The computer screen — “the board,” the nurses call it — reads “No calls pending.” That is a good thing. It means that just now, as the 7 p.m.-to-7 a.m. shift enters its second hour, no babies in the Washington area need emergency transport aboard an ambulance or helicopter to Children’s National Medical Center.

No babies born with umbilical cords wrapped around their necks, no preemies with immature lungs gasping for breath.

And so Joy Avery and Stephanie Lyles do what transport nurses often do in the sixth-floor neonatal intensive care unit, a.k.a., the NICU: They wait.

“You dread the phone to ring, but then you want it to ring,” says Stephanie, who has been a transport nurse for a year. “That’s what I had to get used to.”

They dread it because it means a baby is sick. They want it because it is their job, after all, and they are very good at their jobs.

Stephanie Lyles, left, and Joy Avery, neonatal intensive care unit nurses at Children’s Hospital. (John Kelly/The Washington Post)

When Stephanie was growing up on Kent Island, Md., people were always saying what a nurturer she was. You should be a teacher or a nurse, they would say. A lot of the adult patients she saw in nursing school suffered from COPD — chronic obstructive pulmonary disease — and were on ventilators.

The other nurses had a name for some of them: “frequent fliers.” That meant that once these patients were discharged, they would go home and start smoking again, only to return to the hospital, a cycle that would continue until their deaths.

Stephanie remembers thinking, “That’s so messed up. . . . You guys could prevent half of this if you just wouldn’t light up a cigarette.”

She vowed then to work with the most vulnerable patients, ones who were sick through no fault of their own.

Joy, who grew up in Richmond, wanted to be a NICU nurse for as long as she can remember. When she played with her Barbies, she cast their plastic infants as premature babies in need of heart surgery. She was hooked on “Rescue 911” as a girl and would make her brother pretend to be the helicopter pilot transporting the sick children to her.

Both Stephanie, 33, and Joy, 33, became nurses, then neonatal nurses, then neonatal transport nurses. (Joy’s brother did not become a helicopter pilot. He became a real estate agent.)

At Children’s, the transport nurses wear red and black. They have flight suits in those colors, too, donned when a baby needs to get to the hospital on a helicopter.

As we wait, I ask Joy and Stephanie: Are transport nurses sort of the Navy SEALs of the medical profession?

They both laugh. They see themselves more as mechanics. The fragile machines they must nurse to the NICU are babies who typically weigh less than 5 kilograms, or 11 pounds.

We wait some more.

“I’m always on edge,” Stephanie says, “nervous for the phone to ring.”

“You have to be uncomfortable,” says Joy, who has been a transport nurse for five years. “It keeps you on your toes.”

And then, at 10:30 p.m., the phone does ring. Joy answers it.

At Holy Cross Hospital in Silver Spring, a newborn less than five hours old has what appears to be a heart problem. As Joy goes to change into her flight suit, Stephanie calls Holy Cross to get as much information as she can: How many weeks was the pregnancy? Was it a vaginal delivery or a C-section? What blood cultures have been done? What are the ventilator settings, the size of the endotracheal tubes, the dosage of medications?

The crew of the SkyBear helicopter — pilot Rick Dohman and nurse Robyn Lanasa — has been off practicing flying with night-vision goggles. The chopper is called back to Children’s, landing on the roof at 11. The Children’s team — Joy, respiratory therapist Karen Brant and emergency medicine technician-paramedic Todd Cohen — wheel an isolette on board. This clear box, basically an ICU on wheels, bristles with equipment.

At 11:13, SkyBear takes off, hovers for a few moments above the pad, then tilts and pulls away. As the helicopter heads toward Holy Cross, it is a white dot getting smaller and smaller in the night.

Thursday: The return journey.

How you can help

As the year draws to a close, please consider making a donation to Children’s National Medical Center. Your gift will be used for one thing only: to pay the medical bills of underinsured children.

You can make a tax-deductible donation by going to or sending a check (payable to Children’s Hospital) to Washington Post Campaign, P.O. Box 17390, Baltimore, Md. 21297-1390. Our deadline is Jan. 4.

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