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A WakeMed Healthcare Hero: Jim Helm

Every year the Triangle Business Journal recognizes individuals in our area who are true healthcare heroes. 

While the Journal includes a nice profile and picture of the award winners (available online only to subscribers), we thought you might want to see their actual nominations and read first-hand what makes these individuals so special.

Our second  highlighted winner is Jim Helm.   Jim is a long-time employee who has helped our tiniest patients grow to be big, happy babies.  He also helps families adjust to the special needs of babies born a little earlier than expected.  Although Jim’s patients might be tiny, his passion for his job is huge.  Read a little bit about what makes Jim special in this nomination submitted to Triangle Business Journal.

James Helm
Infant-Family Specialist, WakeMed Neonatology

For more than 30 years, WakeMed and its Neonatal ICU Department have been at the forefront of specialized care for premature babies. In part, that’s because it was an early proponent of a pioneering neonatal treatment called NIDCAP — Newborn Individualized Development Care & Assessment Program. At WakeMed, the NIDCAP approach has been advocated and promoted since the 1980s by Infant-Family Specialist James Helm, whose efforts helped the hospital’s Neonatal Intensive Care Unit (NICU) become one of only four such facilities in the world to earn certification from the NIDCAP Federation International (NFI).

“A lot of neonatal nurseries embrace elements of the NIDCAP approach,” says Helm, who holds a PhD in Special Education from UNC-CH. “What makes WakeMed’s different is that it covers everything, it’s a comprehensive program. Developmental care is integrated into all aspects of the nursery.”

The road to WakeMed’s certification has been a long one for Helm, who started at WakeMed as a consultant in 1984 and became full time in Neonatology in 1988. He became a NIDCAP certified trainer a year later.

As the number of NIDCAP certified trainers began to grow in the 1990s, Helm said more hospitals began to ask, “Well, we have a NIDCAP Certified Professional, does that make our nursery a “NIDCAP nursery”?”

That set the NFI, founded in 2001, to develop a nursery certification process. In 2008, the first hospitals, WakeMed among them, began going through the process. After a two-year review, WakeMed was told that it was doing well in most areas, but needed work in others. And in 2012, WakeMed’s NICU nursery received the coveted NIDCAP certification. It joins a hospital in France and two others in the US as the only facilities so certified.

The NIDCAP approach covers four main areas: infant care, working with the families of the infants, staff support, and the environment. It’s an ongoing and evolving process in a field that’s changed dramatically since he first joined the hospital. “There was a time when our goal was to simply keep the babies alive,” says Helm. “We’ve gotten a lot better at that.”

That’s still the overriding goal, he adds. But increasing emphasis is placed on minimizing developmental problems that a premature birth could cause. “At 24, 25 weeks, the brain is essentially smooth.  It changes dramatically over that last trimester. The environment plays a huge role in how the brain develops.”

For a premature baby, that means a brain plucked from the protective embrace of the womb and subjected to an onslaught of stimuli it may not be ready to handle. “Our goal is to try and eliminate or dramatically decrease that added stress,” says Helm.

Certified NIDCAP observers look for signs of stress, some subtle, some not so, and to see how each baby attempts to manage then work with staff and the family to try and minimize that stress and help the baby be successful.

One strategy NIDCAP adopted early on is called “Kangaroo Care,” which involves frequent skin-to-skin contact between infant and parent. “It makes sense,” Helm says, “because the baby is expecting that contact in the uterine environment.”

A big change from Helm’s early days involves the infant’s exposure to family. “Access used to be severely restricted to premature infants because of the fear of infection. Now, with antibiotics, that’s less of a concern and there’s been mounting evidence of the healing power of family and friends.”

As a certified NIDCAP trainer, Helm spends time working with staff at other hospitals, but mostly works with staff at WakeMed. The certification process isn’t easy. 

“It takes about 18 to 24 months to get certified,” he says. “It’s about the same as a master’s.”

The bulk of his time, though, is spent observing infants in the NICU. He shares his assessment with staff and family to help customize the least stressful treatment for each baby.

Every six months as a part of “nursery blitzes” (intensive training for staff on new procedures), he and colleagues share the latest findings from the trenches, which the staff use to further tweak treatment.

Those findings also helped shape remodeled and expanded NICU, which opens next month (February 18, 2014). One of the big changes reflecting the NIDCAP approach are the individual patient rooms versus the original set up of semi-private, four-bed corrals. “The private rooms make it easier for families to spend more time with their babies,” says Helm.