When we Care for Little Angels at NICU

Family centered approach to care fosters positive relationship between the families and health care team in the Neonatal Intensive Care Unit (NICU). This type of approach affects the overall well being of families and their preterm infant especially during infant’s confinement. It allows for development of good rapport and trust between clients and the NICU health team. Family centered approach in NICU care considers a lot of factors. It has to include the families into the plan of care as well as in decision making for their infant.

A comprehensive assessment is needed to cover all corners of care. Assessment includes the physical, emotional, mental state, spiritual beliefs, social aspect, and culture. Know where the families come from as well as their life experiences. With the very large cultural diversity in the health care field, health care providers should offer care appropriate for such culture. We have to respect their culture, the way they live their lives. Health care team must be sensitive to various cultures but not limited to gender, sexual orientation, race, social class, and economic situations.  The health care team’s decision-making is contingent on family’s culture.

During the planning stage, you as a member of the health team must maximize the assessment data. Invite the family members during discussion.  Allow family members to give their suggestion, and opinion that they think appropriate for the infant in line with their beliefs, culture, and religion. The premature infants are only half of our patients and families are the other half. NICU nurses and the other members of the health team must act as what is expected from a prudent professional. Modesty and respect to each other must be maintained. Negotiation is very crucial in this stage wherein, the health professionals are trying to meet halfway not compromising the very need of the preterm infant. Indeed, planning must be a collaborative approach to caring for these young angels with essentials needs.

The composition of the health professionals is diverse from administration down to social works. The health care team not only includes nurses and physicians but also the social workers and administrators. The team shall meet monthly with the family members to discuss improvements in NICU care. This will surely apply to those premature infants wherein two to three months of confinement is expected. Modifications can be made in the NICU setting. Instead of treating family members as visitors, they can wear those gowns with print family/friends in front. In the bedside, we can have whiteboards wherein the family members can write their names and questions. We can ask them what they want us to call them not just “sir” or “ma’am”. The idea here is to have a family-friendly environment. An environment that is welcoming and open to conversation. Creating such environment, the NICU nurses must understand the experiences of families through orientation sessions speaking about their experiences with the infant at the NICU. Nurses must observe the principles of therapeutic communication. They must communicate clearly and frequently whether bad or good news and be very sensitive. Information makes unknown things known that lessens our anxiety or fear.

Family centered care nurture holistic development of the preterm infant as well as the family. It requires interdisciplinary collaboration that establishes multidisciplinary caregiving with common goals. The implementation promotes involvement of family members in the care of preterm infant right after delivery and most importantly long after discharge home. Thus, family centered care considers the preterm infant as a human being who develops physically, as well as psychologically and socially within a family ecology.

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Freslyn Lim

About Freslyn Lim

I am a Registered Nurse currently taking my PhD in Nursing. I earned my Masters in Nursing major in Nursing Administration in March 2011 and had my clinical experience as Staff Nurse in the ICU, Pediatrics and NICU. I am presently a nurse educator/clinical instructor.

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