September, the ninth month of the year, is NICU Awareness Month. NICUs care for babies born too soon, before nine months, to help them reach full term and live full lives.
NICU care requires the specialized training of many providers acting together as a team. A team is:
“A group of people with a full set of complementary skills required to complete a task, job, or project. Team members
- operate with a high degree of interdependence,
- share authority and responsibility for self-management,
- are accountable for the collective performance, and
- work toward a common goal and shared rewards.
A team becomes more than just a collection of people when a strong sense of mutual commitment creates synergy, thus generating performance greater than the sum of the performance of its individual members.” (italics mine)
Who is on the NICU team and what are their roles?
| Physicians (i.e. neonatology, GI, cardiology) | Medical decisions and oversight of implementation |
| Nurses | Patient care, parent education |
| Breastfeeding support | Help mothers breastfeed, pump, use donor milk, transition among these |
| Milk technicians | Prepare mom’s own milk, donor milk, formula, fortifier |
| Social workers | Support adjustment of families, counseling, connect to outside resources |
| Pharmacists | Prepare and deliver medications |
| Physical, respiratory, occupational therapists | Specific hands-on support for baby’s physical development |
| Dieticians | Support for baby’s nutritional development |
| Parents | Feeding, kangaroo care, observation, medical care and decisions |
In addition to specialized knowledge, the NICU team uses many mechanical, electronic, pharmaceutical, and human tools to support the babies and one another. For example:
- Medical knowledge and experience
- Medication, equipment, and procedures
- 24/7 oversight of the baby
- Kangaroo care
- Breastfeeding and human milk
- Talking, reading, holding, touching baby
- Knowledge of baby
- NICU and family ethical and cultural frames
- Patience
- Humor
- Self and one-another care
- Teaching/learning from one another
The Task of the NICU Team
The “task, job, or project” of the NICU team is twofold:
- Sending baby home safely: survival and successful discharge in the shortest time safely possible
- Laying the medical, social, and family groundwork for baby to grow up and become a full contributing member of the family and community—to live a full life.
To achieve these requires the knowledge and experience of both the professional, trained care providers and the parents. The NICU medical team has worked together for years, supporting one another and premature and sick babies. The setting, colleagues, and team members are familiar, comforting, and well understood. For parents, the NICU setting, providers, equipment, language, and culture are all unfamiliar and frightening at a time of great vulnerability. So why involve parents on the team? Staff can educate parents, keep them informed of baby’s progress, support breastfeeding, help them kangaroo for a couple of hours a day, and have detailed discharge and follow-up instructions.
Better Outcomes with Parent Involvement
Research has taught us that parent membership on the team results in shorter NICU stays and better long-term outcomes. They bring unique knowledge, experience, perspectives, and contributions to the NICU and their babies’ care. NICU providers have much to teach and learn from parents that will improve the care of their babies and babies to come.
Questions for NICUs and Parents
- For NICUs, what is your next step to bring parents fully onto the NICU team? What will it take to get there?
- For present and past NICU parents, how would you have wanted to be a full member of your baby’s NICU team? How can you make your voice heard for other parents?
In this ninth month of the year, we honor NICU providers everywhere. They save lives and ensure successful life outcomes every day. We celebrate their medical, human, and personal achievements in laying the groundwork for a full family and individual life for the babies in their care. We are so appreciative of their caring, step-wise, and thoughtful medical and human improvements to care, including parent membership on the NICU team.
Naomi Bar-Yam, PhD, ACSW, is available to speak at hospitals, community organizations, and conferences on the role of parents on the NICU team and many other topics. Visit her speaker profile on LactSpeak.
