A Special Care Nursery for Infants’ Special Needs
James McGuire, MD
Because no two people are the same, no two pregnancies and births are the
same. Some babies are born healthy and ready to take on the world. Others
need a little medical help to get them to that point. It’s for this
reason that we classify neonatal care according to the needs of infants.
You may be familiar with Neonatal Intensive Care Units, or NICUs for short.
But did you know that there are actually four distinct levels of infant
care that American hospitals and medical centers provide?
Level I – Well-baby Nursery
Infants that are born more or less healthy receive care in a well-baby
or well newborn nursery. These units are typically staffed with physicians,
nurse practitioners and advanced practice registered nurses who are able
to provide care and stabilize infants who are born at 35 to 37 weeks’
gestation or greater or who have minor illness. Level 1 care is usually
provided in the mom’s room. Babies who need more than level 1 care
Level II – Special Care Nursery
In addition to being able to provide the care of a Level I nursery, these
units specialize in caring for infants who are born prematurely at 32
weeks’ gestation or greater or are underweight or are moderately
ill. Additionally, babies who are born more premature than 32 weeks’
gestation are transferred back to a level II nursery for convalescent
care after being treated in intensive care units. At Washington Hospital,
we’re able to provide these important services within our Level
II Special Care Nursery. This allows us to keep babies in their community
where they are closer to their families’ support networks while
infants get strong and healthy enough to go home. Our staff consists of
pediatric hospitalists and neonatologists, along with specially trained
nurses and respiratory care practitioners. Babies who need more than level
II care are stabilized before being transferred to an intensive care unit.
Level III – Neonatal Intensive Care (NICU)
These units care for infants born at all gestational ages and babies born
with critical illnesses. In addition to providers found in Level I and
Level II nurseries, Level III nurseries have pediatric surgeons, anesthesiologists,
ophthalmologists and other pediatric subspecialists on staff who are able
to provide comprehensive care, respiratory support, and sustained life
support for infants.
Level IV – Regional NICUs
NICUs are equipped to provide the most acute care for babies with serious
and complex congenital or acquired conditions. In addition to its advanced
surgical capabilities, Level IV nurseries are staffed by a full range
of pediatric medical and surgical subspecialists who specialize in the
care of very sick babies.
While Washington Hospital does not have Level III or Level IV NICU facilities,
our close relationship with UCSF Health gives us access to one of the
top-ranked NICUs in the country. In fact, in addition to serving as a
neonatologist and as the medical director for Washington Hospital’s
Special Care Nursery, I’m also a professor in the UCSF Department
Because it’s the only Level II nursery in the area and because of
our affiliation with UCSF Health, babies born at Washington Hospital can
receive emergency treatment and be stabilized before being transferred
to more advanced facilities, such as the Intensive Care Nursery at UCSF
Benioff Children’s Hospital in San Francisco. More importantly,
after receiving care in a NICU, infants can then be transferred back to
Washington Hospital to convalesce before discharge.
By having this resource in the community, it lessens the burden on parents
to navigate traffic and rearrange their schedules to see their newborns
in other facilities during an already stressful time.
Learn more about the comprehensive
pregnancy and birthing services as well as the
Special Care Nursery found at
Washington Hospital by visiting
Posted November, 2018