Tuesday, January 3, 2012
Here are some preemie mom thoughts – if you have something to add please leave it in the comments. NICU nurses often lurk on preemie pages to hear what we’re saying about them so they can improve.

What Would You Say to NICU Nurses? Preemie Moms Respond...

If you don't like working with babies, please find another job!

Please keep your personal opinions about our babies to yourself.. if a neurologist can not confirm that my baby will have CP or anything else wrong, please keep your opinions to yourself.

To the nurses who care about their babies & their parents.. THANK YOU!

Something I loved about one of our NICU nurses... we were working on bottle feeds with DS, he had not been able to drink a whole bottle despite our efforts. Probably the third day we tried his nurse sat down with me and politely said, "Can I show you how we feed the babies?" And waited for my answer before taking DS out of my arms. She showed me a technique I would have never thought of (I've fed babies before, usually in the crook of my arm cradling them, not sitting up with my hand on their chin, etc.) She then handed him back and helped me get positioned. Then it got even better, he took all 2 ounces! The nurse stood up and announced to all the nurses "B just drank his first whole bottle" and they all applauded, I melted. Talk about making a major moment for us. It really is the little things that count.

Making a parent feel like their child is the most important baby you are caring for (let's say if you are assigned to more then one) is the best thing you can do for a NICU parent. Remember the compassion and why you do what you do...We had one or two nurses who just didn't have time do care for our babies the way they should have been cared for, or so they acted. I actually had a nurse tell me via phone, "I tried bottle feeding him but he was pokey so I just didn't want to bother, I poured the rest down his tube."

I had a NICU nurse that always fed LO early. It made me so sad when I'd walk into the room all excited to feed my baby and she'd already be feeding in the nurse's arm. She never even offered to let me finish the feedings. I *hated* when she was our daytime nurse.

I loved when the nurse would offer suggestions when she saw one of us struggling. She always made sure to not make it unwanted or unnecessary advice...I think her timing and tact were fantastic.

My favorite nurses were the ones who didn't make me feel like I was a bother when I wanted to breastfeed.

And finally, while I don't mine chit chatting, I did not come down here to entertain you all day. I am here to be with my child.

This. Holy hell I hated when I called to ask her schedule or left for a little bit and they'd feed her early. Not because she was crying or hungry but because they had other babies to care for and needed to fit it all in.

Most parents know exactly how many minutes/hours/care times each day they spend in the NICU. Nurses telling me I spent too little time or too much time there was always hurtful.

Let the parents help as much as possible during care times. Dont assume we dont want to.

My daughter coded several times while in the NICU. The 2 times I remeber were the worst and the best handled by the nurses. One nurse totally ignored me and lost her cool in front of me. The other was really calm and communicated with me and talked to me while getting my daughter stable. Suprisingly the one who lost her cool was a seasoned nurse and calm and collected nurse's 1st code was my daughter.

Our NICU nurses were amazing for the most part. We were very happy with the care our daughter received. My worst experience with a nurse was this: I exclusively pumped because my daughter wouldn't breastfeed (at first she had a feeding tube and was too young, as she got older she just had no interest). I was also struggling with low production. I was pumping bedside one day when a nurse said to me "That's all your getting?". This comment was extremely hurtful as I already had major guilt at not being able to produce enough for all her feedings. When I recounted this episode to my husband, I burst into tears.

Besides this experience, I thought the nurses were amazing, although it annoyed me when a new nurse would speak to me as if it were my first day there, which I found condescending.

Treat the parents like they are the expert on their baby, not you. Yes, you may have the medical expertise. But, you don't have the "mommy or daddy sense" that the parent does.

Also, be the person who stands in front of "the bus" and voices concerns to the neos and nnps that parents are to afraid to bring up. You will probably be talking to the parents more than anyone. If the neos or nnps are doing things you know are upsetting the parents, ask them to explain it better to the parents or speak up and see if there is another route that can be taken. Let the neos and nnps know the concerns the parents are having. It isn't always easy to 1) see the neos on rounds or 2) speak up.

