Karen Zanezzi lay on the ground as co-workers kneeled around her, talking loudly as they hurriedly taped a straw in her mouth, taped her arms down, checked her heartbeat and turned her over.

One word came to her mind: "Invasive."

Now the registered nurse and her co-workers at the University of Utah's neonatal intensive care unit know what their defenseless patients experience -- and they pledged to do better.

The group was part of a "Preemie for a Day" training, sponsored by the March of Dimes, to help the U.'s NICU staff continue to improve care of their premature charges. The goal, essentially, is to make the NICU more womb-like to support the preemies' development.

Medical care has advanced enough to save extremely premature babies -- the U. cares for them as young as 23 weeks (40 weeks is full term). Now, the profession is focusing on enhancing their quality of life.

"It's just not enough to save the babies," said Kay Johnson, who led the training as clinical education coordinator for Children's Medical Ventures. It manufactures products such as diapers, monitors and positioning aids for premature babies.

Some 50 U. employees, mostly registered nurses, participated Thursday. The group experienced what it was like being admitted to the NICU after birth -- another participant described it as "terrifying" -- and trying to drink out of a bottle. They played with Play-Doh, meant to approximate the malleable fetal brain that they permanently alter through their care.

"We need to be quieter. We need to be more gentle. We need to slow down," said Lynne Lawler, a registered nurse who "admitted" Zanezzi.

In the womb, babies are curled up, warm and accustomed to the soothing sounds of their mother's heartbeat. Thursday's volunteer "babies" experienced that by laying on a yoga mat in a quiet room while listening to a recorded heartbeat.

Premature babies are then shoved into the technological world of the hospital; their birth is akin to how a trauma patient is treated. The group in training turned on the lights and crowded around their "patients," mimicking what they would do while taking their blood pressure and length and head measurements and inserting IVs and a respirator.

They said the noise and rough treatment was pretty typical in a real NICU.

But since premature babies' nervous systems are undeveloped, they aren't ready for the stress and stimulation. Studies have shown the NICU environment -- the bright lights, loud sounds and frequent prodding -- may alter brain function and brain structure.

It can cause sensory dysfunction, where children are easily distracted and have difficulty calming themselves down, are sensitive to noise, light, touch and movement, and sometimes can barely tolerate eating.

Johnson recalled children who would gag if food touched their face, who couldn't stand to touch sand, who only wore clothes straight from the dryer.

Rachel Hixson can relate. Her now 8-year-old daughter, Annie, was born at 23 weeks and is legally blind and is developmentally delayed. But her biggest challenge is sensory dysfunction, which Hixson attributes to time in the NICU.

"That's the price she paid to live," said Hixson, who is a March of Dimes parent advocate at the U.'s NICU. "This training reduces that cost on babies."

She said the U. has already vastly improved: Lighting is indirect, carpet muffles noise, rooms are smaller and new beds are more cocoon-like.

But even the nurses said there is room to improve. They learned tips like letting babies brace their feet on a blanket as soon as possible, placing a warm hand on top of their head to calm them, paying attention to their feeding cues instead of the clock.

Zanezzi's takeaway idea: "Just taking a deep breath and really focusing on how the patient feels."

hmay@sltrib.com