NICU nurses open their hearts to tiny patients

By Maureen Gilmer, IU Health senior writer, mgilmer1@iuhealth.org

For 10 years, they had tried to have children. When Kelsey Frey learned she was pregnant with quintuplets, she and her husband, Jeremy, were over the moon.

But they were cautious too. They’d already suffered two miscarriages, and they knew there were serious risks involved with carrying multiples, especially five babies at one time.

When Kelsey began showing signs of pre-eclampsia (dangerously high blood pressure that can be fatal to moms and babies) at 22 weeks’ gestation, she was admitted to the Maternity Tower at Riley Hospital for Children.

The hope was that delivery could be halted until at least 28 weeks, but at 24 weeks and 2 days, on Oct. 25, 2022, the Frey quintuplets were delivered via C-section by Dr. Christopher Mernitz.

Sadly, one of the quints, Brooks, was stillborn. Two more, Bailey and Liam, would face insurmountable health challenges and pass over the next several weeks.

It’s more grief than any family should have to absorb, but the Freys found comfort and support in their family at home in northern Indiana and in their new family at Riley.

Kelsey Uitermarkt and Makayla Howard were two of the NICU nurses who cared for the babies. Their impact was so strong that Jeremy and Kelsey Frey nominated them for DAISY awards, recognizing nurses who exhibit excellent clinical skills and compassionate care.

“We wanted to share our gratitude for a couple of exceptional nurses who truly went above and beyond for our family as we navigated 129 days of hardships in the NICU,” Jeremy wrote.

He went on to describe how he and his wife, who live nearly three hours away from Riley, struggled to be present for their surviving babies in the NICU, Luke and Avie, while also mourning the loss of Brooks, Bailey and Liam.

In addition, the couple have three older children at home whom they adopted.

“Oftentimes, Kelsey and I would see each other in passing or spend a night or two together at the hospital, but it was important that one of us was at the hospital every day,” Jeremy said.

Holding the family together at Riley was their care team – doctors, nurse practitioners, respiratory therapists, social workers, NICU Nest, child life and bedside nurses, particularly Uitermarkt and Howard, both of whom joined the Maternity Tower NICU team two years ago.

The two nurses would spend nearly every shift with one of the Frey babies until Avie and Luke were discharged in March. Howard began caring for Luke on his second day in the NICU.

“Other nurses would tell us they never got a chance to have Luke because he was ‘Makayla’s boy.’ This gave us such peace that somebody loved our babies this much,” the couple said.

Meanwhile, Uitermarkt had Liam that first week before becoming Avie’s primary nurse a few days later.

“Avie became my girl,” Uitermarkt said. “She had the sweetest little face. I just fell in love with her.”

Uitermarkt was with Avie across the hall around the time Liam passed away Nov. 27. (Bailey had died 12 days earlier after undergoing surgery for necrotizing enterocolitis.) Both Uitermarkt and Howard comforted the shattered parents and helped with the older Frey children, who had come to see their brother Liam “this side of heaven.”

“I remember thinking, I need to do everything in my power to make sure they get Avie home,” Uitermarkt said. “They had lost three kids already and they kept showing up. They showed up the next day to see Luke and Avie. They’re showing up for their kids at home, they’re showing up for their kids here, and they’re walking through the hardest thing they’ve probably ever had to walk through.”

Jeremy remembers how, throughout the ordeal, both nurses cried with them, acknowledged their pain and encouraged them to keep going.

“Makayla had a strong love for our children,” he said. “She was there when our Luke boy opened his eyes. She immediately grabbed the big picture of Kelsey we left at the hospital so he could see his mama first. She celebrated their 100th day of life with us as well. She was their biggest cheerleader.”

Uitermarkt also went above and beyond, he said.

“She was made for this job. She lights up the room. She was just as kind to us as she was to the babies, always talking to them and explaining everything to us. We appreciated it as it was all new and scary at first. Nurse Kelsey loved them endlessly.”

For her part, Uitermarkt said she wouldn’t be the nurse she is without Avie.

“She helped improved my clinical judgment and my critical thinking, but she also reminded me why I became a NICU nurse.”

Kelsey Frey remembers one night when she had been up late holding her babies, then laid down to get some sleep. She awoke a few hours later to the gentle sounds of Uitermarkt and Howard talking to the babies.

“Kelsey was holding Avie, and Makayla was holding Luke. To wake up and see that they were already getting love and attention made us happy,” Kelsey Frey said. “Knowing they were taken care of and loved gave us some peace.”

It was during this time that the two nurses, who had been friends and co-workers before, became more like sisters, they said. And the Freys became an extension of their own family.

“They took Kelsey and me into their family,” Howard said. “Those babies and that family made me a better nurse.”

Even when they weren’t assigned to one of the Frey babies, the nurses would drop by their rooms to check in and celebrate milestones like getting their breathing tubes out or trying their first bottle.

They made crafts, often using the babies’ hands and feet, that filled their hospital rooms, with some now having a place on the walls of the couple’s home.

Luke and Avie Frey, who weighed just over 1 pound, 5 ounces each at birth, have been home for five months now and are thriving.

“They are big and healthy,” Kelsey Frey said.

Luke weighs 14 pounds, 4 ounces, and Avie is 14 pounds, 2 ounces.

They continue to see the BPD clinic at Riley (bronchopulmonary dysplasia) but have “graduated” from other specialists’ care. Each time they return to Riley for follow-up appointments, the Freys say it feels like going home in a way.

“It was our home away from home,” Kelsey Frey said. “When we come back, we see so many people who remember us and still greet us.”

Two weeks ago, the couple brought their babies up to the NICU to see the team again, a highlight for Uitermarkt and Howard.

“Makayla and I both agree, when we know we’re seeing Avie and Luke, it feels like Christmas morning,” Uitermarkt said. “Just to see how far they’ve come is insane. They are truly little miracles.”

Both nurses say none of it would have been possible without the entire Riley team and collaboration with the parents.

“Our team is absolutely incredible,” Uitermarkt said. “We were quite organized for these kiddos’ arrival, but the heart that the team poured into this family and wanting to do what was best for these kids is evident in every decision they made along the way.”

And the Freys are “incredible parents,” she added. “They were always so kind and gracious, but they still advocated for their kids when appropriate. They are the ultimate NICU family.”

Howard, who was present for both admission and discharge, agreed, acknowledging the “strength and compassion” the couple showed for their children in the NICU and at home, as well as the nursing staff, the medical team and other families in the NICU.

“They were a smiling face for other families and were able to support others going through similar experiences,” she said. “I think it was extraordinary the love and compassion this family showed other people in moments that a lot of us cannot even imagine.”

After 4½ months in the NICU, leaving Riley was a celebration for the Freys, though not without some tears.

“One of the saddest parts was leaving behind nurses who became family,” Jeremy said. “They encouraged us and truly carried us through some of the darkest moments of our life.”

Photos submitted and by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org