Prematurity Awareness Month: Our Level II… - Wyoming Medical Center

Prematurity Awareness Month: Our Level II nursery means more babies and families stay in Casper

Nov 16, 2016

Labor and Delivery team members pose in our Mother, Baby and Family Center. They are, from left, Brandi Roybal, R.N.; Lathyn Hokanson, R.N.; Elizabeth Wilson, M.D.; Kristie Watson, OB Tech; Monica Money, R.N.; Jennifer Gallagher, R.N.; and Stacy Baker, R.

By Monica Money, R.N., Jennifer Gallagher, R.N., and Amanda McIntosh, M.D.

Two years ago, our Labor and Delivery team transitioned to the Ruth R. Ellbogen Mother, Baby and Family Center, and we have made great strides in the care of our infants born at Wyoming Medical Center.

The pediatric hospitalist program — along with our Levell II Nursery — allows us to care for more premature babies and keep more families in Casper. We have seen big changes, not only in our location, but also in how we care for our moms and babies.

What are Pediatric Hospitalists? They are specialized doctors who work in the hospital setting exclusively and do not operate a private practice or clinic. Our pediatric hospitalist program allows your child’s personal pediatrician to focus their attention on the children in their office without being interrupted by hospital calls.

Our pediatric hospitalists are board certified, meaning they demonstrate exceptional expertise and skill in their specialty. They work closely with the physicians in the community and keep local pediatricians up to date about their child’s hospital care. This communication is essential to the long term care of the child.

Because our pediatric hospitalists are on site 24 hours a day, we are able to routinely care for preterm infants, defined as less than 37 weeks gestation. Depending on the health of the baby and other factors, we are also able to care for some babies as young as 34 weeks gestation.

Our Level 2 NICU (Neonatal Intensive Care Unit) is staffed by specialized nurses who care for newborns with a variety of challenges. These include low birth weight, glucose or temperature instability, congenital malformations, feeding and oxygen issues and a multitude of other medical problems. Nurses go through a rigorous orientation process with ongoing education in order to work with Level 2 babies in the NICU. We routinely care for babies who need short-term ventilator support as well as ongoing cardiac and respiratory monitoring, intravenous nutrition, feeding tubes and IV antibiotics. We also provide for our preterm infants’ nutritional needs through our Donor Human Milk program, available to our neonatal population at all times.

This specialized care means more premature babies get to stay in Casper, closer to home and extended families, rather than being transported to a Level 3 or 4 NICU in another state.

We are proud of the specialized care we provide, but we also realize that all infants are different. Some premature babies simply have more complications than others and require a higher level of care. Infants born very premature — or less than 34-weeks gestation — are at highest risk for complications. They require more specialized care that is best provided by a neonatologist and, sometimes, a neonatal surgical team.

Our physicians have a strong working relationship with neonatologists and pediatric specialists at both Rocky Mountain Hospital for Children and Children's Hospital Colorado in Denver which offer Level 3 and 4 NICUs. Physicians consult with neonatal specialists via telephone and through telemedicine to provide the best care for preterm infants. We work together to keep as many infants in Wyoming as we can, while still providing excellent and safe care.

As a Level 2 NICU, we do transfer many babies to those hospitals that provide a higher level of care. These include babies born earlier than 34 weeks or with cardiac defects, those requiring long term ventilation, those that need surgery or those who need in-person pediatric specialty consults and highly specialized treatments.

A newborn in our Level II nursery.

Although new treatments have improved outcomes for infants born prematurely over the last 20 years world wide, we know that many infants born prematurely do not have the same outcomes as those born at term. The more premature an infant is, the higher the risk of mortality and complications.

Our very skilled pediatricians and obstetricians work together to make the best decisions for both mom and baby. We follow strict standards set by the American Congress of Obstetricians and Gynecologists (ACOG) as well as the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN) to prevent preterm delivery to the best of our ability. Our OB physicians are highly qualified to care for high-risk patients such as those with preterm labor and pregnancies complicated by diabetes, high blood pressure, infertility, growth restriction and other challenges. They also have long standing relationships with the perinatal experts in Denver who are always available for consult.

Premature delivery is a very real problem. November is Prematurity Awareness Month and Thursday is World Prematurity Day. While we at Wyoming Medical Center are committed to the prevention of premature delivery, we are very prepared to care for mothers in preterm labor and their babies who come too early. Our commitment to this initiative has decreased the incidence of premature delivery at Wyoming Medical Center and has allowed us to transport moms and babies to a higher level of care when necessary. We are proud of our achievements and will to continue to provide the highest standard of obstetrical and neonatal care to our community.


Monica Money is a registered nurse and clinical education coordinator for the nursery at the Ruth R. Ellbogen Family, Mother and Baby Center at Wyoming Medical Center. She has been at the hospital for three years and has been an OB/Nursery RN for the past 11 years. She has a bachelor of nursing degree from the University of Wyoming and is a Certified Lactation Counselor. She also directs the Neonatal Resuscitation Program Education for Wyoming Medical Center. Email her a


Jennifer Gallagher is a registered nurse and clinical education coordinator for obstetrics. She has worked at Wyoming Medical Center for 24 years, starting in 1992 when she washed dishes in the cafeteria. She has worked as an OB nurse for 13 years. She has a bachelors of nursing degree from the University of Wyoming and is certified in Electronic Fetal Monitoring and Maternal-Newborn Nursing. She also teaches our Childbirth Education Classes. Email her at

Dr. McIntosh is a pediatric hospitalist at Wyoming Medical Center. She earned her medical degree at the Univeristy of Kansa School of Medicine, Kansas City, Kan. She completed a residency in pediatrics at University of Colorado/Children's Hospital Colorado in Denver.