Once again, Vanderbilt NICU in Nashville leads the way in nurses' emotional support.

The year was 1994. A nurse named Andrew Todd in the Vanderbilt University Medical Center NICU was looking for information on why he felt so overwhelmed while caring for dying babies. He found nothing. At that time, nurses in the NICU did not really talk about using, remouing, or withholding life support to each other. Todd, without formal research training, decided to study his peers and ask them to talk about their fears, their heartaches, and their despair when caring for babies who were dying. With support from Vanderbilt ethicist Richard Zaner, PhD, Todd wrote a groundbreaking book called Journey of the Heart: Stories of grief as told by nurses in the NICU. Published in 1995 by the Vanderbilt University Press, this text, no longer in print, was the first to openly display the feelings of nurses caring for children for whom technological support might be futile. Todd paved the way for others to question the goals, successes, and failures of neonatal medicine. It is uncertain whether any formal change took place for the nurses at Vanderbilt after Todd's book. It seems he was a man before his time. Fast forward to 2004. Nurse Angel Ewing, Case Manager for the same Vanderbilt NICU, sees the need to support nurses who may be experiencing moral distress. And Vanderbilt is now home of Dr. Brian Carter, neonatologist and ethicist known for his work in perinatal ethics and palliative care. Together Ewing and Carter, neither of whom have ever met Andrew Todd, created an ongoing program to provide ethical and emotional support to those working in the NICU. Ewing and Carter describe their program here.