Professionals at the University of San Francisco in San Francisco, CA. The author reports no

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1 Reflections What Keeps You Awake at Night? Candace (Candy) Campbell Candace (Candy) Campbell, DNP, is an assistant professor in the School of Nursing and Health Professionals at the University of San Francisco in San Francisco, CA. The author reports no conflicts of interest or relevant financial relationships. Address correspondence to: , AWHONN Have you ever thought you might like to do some research on a particular topic, but you don t have a graduate degree, so you think it is no use? I hope that after you read my story you will think again. It all began in On my first day working as a NICU nurse, my preceptor and I were en route to a cesarean birth. She grabbed a scale; if the poor little preemie didn t top 950 g, we could only offer lifesaving comfort care (i.e., a warmed isolette and warm blankets). Period.

2 But as the years passed, technology caught up pretty quickly, and by 1995 we were able to save preemies of 500 g! But something kept me awake at night. One day, there was an article in a syndicated newspaper that had parents really upset. It told of a study about the long-term outcomes for premature newborns. The study group included children born in the 1980s, and the news wasn t pretty. It said that those children usually didn t finish high school and that many were severely disabled, and it asked questions about the public health efficacy and ethics of offering any services to newborns weighing less than approximately 2,000 g at birth. Of course, in the NICU, we knew that the study was not a fair comparison to the results we were seeing in Still, we all were wondering: What really happens after these micropreemies go home? I remembered my high school journalism teacher, Mr. Mohne, and what he always taught us: Follow the question and see where it leads. His voice echoed in my mind as I pondered. I had this dream that if I could just convince one of my film producer friends to take the project, it would make a nifty documentary. One by one, they refused and told me, If this is your baby, then you should raise it. Well, that was not what I had in mind. It would mean going back to school to study film. I had all kinds of reasons why that was a ridiculous notion: I was working in the NICU full-time,

3 acting and writing on the side, and I was also a divorced mom and sole support of three children. There was NO WAY. But I couldn t shake Mr. Mohne s words. First, I searched the literature, but there wasn t much written yet on outcomes for extremely-lowbirth-weight infants. Then one day I attended a Western Regional AWHONN conference and met Dr. Robert Piecuch from the University of California San Francisco (UCSF). He was the director of developmental research and the pediatric follow-up clinic at UCSF, and his presentation was a real turning point for me. As we talked, he asked me why, since I already had a degree in communication and theater and was a writer, was I hesitant to go to film school. He thought it would be a natural next step. (Again, not what I wanted to hear.) But I bit the bullet and enrolled in film studies at the local college. After a semester, I realized I would soon need some equipment for which I had no money. Providentially, I was complaining about this to my coworker, Steve, who listened to my tale of woe and asked, Did you just tell me this because I have all the equipment you need, plus an editing suite? Eureka! Steve became my director of photography, and the actual project process began. Of course, there were many challenges I couldn t foresee. Steve had camera equipment, but he didn t have a professional-quality microphone. I landed a commercial acting gig, which provided the cash for a really good one. My project was too large for Steve s computer. Sigh. I needed an editing suite.

4 Providentially, again, I met a producer of PBS films. He remembered me because he also produced a series of films that I acted in for Lippincott. He cosigned on the project as my mentor, which qualified me for a Bay Area Video Coalition (BAVC) sponsorship and equipment grant, and put the project under their (501)3c nonprofit umbrella. Now, anyone who wanted to help fund the project would get a tax-deductible receipt. Sweet! I used my credit card, in faith, to purchase the editing suite, but had no money to pay it off. I showed some of the rough footage to a few friends and a representative from MedImmune (makers of palivizumab, which is used to treat extremely-low-birth-weight infants), and they wrote two grants to help fund it. As a computer novice, I struggled to learn the editing software. I didn t know what I didn't know! It took me over a year to create the 2-minute trailer. All the rough footage and the final film project had to be professionally transcribed (another expense I could not meet). Luckily, my distant cousin, a professional transcriptionist, revealed that she would complete it for free! I was getting the feeling that somebody up there wanted this film to be made. When the fine cut was (finally) finished, I began applying to film festivals. No luck. While reporting on the Cinequest film festival, I met a lady from the International Medical Media Film Competition, who encouraged me to enter in the category of Children s Health that year. Amazing. My first film won a prestigious award!

5 Award in hand, I thought securing distribution would be a piece of cake. Wrong again. I applied to every educational distributor I could find. Nothing but rejection. When Aquarius Media called, I expected to hear another rejection. Instead, I heard myself replying, What? You want a contract? And it will be distributed on four continents? I could hardly believe it. Maybe it was a good thing that my naiveté preceded my thought process, because following the question took 5 years. As a single mom with three teens, if someone had told me, This is going to cost you all your free time and money for about 5 years, I would have let the idea slide. People still ask if the film was my master s thesis. Nope. My master s thesis was the next question I followed. Now it s your turn: What question keeps you awake at night?

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