Gretchen Vanders gives her patients lots of hugs and kisses.

A neonatal intensive care unit nurse for 36 years of a 40-year career, Vanders has never been tardy in showing up to care for the premature infants. She also helps parents get through the frightening and bewildering experience of having a newborn in the NICU.

Vanders, 61, recalls working in "preemie nurseries" that didn't even have monitors or ventilators and she's watched the advances in medicine that now can save babies born prematurely at 24 weeks. "We've learned to save smaller and smaller babies," she said.

Vanders, who has raised two daughters and has three grandchildren, finds her job as a staff nurse in the NICU satisfying and stimulating.

"It's never boring," said Vanders, who earned her nursing diploma from the Blodgett Memorial Medical Center School of Nursing in Grand Rapids. "It's a challenging and rewarding job and I love it. That's why I'm still here."

As part of her daily routine, Vanders finds herself deeply involved in patient education as well as her clinical duties. Sometimes new parents have to be taught things as elementary as changing a diaper or taking their infant's temperature. She also encourages parents to visit their babies daily in ICU, give the infants baths, take photographs with siblings and, when possible, to do skin-to-skin "kangaroo care" touching with the newborn.

"We do that as soon as we can [kangaroo care] because it's wonderful for the baby and the mother," said Vanders, who doesn't complain about the extra time it takes to move tubes and attachments so the parents can have a quality experience.

A co-worker who nominated Vanders for the Nursing Excellence Award described her as dedicated, hardworking and extremely caring with an infectious, positive attitude. "[She] is very affectionate and loving with the babies she takes care of. They get lots of hugs and kisses." She's also had to be a grief counselor and a source of comfort and information for parents whose premature infants die.

"It's not easy and it's particularly difficult when you're losing a baby, or know a baby is not going to be a normal child," Vanders said. "This is why you have to get involved with the parents and teach them everything you can."

Vanders works three 12-hour shifts a week and said she'll remain on the job for a couple more years because it's so enjoyable to her. One of her greatest joys is helping parents who are frightened and confused to understand the procedures and get through the experience of having a baby in the NICU. "There [are] lots of decisions nurses have to make, and experience helps," Vanders said. "Every baby is different and, let me tell you, every parent is different."

There are always new challenges in the rapidly changing specialty of neonatal care, Vanders said, a recent change being the installation of a different system to ventilate babies. The nurses now use CPAPs-little prongs put in the nose to deliver air or oxygen-which isn't as damaging to the lungs as ventilating machines. "The outcomes are better and babies are going home a little sooner," Vanders said.

Vanders said grateful parents often return with their babies months after leaving the NICU to show her how well the child is progressing. She also has a refrigerator plastered with pictures of youngsters she treated as preemies, along with notes of gratitude from mothers and fathers who have lovingly referred to her as "aunty," and "grandma."

"I've even been invited to birthday parties," said Vanders, who's received so many notes and cards that she's had to store them in a big box in her basement. One of the notes she has sums it up best. It reads: I would like to thank you so much for all the love and attention ... you are an angel.