Wednesday, August 15, 2012

Caring For NICU Parents

As RNs working in the Neonatal ICU, we are typically given a patient assignment ranging from 1 critically ill infant on a ventilator(s) to 3 to 4 "feeder/growers". Sometimes, depending on the babies involved, these assignments can be overwhelming and keep you running all night.

However, the baby is only one (large and important) part of our responsibility. Too often, care of the parents of our sick babies is neglected or considered unimportant. Still, one of the most common phrases you hear around the NICU is "A stressed parent leads to a stressed baby".

These parents are thrust into an environment that can be terrifying to them. They are scared for their baby. They likely don't understand what is happening with their child. The equipment, jargon, and noises are frightening. Often, they feel guilty for having their baby so early. Probably most importantly, they have had all control regarding their infant taken from them, and are dependent on strangers in scrubs to keep their baby alive and well. With the advent of Google, most modern parents will search the internet for information about their baby...and will find the worst-case-scenario which will just add to their stress and fears...and most likely doesn't even apply to their child. Lately, everyone's an instant expert.

The cliche about stress, above, happens to be true. And since it is, it only seems logical for caregivers to make an effort to alleviate as much of this stress as possible. It's an added task tossed on top of an already great list of things to do, problems to handle. But, it must be addressed.

Too many times in my NICU career, I've had parents of a 7 day old infant tell me that they haven't been given the chance to carry their baby, or Kangaroo Hold, or feed, or check a temperature, or even change a diaper. Not once in a week! Both the baby AND the parents need this contact!

There exists a multitude of excuses that we as caregivers use to try to get the parents out of the way. I've heard several recently, from parents:
  • The baby's temperature is low. 
  • I don't want to risk losing the IV by wrapping the baby and carrying him.
  • We just fed him, and he needs to sleep so he can digest the milk.
  • The baby's "sats" have been going up and down too much lately.

Unfortunately, it often comes down to the fact that the nurse is busy, there's too much going on, or just pure laziness that leads us to try to set the parents aside. We have another baby to feed, or a med to give, or the other baby is de-satting. Or, it's my break time. When we use equipment as an excuse, parents become intimidated and might be reticent to hold the kid later. They're already afraid of all the accoutrements we have attached to our patients.

I choose to believe that it's a minority of nurses that do these things. Involved parents are good for the health of the baby, and we all want the babies to become or remain healthy, so we're all certainly going to do everything possible to attain this goal.  Right?

Certainly, there will be times where we just can't oblige the parents when they want something. The NICU does become very hectic at times, and frankly...the parents can simply wait till their next visit to cuddle their angel. But we need to be sure we're not just putting them off because we see them as an imposition on our time.

So, my fellow NICU caregivers: Let's make a commitment to ourselves to help these parents get through the trauma of having a sick baby. Let's educate them, involve them in the care of their child, treat them with respect, and understand that they are as much our patient as is their baby.

Do it for the babies.



  1. Well said! -nuhuhno

  2. I am sure there are nurses that give what is required and nothing else.I am also sure they are few and far between.

    Even though I have never met you in person I can tell from our internet conversations you are a caring man, loving husband and devoted grandfather.

    Reading your Blog will give me insighta into the job you and other do to take care of the tiny premies. Although I will be sad for some of the parents I will enjoy learning more on the subject and hearing about success stories.

  3. Very true Tim! Good job on the blog... I haven't had time to follow through with mine!

  4. Thanks for taking the time to read and comment, ladies.

  5. Well done, from one of your former (parent) patients. lol

  6. Tim:

    I think this is very true! Families of sick patients are often neglected, not only in NICU, but in all other areas of the hospital. I strive to provide the best possible care for my patients and their families (however at times I can see that others are "too busy" to do so). I think its something that needs to be stressed to coworkers, administration, students, etc. Parents and family members also need to be aware of their rights and be educated in regards to their child.

    I think this is a great website and look forward to read more of what you have to say. I miss you!

    - Jill

  7. I miss you too, Jill! Thanks for reading and commenting. :)