All of this, but especially the bolded part [Treat the parents like they are the expert on their baby, not you. Yes, you may have the medical expertise. But, you don't have the "mommy or daddy sense" that the parent does.]. If Z was having a tough day, we would usually not kangaroo with him. We learned that he did worse when he was held if he was already in a touchy mood.

On the day of his first eye exam, he'd also just been moved back to the CPAP from the canula. He was having a tough day. The nurse offered to let me hold him, and, at first, I refused because I knew he needed rest. She pushed me a bit, and he had the worst apnea spell ever. He almost had to be bagged. It was terrifying. I still feel a bit of guilt about it - if I'd listened to my instincts, he wouldn't have had that spell. The nurse should have respected my opinion when I told her I didn't think it was a good idea.

We had one nurse that we loved in particular, and she always always always listened to what we thought needed to be done in terms of holding our son. If he was having a rough day, she always understood that we didn't necessarily want to make it worse by holding him. This same nurse also was willing to be the "bad guy" in a tough family situation we were having. That was awesome. Having the nurses stand up for you and your baby was much appreciated, even if it was outside of her normal duties.

I also agree with the thoughts about how important it is to have a caring nurse when it comes to feeding. I remember one nurse in particular who tried to rush my son through a bottle feed. The rule was that if he had 2 bradies during a feeeding, it went down his tube. Most of the nurses were very careful with the pacing to avoid a brady, but she just rushed through it. He bradied a couple of times very quickly, and it was like, "Well, that's the end of that! Down the tube." It broke my heart.

As my LO got older, it made me happy when I came in and LO was being held. I realize this is probably last on their to-do-list, but it's nice to see them gettin' some lovin' when they are in the hospital

We loved the nurses who saw Henry as an individual and got to know him and us. ITA with pp that treating the parents like the experts they are is key, esp. in the feeder grower stage. I loved it when they asked me what he liked and how he did with certain things. I also liked it when they realized that chit chatting about random things helped me pass the time. Sometimes the silence was deafening!

Some "pointers": When parents call for updates remember that they are unnaturally separated from their LOs and every details DOES matter ( I hated it when I called at 2am and all they could say was "nothing much happening, you should be sleeping!"). My favorite nurses told me the funny positions he was in and the cute facial expressions he was making.

Remember that parents notice everything going on around them. If you handle another baby a little too roughly, let it cry too long, or complain about another set of parents, we assume you'll be doing the same thing when we leave our LO.

Esp. early on, every chance we get to touch our LOs and care for them is monumentous. Don't rush to "get things done" before we get there- save that dirty diaper, temp, or repositioning for us to do! Also I loved it when the nurses asked us to do these things and made it a given that we wanted to/were going to hold our LO as much as possible without us having to ask!

Finally talk to the parents of your primaries about their preferences for painful procedures. I liked to be there because I could offer some comfort by hand cradling or giving sweet ease. It would burn me up when he seemed to get stuck every time I left for a minute to grab food or go to the bathroom. It felt like they didn't want me to watch- like they weren't good at it or it made them nervous.

I pretty much agree with everything the PP have said.

I liked the nurses who took initiative to go beyond their job. eg. (1) calling us when he did something cute, finished two whole bottles in a row etc. (2) asked me which of his clothes were my favourite so that if they had to change him when I wasn't there they would put him in something cute. (3) one morning I came in and the night nurse cleaned out his whole cupboard and organzied and folded all of clothes instead of reading a magazine when she wasn't busy.

Know that I'm the mom and while I respect that this is your job, it's my CHILD. Please help me and let me parent her. I have had issues with some nurses doing things without me ahead of her schedules times and while it may just be a diaper change to you, it is one of the few things I can do for my baby.

Explain things! I consider myself a reasonably smart person, and I'd have to play context clues to figure out the jargon. I appreciate it so much when nurses answer my questions. I ask for updates and specific questions every time I call and visit. I shouldn't find out that she's coming off a med 5 days after you started it.

