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A day with PIPER: taking care of Australia's critically ill babies

Photo: Kay Downing
As a Neonatal Retrieval Nurse, no day is the same for Kay Downing, who spends her days taking care of critically ill babies with PIPER (the Paediatric Infant Perinatal Emergency Retrieval) at Victoria’s Royal Children’s Hospital.

“I can safely say a neonatal retrieval nurse’s role is vastly different compared to working on a neonatal unit,” says Ms Downing.

“On a unit, you have more people around to help in an emergency situation. All equipment is at hand and easily accessible.

“There are also different levels of capability for nurseries throughout Victoria which means the level of care that the hospital is able to provide varies.

“Therefore, in PIPER it is key to know the referring hospital’s resources, in order to advise them in supporting the patient until the team arrives.
“The time waiting for PIPER to arrive is always a very stressful situation in a smaller units and hospitals, so we offer support with both medical and nursing advice regarding the patient’s care via phone to the referring hospital.”

Ms Downer says neonatal nurses require high levels of compassion and empathy, especially when it comes to the parents and extended family of neonates.

“This is especially important in an emergency retrieval, as having a sick baby and then not always being able to travel with their baby, is very stressful for parents.

“We’re not able to transport both parents, but always try to take one parent with us.

“Those parents from rural Victoria will then have a long drive ahead of them until they are reunited at the receiving hospital with their baby.

“Sometimes mothers are too sick to travel and it may be many days before they see their baby again.

Ms Downer said she decided to become a neonatal nurse following early placement, and discovering just how ill babies could be at birth.

“After qualifying as a midwife and consolidating my midwifery training, I took the opportunity to work as a neonatal nurse, as I enjoyed my placement so

“I enjoyed my placement so much during my training and have remained in neonatal care ever since whether it be on a unit or for the last 12 years with Piper as a retrieval nurse.”

After three years of initially gaining experience on the neonatal unit, Ms Downer then undertook her neonatal intensive care course.

“I especially love my retrieval role as every day is different, always going to different hospitals all over Victoria.

“We also move babies from interstate and occasionally internationally too.

“A satisfying part of my role also is taking babies back to the hospitals that they came from when they are well enough.”

Although rewarding, life as a neonatal retrieval nurse is not without its challenges.

“For instance, making sure a baby is stable enough prior to transfer.

“We transport babies by fixed wing, helicopter and by road ambulances.

“Working in a confined space if the baby deteriorates, or trying to re-stabilise a baby in a plane is very difficult.

“As a retrieval nurse we work many hours and work lots of overtime. Fatigue is an enormous challenge.”

Ms Downer says a typical day as a neonatal retrieval nurse starts off with a check of all the emergency equipment.

“We all carry pagers and if a hospital is referring a baby for retrieval then we get paged into a conference room to listen to the referral.

“At the end of the call the Neonatal Consultant will decide if we retrieve the baby or if we continue to consult over the phone as required.

“Our aim is not to split babies and parents up.”

The retrieval team consists of one nurse, one doctor and a driver for road transports.

For air retrievals, there’s also a flight paramedic, as well as flight crew.

For more stable babies a nurse may retrieve a baby without a doctor accompanying them.

“I have quite a few memorable experiences and probably too many to mention,” says Ms Downer.

“Of course a parent’s gratitude and appreciation of the work we do remains at the top of the list.

“However, logistics and trouble-shooting are always memorable.

“When you have to think outside of the box it makes you appreciate the differences between working on a neonatal unit and working in an emergency retrieval role.

“Good communication is paramount in this role.

“Overall this is a fantastic job and I would definitely recommend neonatal nursing as a career.”


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Nicole Madigan

Nicole Madigan is a widely published journalist with more than 15 years experience in the media and communications industries.

Specialising in health, business, property and finance, Nicole writes regularly for numerous high-profile newspapers, magazines and online publications.

Before moving into freelance writing almost a decade ago, Nicole was an on-air reporter with Channel Nine and a newspaper journalist with News Limited.

Nicole is also the Director of content and communications agency Stella Communications ( and a children's author.