To some parents, one of the most confusing parts of being in the neonatal intensive care unit (NICU) is figuring out who’s who. Doctors, nurses, specialists, technicians and therapists can all make up the team of professionals caring for your baby – a group sometimes referred to as your “care team”. The number and types of people you deal with will probably be even greater if your baby is hospitalized at a university or teaching hospital.
The following is a brief overview of the different types of caregivers who may be involved in your baby’s care while they are in the NICU:
Neonatologists – Experienced physicians who have received specialized training in caring for critically ill and premature newborns. Your neonatologist supervises any doctors in training who are helping to care for your baby, and usually have the ultimate say in plans for your baby’s treatment and discharge. The neonatologist may also be called the “attending.”
Fellows - Doctors who have completed their residency, and have gone on to get more specialized training. Usually these will be neonatology fellows, but depending on your baby’s condition, you may meet fellows from other specialties too.
Resident Physicians (“Residents” and Interns) - New doctors, who have finished medical school and are now receiving on the job training in their chosen area of medicine, like pediatrics. Interns are doctors in the first year of their residency training.
Medical Students and Sub-Interns – In teaching hospitals, medical students can be usually be identified by their short white coats. It might sound scary at first, but having a medical student caring for your baby has its benefits because they usually have fewer patients, and more time to spend listening to your concerns and trying to answer your questions.
Neonatal Nurse Practitioners (NNPs) - Specially trained registered nurses who care for ill and premature newborns. NNPs act in many of the same roles as neonatologists and fellows.
Nurses – Individuals responsible for feeding, comforting and bathing your baby when you are unable to, dispensing medication, changing IVs, managing monitors and equipment and measuring and recording your baby’s vital signs. Depending on the way your NICU is organized, your baby might be assigned a primary nurse, who will care for them most days that they are in the NICU. Your baby’s nurses are very important assets in their care, and important sources of information for you.
Physical Therapists – Therapists who provide exercises and treatments which help your baby’s muscle development.
Occupational Therapists – Therapists who work with you and your baby on developmentally appropriate activities. They will help your baby learn to calm themselves and regulate their response to things like touch, noise and lights, and can help you learn to hold, move and play with your baby in ways that are appropriate for them.
Speech Therapists - Therapists work with babies that have feeding or swallowing problems. They suggest exercises to train the mouth and improve your baby’s suck, and can suggest special food additives or special nipples or bottles for babies with certain kinds of feeding difficulties.
Respiratory Therapists – The people who maintain and manage equipment like ventilators and CPAP machines, suction your baby’s airway, obtain blood gasses (although this may also be done by your child’s nurse), assist with intubations and administer inhaled medications.
Lactation Consultants - Specially trained individuals who are available to help moms and babies succeed in pumping and storing milk and learning to breast feed.
The NICU is an overwhelming place. If you have any questions about your baby’s care, or the people giving it, just ask!
The information in this article is for educational purposes only. It is not meant to replace or supersede advice from your doctor. If you have concerns about your child’s health or well being, consult their doctor right away.
Authored by Kristie McNealy MD, founder of NICU 101. For reprint permission, or to publish on your site, contact Kristie.
Thanks for this Kristie! I know my first go at the NICU, it was very overwhelming. It also seemed like with the shifts, I would just get used to a nurse who had a couple long shifts, and then a new one would come in. I don't think I really got the team concept until the twins were in NICU.
It's also good for NICU parents to really get to know the NICU nurses, since much of their contact is with them. These women know a great deal about care of premature infants, and can offer a lot of advice.
One thing that you want to do is remember this. When your child is critical you get the best nurses on staff, then as they get better and grow you get less experienced or maybe the nurses that other parents have complained about. The thing is, is that the nurse's are your childs other Mommy until you leave the hospital, so you do have a choice. When you get the nurses you like ask them to chose your child on their next shift, then ask them who the best nurses are on the night shift and the shifts when they are gone. Get her to ask the other good nurses to take your child. I hate nothing worse then a nurse who like's to leave the room repeatedly to go and gossip with other nurses. Your best bet on one of these nurse's is NOT TO COMPLAIN, Wait to complain until you leave the hospital. Nurses are like sisters, they can talk about eachother but you had better not say a word, or you will be on the nurses po-po list. Just finagle your way into asking another nurse to ask for your childs room. I have seen people complain on a nurse and get stuck with her straight for two weeks. Personally their child was geting only adequate care with this nurse. Some nurse's may seem cranky or rude at times, but I could care less, If they are good at what they do and can give my child the best care. Talk to the nurse's and listen to their conversations. If you are in a hospital where you can complain and get another nurse, whitout any repercussion, then do it. Before you complain though, watch what is happening or going on with other parents who have complained. This may not seem like it could be true, BUT IT IS.