Whew, lol that sounded quite vent-like. Overall, we've had a great experience with our NICU drs and nurses, but these are the things that irk me.

It makes me feel absolutely wonderful when I hear that a nurse called when she was off to check on Layla. It helps to know that people care. :)

This is tough for me, because I have half a preemie/NICU mom brain and half a nurse brain ;)

The biggest thing to me is when they include us. Including us in rounds, daily care, feeding, ANYTHING, means so much to us. When my daughter was first born, I was on a Mag drip and couldn't see her for two days. When she had been in the NICU about 3 hours and had been stabilized and intubated, my husband got to see her. He was obviously very upset and terrified and our nurse, who we LOVE and is one of our primaries and is having surgery tomorrow and won't be back before we go *sob*, let him take her temperature. Such a small, menial task in a normal world, but my husband said he will NEVER forget her for being so kind and patient with him in such a scary situation. Makes me tear up just typing it!

I also love that her primaries text & call each other to update each other on her. I heard all three of them were in a training class last week and one said, "uhh who's taking care of our baby?" LOL I know some parents don't like when the nurses refer to the babies as "my baby", but to me, as a nurse, that just means that I am taking ownership of what happens during my 12 hours. When I'm working, I am 100% invested in my patients!

Talk to my baby and talk to the other babies. Don't just silently go through the motions with your care. I think it's important to tell the babies how good they are doing, how great they look, how cute they are- all the things that mommy and daddy would say if they were there.

There is so much but I can't think of it all right now. So I will contribute a DO and a DON'T DO:

1. Please DON'T hesitate when I ask to hold my child (when he is stable enough to be held of course). I had a few nurses hesitate in the beginning, like they didn't want the extra work. Most nurses are great with this though bc they see the importance of bonding.

2. DO take the time to teach parents. There is one nurse who always calls us for bathtime and the first time or two she really guided us and explained how she does things (of course saying that we can choose to do it her way or find our own way). She gave us wonderful suggestions that really made bath time easier. And most importantly she took the time with us to teach. She didn't rush us or seem impatient.

Ditto this [spain116: Talk to my baby and talk to the other babies. Don't just silently go through the motions with your care. I think it's important to tell the babies how good they are doing, how great they look, how cute they are- all the things that mommy and daddy would say if they were there.].

And approach the baby gently and with a quiet voice. Don't be rough with her, respect her space and tell her what's happening next, even if it seems like the baby doesn't understand. Don't speak loudly around the incubator and laugh with your friends. Especially for tiny babies, keep the lights dim when possible.

For me... something that was especially important was for the nurse to remember that although this is her 1 billionth blood transfusion/PICC line/Desat/Brady/Apnea/Choking episode/Intubation/CPAP/Cannula etc. etc. etc. It is most likely our first (of maybe many) and it is OUR baby that it is happening to. So don't be so non-chalant about it. Tell us what is happening and why. Explain that this is good for the baby because it is what they need right now. Hug us if we want or let us cry if we want.

Also, as PP said, there was nothing I liked more than to call or arrive to see that my son was being held/carried/cared for by a nurse and not just during a diaper change/temp check/feeding. One day I showed up and my son wasn't in his crib and I couldn't see him in the room, until a nurse turned around and she was holding him at the table as she did her notes. Another time I called and the nurse on the line was like "he is doing great, so-and-so is dancing around the room with him and singing" I said, in a panic, "if he is off the monitors, how do you know he is ok?" But the nurse assured me that they "know" him and he was fine... and he was! (He was much older at this point tho!).


I shouldn't be learning about how to take care of my newborn in NICU through message boards and websites. Please take the time to be sure another nurse has gone over things we can do - like laundry, baths, decorating the incubator, etc. I was so grateful when one of my nurses told me I was allowed to change his diaper! I'm still not tired of it. Sadly, I only learned that I could have been taking his temperature, too, after reading these responses nine months later.

