If you have ever had a sick newborn baby in the Special Care Baby Unit at King Edward VII Memorial Hospital you probably remember the nurses who cared for your baby much the way you would remember an angel.Each year around 300 newborn babies find themselves in the SCBU at KEMH, the equivalent of the Neo Natal Intensive Care Unit (NICU) in the United States. Neo Natal Nurse Megan Provencher is one of a staff of 13 that works in SCBU.Ms Provencher is originally from Florida. After nursing school, she worked in a medical surgical unit in Tampa, Florida, and then applied at a hospital to work with postpartum mothers.“They said they didn’t have any positions available,” she said, “but there was talk of letting new nurses come into the NICU and training them and moulding them to be exactly what they needed”.“I had that wonderful opportunity in Tampa. After six months of orientation and highly specialised training to become a NICU nurse I worked there for two years. I thought this is incredible and I want to see how other places do things.”Ms Provencher got the idea that she would travel all over the United States and the world working as a NICU nurse.Her first stop was Dallas, Texas, working in a 50 bed unit. “I saw heart surgery at the bedside of a one lb baby,” she said. “I saw some really incredible things. I had such incredible experiences along the way.“It was nice to see how different places function. You come in and conform to what they do and adapt to the way they do things. The next place after Texas was Bermuda. I got the job here. It was supposed to be for a quick travel assignment.“I intended to stay just three months but I fell in love, literally. I have been here for three years now, and I just got married. Who knew that this travelling, free spirited nurse was going to come here and settle down a bit?”She said there were some differences to working on an Island like Bermuda compared to working in the United States, such as the greater complications surrounding obtaining hospital supplies.“Supplies may not arrive on time, or might be sitting on the dock and you have to still be able to perform at your highest level of care,” she said. “In a hospital in the United States, very often you would be able to borrow from the hospital down the road.”Ms Provencher is a level three NICU Nurse and the SCBU unit is a level two.However, the SCBU sometimes care for level three patients until they can be flown overseas for more specialised care.“We do ventilatory support,” she said. “We can do chest tubes here. We can do Constant Positive Airway Pressure (CPAP) (a life saving technique).“We do things that a level three NICU can do, but for longer term care the really tiny ones do need to be flown out. Until then we are able to keep them alive and well.”Premature birth is a common reason for being in the SCBU. Premature birth is considered anything less than 37 weeks.If a mother is at very high risk or if the baby will be extremely premature, mother and baby are usually sent overseas to a tertiary care facility prior to delivering.If delivery is imminent and cannot be stopped, KEMH can resuscitate and stabilise babies born greater than 24 weeks. They transfer babies overseas that are less than 30 weeks or those that require specialised procedures or treatment.“Sometimes babies are born on their due date, but need extra help as well,” Ms Provencher said. “They might need extra help if the umbilical cord was wrapped around their neck too tight and they struggle to get their first breathe.“Sometimes they might be in the SCBU because they became stressed during the delivery and their heart rate fell. Another reason is if they passed meconium, their first poo, in the womb and then breathe it in. This can be very dangerous.“Sometimes we don’t know the water is contaminated until they come out. That is something that can be even scarier than having a premature baby.”One of the most rewarding things about her job was being out of the hospital and seeing her former patients with their parents thriving.Sometimes parents come back to visit the nurses in the SCBU or send pictures to show how well their babies are doing.“They will never forget our names or faces,” she said. “You are such an integral part of their life. I say SCBU nurses are someone you hope you never have to meet, but if you do need us, we are there for you.”She said the SCBU has busy and quiet times, but there always needs to be a full staff ready to go, because there was no way to know when they would be needed.“What I would like parents to know is that in Bermuda you should take all the birthing classes and you should have an idea of how you would like things to go,” she said. “You should be very well informed, but ultimately if things don’t go as planned, that is why we exist.“We are here and we have some of the best trained staff, and some of the best equipment that rivals our North American counterparts. That should be very comforting and you can feel confident about having a baby here.”