Telethon 2025: Perth Children’s Hospital’s Cathy Dunstan tells of looking after critically ill babies in NICU

When clinical nurse consultant Cathy Dunstan talks about her work, one word repeatedly pops up.

Rewarding.

Ms Dunstan manages the neonatal intensive care unit at Perth Children’s Hospital, and she has dedicated her career to nursing some of WA’s most critically ill babies back to health.

One of the last cohorts to undertake hospital-based training, Ms Dunstan completed her nursing certificate at Princess Margaret Hospital. Further studies saw her complete midwifery and neonatal intensive care courses.

Most of her career has been spent in the NICUs of Princess Margaret and then Perth Children’s hospitals, with a little bit of time at King Edward Memorial Hospital thrown into the mix.

“The real joy of neonates is that it’s a whole journey,” she said.

“Most other nursing you look after one bit . . . but when babies are born, they come in and you’re doing intensive care, so you have the whole intensive care journey.

“But then they stay with us until they’re ready to go home, mostly. So you’re seeing that whole journey from the very beginning.”

The veteran nurse takes a moment to consider every question as it’s asked.

But an underlying wit, likely reserved for those who know her better, reveals itself with a few quips here and there, accompanied by a glint in the eye and a “but don’t write that”.

Ms Dunstan is a nurse that means business in all the best ways.

She carries herself with a quiet resolve, and is considerate of her colleagues, parents and tiny patients as we move around the NICU to find the best spot for a portrait.

In her 35 years of nursing, it is the advancement of ventilation technology that has left its mark.

“I think ventilation is the big change. When I started, a ventilator gave a breath, it went in and out, and you could adjust the pressure, and that was about all,” Ms Dunstan said.

“Whereas now there are so many different modes, and you see babies come in that are critically unwell, and by changing ventilation strategies (they have an) amazing recovery.”

Much of the upgrades to ventilators, warmers and incubators over the years have been a direct result of the millions of dollars raised by West Australians giving to Telethon.

“When I started in neonates, they used to say that you could tell a neonatal nurse because you could smell their hair burning from standing under the overhead warmers,” Ms Dunstan said.

You should be really sad about sad things and really happy and celebrate the happy things. That’s what helps you to be a balanced person, but also a good nurse.

“But now we’ve got these incredible warmers, which Telethon has given us, and the heat source is so direct to the babies, and they’re so efficient, you don’t have to have it turned up high or turn it up and down and up and down, they self-regulate.”

With 700 to 800 admissions each year, the 30-bed NICU is always busy.

It’s a place that can be a parent’s worst nightmare one day, and their saving grace the next.

“The toughest days are always the days where the parents are told that their baby’s not going to make it or is going to have a really awful outcome,” Ms Dunstan said.

“For a family not to be able to take their baby home — nobody thinks that’s going to happen.

“The reality of that is heartbreaking . . . it doesn’t feel like it’s right. It feels like it’s one of life’s travesties.”

It’s one of the toughest truths Ms Dunstan has had to help parents understand, and come to terms with herself.

“Sometimes no matter what you do, it’s not enough,” she said.

“The long-term patients are probably the hardest that then don’t make it, because you’ve fought really hard with them . . . and the parents, and you’ve watched all those steps and seen their little improvements and been hopeful that things will go well.”

She said it doesn’t get any easier — and it shouldn’t, either.

“I don’t think it should. I think if you think that bad things are normal or OK, then you shouldn’t be doing the job anymore,” Ms Dunstan said.

“You should be really sad about sad things and really happy and celebrate the happy things.

“That’s what helps you to be a balanced person, but also a good nurse, to accept that and to help everybody around you feel that too.”

It’s in the support of colleagues who have walked the same road of losing a patient whose life had just begun that neonatal nurses take solace.

Amid that often heavy toll, however, are moments of joy and celebration.

When babies with complex illnesses, who might have stayed as long as 16 weeks, get to go home, it’s a whole ward celebration with graduate certificates and all.

“Babies can have a really rough journey, but they’re incredibly tough,” Ms Dunstan said.

“You see these babies that have these backwards and forwards journeys where they’re getting better and then they’re sick again, and it’s really rewarding to see that they can come to the end of that. They’re so strong.”

As for the team she’s surrounded by, Ms Dunstan has nothing but praise for her “incredible group of nurses”.

“That’s what makes neonatal care, having people that are gentle and supportive and extremely knowledgeable,” she said.

“Nurses give so much of themselves every day when they come to work, working shift work and night duty and weekends, that’s really rewarding to be part of.”

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