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NICU Boot Camp - Navigating the NICU

Step 1 - Understand some of the basics of living with a baby in the NICU

Who is everyone

Your baby will probably have some or all of the following caregivers:

  • Neonatologist (NICU doctors - specialize in NICU babies)
  • NICU Nurses (Training = regular nursing school & nursing degree, with on the job NICU training. Many also have advanced degrees and certifications)
  • Respiratory Therapists (caregivers trained to assist with breathing - will manage ventilators, CPAP, cannulas and more)
  • Nutritionist (will coordinate care with neonatologist to be sure all nutritional requirements are optimized)
  • Social Worker (will assist with emotional support, financial support, and connecting families with available resources)
  • Physical Therapist 


Why do they keep changing?!?

Parents everywhere find themselves frustrated when the caregivers for their baby keeps changing. It's not uncommon to have a different nurse every day or 2. Why is this, and what can you do?

Why - Many nurses work 12 hour shifts, meaning that nurses working full-time will only be on the job 3 days a week - they can't be there every day. In addition, as you can imagine, each unit is comprised of a variety of nurses with different skill sets, so sometimes a nurse who was your baby's caregiver one day needs to be assigned to a different baby the next day because of some skills that nurse has in particular. 

What can you do?

Some hospitals have primary care nursing as their staffing model, which means babies are paired with a few main nurses, and those primary nurses will care for the same primary babies every day they're at work, as long as the baby is in the NICU. This is a wonderful model for parents, because of the consistency it provides. But it's challenging for NICUs to maintain this staffing, particularly if it's a smaller unit, because sometimes those nurses are needed elsewhere. 

If you find yourself with a case of new-nurse-every-day, speak up. Talk to the charge nurse to ask what can be done to improve the consistency of caregivers for your baby. 

But try to keep an open mind - the more new nurses you meet, the more new ways of doing things you'll experience. You may find that it's one of the new ones who teaches you a new way to feed

What if I don't like someone

Yes, you can fire a nurse. Let me explain. 

When a nurse caring for your baby is someone you don't particularly like, you may wonder if there's anything you can do. Absolutely! Whether it's a nurse that you just don't click with or a nurse you feel profoundly worried about, you can (& should) speak to the charge nurse of your NICU. 

You can't, in fact, have the nurse fired from the job, but you can ask that the particular nurse not take care of your baby any more. Unless it's an extremely small unit with no other options, most NICUs will try their hardest to honor those requests. 

If you're feeling guilty about speaking up, please don't. We nurses go through this all the time. The charge nurses hear requests like this all the time. There are two very good reasons to speak up:

1. You should not have any more stress than you have already. If a nurse is stressing you out, you owe it to yourself to ask not to have that nurse any more. 

2. The administration of the hospital should know about nurses who are causing families to be upset. If it's just a simple personality conflict, that nurse probably doesn't have a bunch of parents reporting. But if that nurse is genuinely inappropriate, genuinely rude or unskilled, the hospital DEFINITELY needs to know so they can take action.

How much time to spend At the NICU

This is a source of incredible stress for parents - how much time can they and should they spend with their baby? The answer depends on so many variables, it's nearly impossible to come up with an ideal answer. 

You should feel welcome to be with your baby as much as you like. You should also feel welcome to be away from your baby when you need to be. 

So it's your call. If your nurses seem to be trying to push you out, but you want to be there, let them know you hear them but you want to stay. If your nurses seem to be trying to make you feel guilty for not visiting enough, let them know you are doing what you need to do to balance your sanity and your other obligations. Even though they may seem to be pushing one way or the other, I guarantee you that you're not the first parent to do whatever it is you're doing. Their job is to care for the baby, and your job is to parent the baby, so they'll have to adapt to whatever it is you need to do.

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