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The Baby Is Ready to Go Home, But the Car Seat Is Broken. What Does Temple’s NICU Do?

July 08, 2016

Maria Sierra-Ortiz, 54, has been a social worker at Temple Hospital for 20 years, much of it assigned to the neonatal intensive care unit. Her office is on the fourth floor, the main social work office is in the basement, and the NICU is on the third floor.

Maria is still in heels, often on the stairs, always on the go. “When I get interns,” she says, “the first thing I say is, `Do you have a heart condition?’”

Maria, who has a master’s degree in social work, loves her job. “It’s involving yourself in the humanity part,” she says, “getting into the mess, if you will, and making a difference.”

Here is a problem she helped solve the other day:

A young woman had given birth on a Monday, but her baby had swallowed meconium and had a few other medical issues. The young mother went home, but her baby stayed in the NICU. The mother came back every day, and was told on the fifth day, a Saturday, she could take her baby home.

A friend had lent them a car seat, and on Saturday morning, the grandmother brought it to the hospital. But nurses noticed right away the straps were cut in back. The car seat was no good.

Because the mother was so young, and had other areas of concern, the Division of Youth and Family Services, the state child welfare agency, was involved. It had evaluated the home and approved the infant to go home with the mother.

But any delay, even because there was no car seat, could risk having the agency reconsider, Sierra-Ortiz said. “The mom would have been destroyed not taking her baby.”

“You can see in their eyes,” she added. “They had nothing. There was no way out. There was nobody to call. No way to get $10 or $15, much less a new car seat. The mother and grandmother start arguing. I say everybody just be quiet. Give me a second.”

“Let’s figure this out.”

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Four years ago, when Dr. Heidi Taylor joined the unit as a neonatologist, she started a bake sale. Everyone in the unit pitched in, even medical students. They’ve raised over $1,800 to help buy supplies beyond the hospital’s budget, including high-tech swings, known as Mamaroos, which are especially soothing for drug addicted babies in the NICU going through withdrawal.

Staff used its bake sale funds to buy preemie pacifiers and breast pumps, and blankets and clothes for babies who otherwise would go home literally with just the shirt on their backs. This year Dr. Taylor, now the head of neonatology, has decided to hold a raffle as a fundraiser.

People here are always opening their wallets. The other day a nurse gave a week’s worth of bus tokens to a new mother who was walking a mile each way every day to see her twins.

Car seats over the years have been a challenge.

For many years, Dr. Nancy Robinson, the former head of neonatology, retiring in December, would just hand Sierra-Ortiz $500 or $1,000.

Sierra-Ortiz would stop at Burlington Coat Factory on the way home and buy car seats.

Sierra-Ortiz bought eight or nine car seats out of her own pocket over the years. For a while, she asked families to chip in whatever they could, $30 or $50, so she could use that to help buy a car seat for the next family. The hospital told her she couldn’t really ask families for money.

The Children’s Hospital of Philadelphia now runs a program sponsored by Kohl’s that gave away 1,400 free car seats last year. Anyone on public assistance is eligible, but must sign up six weeks in advance and attend a class. Temple sends many of its expecting mothers over there. But not all of them know about the program, or get there.

Two years ago, with an intern, Annie Byrne, now an employee, Sierra-Ortiz applied for a grant from PennDOT, run through the Pennsylvania Chapter of the American Academy of Pediatrics, for 12 car seats, which were delivered to the hospital by Even-Flo. But those are all gone, and an application for another dozen is pending.

There was really only one solution to the problem of the broken car seat. The entire team understood the risks of a delay. They opened their wallets.

Dr. Keri Fugarolas, an attending physician, was first to say, “Let’s help with the car seat.”

“We all pulled out money,” said Sierra-Ortiz, “the nurses, the doctors, a cleaning lady had $5. Everybody in that unit, we’re a family.”

“There are so many people at Temple who do good that goes unknown,” added Sierra Ortiz.

Maria Trillana, a nurse there for 26 years, threw in $20.

“If you see that extra effort, that she comes every day and tries so hard with her baby, she deserves a break,” said Trillana, a NICU nurse for 26 years. “Sometimes the circumstances are just against them,” she added. “It helps to see beyond what is in front of you.”

Staff collected over $100. Sierra-Ortiz called around to get the best price. An emissary was recruited to go to Walmart on Roosevelt Boulevard and purchase a car seat, which within an hour was presented to the young mother.

“Just the look in their eyes was enough for us to see this is what they needed, a lending hand,” said Sierra-Ortiz. “They were just so thankful. They couldn’t believe we were doing this. It was not only providing the car seat. It was the relief of not having to involve now again DHS, of being able to take her baby home. That small gesture opened the door for so many other wonderful things to happen.”

The great aunt drove over to get them that Saturday afternoon. The car seat was belted in, the little baby tucked in safely, and home they went.

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Michael Vitez, winner of the 1997 Pulitzer Prize for Explanatory Journalism at The Philadelphia Inquirer, is the director of narrative medicine at the Lewis Katz School of Medicine at Temple University.