“My husband has never been comfortable asking for directions or help of any kind. But even he has to admit that the support staff who guided us through our NICU stay were necessary and important for a good experience.”
It takes a village to raise a child, and in the NICU, a “village” supports the medical team, nursing team, and your baby. Again, each NICU may have some or all of these team members, and not every baby will require the services of every one of these team members.
If your baby needs help breathing, a respiratory therapist, also known as a respiratory care practitioner, will help manage the appropriate equipment and associated monitoring devices. Some respiratory therapists are trained in endotracheal intubation and may also draw blood to obtain a blood gas from your baby.
The nutritional aspects of your baby’s care may be supported by a pediatric or neonatal nutritionist who will help optimize your baby’s growth and development and may recommend specific additives for your baby’s breast milk or formula.
Breastfeeding support may be provided by lactation specialists, or by lactation nurses or doctors who have specialized training within your NICU. The lactation specialist manages complex problems of breastfeeding mothers and babies.
Infant Developmental Specialist
Infant development specialists are individuals with training who work with the NICU team to assess your baby’s development. These services may be provided by a variety of people, all ensuring that your baby’s environment in the NICU and after discharge is optimal for his or her development.
Pediatric/Family Clinical Psychologist
Clinical psychologists may also be available in your NICU to help the team provide support to you. These specialists focus on supporting parents as they develop relationships with their infants and with the NICU staff.
A social worker in the NICU will help coordinate a myriad of services including your own support structure, financial and insurance arrangement, and even housing and transportation needs.
Your unit may also have a parent educator, usually a nurse, who provides information and instruction for NICU families. This education is usually offered in a group setting, such as through scheduled classes.
A pharmacist with specific training in neonatal drugs and doses helps ensure the safety of medications and IV nutrition used to treat your baby.
Occupational, physical, and speech therapists all have special skills to help foster your baby’s neurologic and physical development. These therapists may help with establishing a nipple-feeding program for your baby and may also recommend a range of exercises and stretches for your baby.
Case Manager/Discharge Planner
Some NICUs use the services of a case manager or discharge planner who may follow your baby’s hospital course and ensures that orderly progress is being made toward discharge. Either of these people may also help arrange for your baby’s transfer to a NICU closer to home.
Medical Students/Nursing Students
If your baby’s NICU is part of an academic medical center, medical students and nursing students may also be present in the unit. These students are not yet physicians or RNs but have typically completed all of their core medical or nursing training. Medical and nursing students are closely supervised while working in the NICU.
Your NICU may also have a chaplain or spiritual representative from a specific religion. If one is not present in the NICU, you can often request a member of your religious affiliation to visit the NICU. The chaplain’s role is not to convince you to believe or practice religion in any particular way, but rather to help you use any spiritual resources comfortable for you.
Many NICUs participate in research projects to improve the quality of care for babies or to better understand and treat the diseases of newborns. To help facilitate these research projects, your NICU may have one or more clinical investigators (nurses and/or physicians) present who can discuss whether your baby might be eligible to participate in one of these research projects. Rest assured that your choice to participate or not participate in any research will not change the quality of your baby’s care or the devotion of the team in providing that care.
Your NICU may have a team of parents, some of whom are still in the unit and others of whom have gone home with their babies, who serve as a resource to newer parents in the NICU. These “veteran” parent groups do not provide any care for your baby; rather, they help provide care for you. Referred to as family or parent support groups, parent-to-parent providers, or peer advocates, these parents have “been there” and know the details specific to your unit. Your unit may also participate in the March of Dimes NICU Family Support Program. Whatever the name of these parents in your NICU, they can provide a listening ear, validate your experiences, provide suggestions on who can best answer your questions, and remind you that you are not “in this” alone.
When you enter the NICU, you are greeted by the unit clerk who handles the flow of people, paper, and information into and out of the NICU. This person may be identified by other titles, such as unit secretary, patient services coordinator, or health unit coordinator.
Your hospital’s financial counselor can answer questions concerning your hospital bill, help you submit your bill to the appropriate agencies for payment, and set up a payment plan if you are responsible for any portion of the bill.
Simulation Center Staff
Your NICU or hospital may have a simulation center where both care team members and parents can undergo simulated experiences with mannequin babies to improve care and learn necessary skills for taking care of the baby after discharge. You may learn specialized care techniques for your baby in one of these simulation centers or simply have a chance to practice CPR or rescue breathing as part of routine first aid training. If your NICU has a simulation center, you may meet a simulation center coordinator or coach sometime during your baby’s hospitalization.
Still More People
Other personnel in the NICU may include laboratory technicians (trained to obtain blood samples); x-ray technicians; ultrasound technicians; patient care associates who help keep bedside supplies stocked; and others, including housekeepers. Sometimes staff members are cross-trained; in addition to their specialty role, they can help perform unit duties such as taking routine vital signs, administering uncomplicated feedings, and transporting patients to different areas of the hospital. Whether providing direct care or mopping the floor, all hospital personnel provide vital services for your baby’s care.