play is defined as any kind of freely chosen activity, intrinsically motivated, and personally directed. It is vital for physical and motor development, but also social, emotional and intellectual development.

Play in NICU might be challenging due to baby`s clinical state, which might not be suitable for doing some activities; due to distracting noises, the equipment connected to the baby, the regular procedures that the baby is undergoing or lack of space for keeping the toys. In our case, the play was an issue because Aurora and Victoria had chronic lung disease and they used most of their energy on breathing. However, we tried to stimulate them in a way that wasn’t too demanding and stressful for them.

Apart from talking and singing to them whenever it was possible, we made sure they also had the toys that were suitable for their age and also, recommended by the play therapist and occupational therapist — for example, sensory lights or musical instruments. We even used an application on the telephone for visual stimulation.

Aurora playing with the sensory lights provided by the hospital.

Our play sessions in Nicu represented a great time to bond with the girls, to see their psychological progress and to share smiles, which we enjoyed a lot. If the girls were awake at the same time and in a good mood, we use to put them together on a play mat and observe them, making sure the water from the tubing that belonged to the breathing machine, was not going into their nose.

Aurora and Victoria playing together

Sometimes, we use to put them next to each other in their bouncing chairs and entertain them by playing peek-a-boo, reading a story or show them different toys. We used to facilitate play by putting the girls in a comfortable position, for example making rolls for their head, so they felt their head safe, which also helped with the correction of their head shape. As you know, babies are at risk of plagiocephaly, because of their relatively soft skull.

Play session in NICU

When on the play mat, we use to roll a towel and put it around them to encourage movement, bringing hands together or touching their feet. In term and healthy baby, these things happen naturally, and the parent notices his baby already rolling over and putting his feet in the mouth. A premature infant instead, needs help with the smallest things to build up his mobility, strength and confidence, and play represents the best way to achieve these things.

Once Maria was allowed to visit her sisters, she used to bring her toys so they could play with them and to pretend to be a doctor and treating them. It was fascinating to see how play connects the children and helps them communicate. When she was around, Aurora and Victoria kept watching her and smile, showing they loved her presence.

Maria playing with Victoria

It is important to know that a premature or sick baby has his rhythm to play and parents should respect that and follow it, to make sure the baby is not overstimulated and distressed. Whenever the baby looks overtired, or I pain, he should receive the opportunity to rest and recover, until he shows he is ready to play again. Aurora and Victoria as well, had days when they just wanted to sleep, to be held, and not being interested in any toy or activity and we just listened to them.

Aurora had a period when she was continuously fed via an NJ tube because she got stuck from the breading point of view and doctors considered it would help her lungs if her tummy was empty and the possibility of vomits was reduced, which prevented the aspirations to her lung. The insertion of the NJ tube required a lot of attention, ability, and an X-ray to make sure it is in the right place. During that period, we have been extremely cautious with the way we moved or let Aurora play because nobody wanted her NJ tube to come out, and restricted at the same time by the feeding pump that was pushing the milk.

Aurora having Nj tube.

In conclusion, play in NICU is crucial, although sometimes it is so difficult to achieve. I found it upsetting and stressful to take care of so many tubes and wires; to make sure I do not pull something or harm the girls. I dreamt to the day when I could run in the park with them, let them roll over and lift them to the sky, without any restraint, without any impediment. I desperately wished that freedom, and when it came, it was such a relief.

Thank you for reading!