List compiled by Stephanie of Urban Flowerpot


Nicolle86 said...

there is so much that I would like to add to this but one thing I noticed about one nurse when my oldest was in the NICU was that she didnt care or seem to care about the parents of the babies. I was diagnosed with PPD and had gotten to the point that even with therapy I couldnt stand to go to the hospital to see my son. This one nurse apparently didnt care or didnt notice because she called me one day and threatened me, told me if I didnt start coming in that she would call CPS and have me son removed from me care. Needless to say i was in tears for hours after that and my fiance went to the NICU right after that and chewed her ass about it in front of the charge nurse and she was then told by the charge nurse to apologize to me. After that she was super nice to me.

Nurses need to know that the babies arent the only ones they need to care for, the parents need care too and support. Its a hard road to go down when your child is in the hospital and you leave every night without them.

Other then that one nurse every nurse that I have dealt with pertaining to both of my sons being in the NICU I would say were the best.

Mab said...

My NICU nurse took a picture of T when he first figured out how to suck his thumb. That picture is a prized possession. I never forgot that she thought of us and wanted to make sure we saw that moment.

Macee Josserand said...

Our NICU nurses were amazing for the most part. My favorite nurses took the time to teach me things, talk to me, and allowed me to help in every way I possibly could. I was able to stay with my daughter in the NICU, but my husband had to go home over 2 hours away to work during the week. We were fortunate enough to have an AngelEye camera on our daughter's incubator so my husband was able to see her by computer anytime of day or night. Some of the nurses made it a point to include Daddy in the daily care by leaving cute little notes telling something cute or silly she did or saving weigh in time (our fav time of the day) until Daddy got off work so he could watch too. Our NICU was very family centered so most of the nurses took time to care for our well being also. The little things mean a lot.

Even though most were wonderful, a few did get on my bad side and were on my do-not-touch-my-baby list. One absolutely would NOT listen to me. When I tell you that my 3 week old, 29 wk adj, baby cannot have the pacifier because it disrupts her breathing...or that my baby have trouble breathing when positioned on her right side....listen to me! That nurse would put the paci in her mouth behind my back and before you know it she's had another deep brady. My husband and I went to eat that same day, came back and after I told her not to put her on her right side because she can't breathe well in that position, my daughter was on her right side. While we were gone she had several episodes, one requiring stimulation. As soon as the nurse left the room, I repositioned my daughter (I hadn't ever done it before then!) then went straight to the charge nurse to complain and request a different nurse. So LISTEN to the parents, especially if the parent has been there every single day, all day long...and it's your first time with their child. That was my biggest pet peeve with the nurses I didn't like...they wouldn't listen to me.

Dissatisfied customer said...

I love this post because as a NICU nurse who likes to reflect on her practice it's extremely valuable to get feedback from parents as far as what made their stay in the NICU easier or harder. This post will give me endless things to think about in the way I practice and interact with parents. Which gave me the thought of maybe offering some helpful hints to NICU parents things NICU nurses might love to have their input on.

For starters please let us know if you want to change diapers, take temperatures, touch, contain, and hold your baby. Sometimes asking is the first thing out of my mouth and sometimes I don't ask because I'm getting the I'm too scared vibe from you and I don't want to upset you or make you feel ackward by asking only to have you turn me down. (I've been told by some parents they hated being asked if they wanted to change a diaper or take a temperature because they weren't ready to and then they felt guilty for saying no, and I've had some parents say they hated not being asked. Let us know where you are at with this is so helpful!). So by letting me know upfront I like to x,y,z it's great to know what you like to do so I can leave those things for you or we can do them together. If you are struggling with PTSD or just having an especially hard time visiting and aren't visiting because you're struggling please let us know. .

Also, let your nurse know your plan for the day. Knowing ahead of time (whenever possible) when you're going to be at the hospital is immensely helpful. That way I know to not thaw that precious breastmilk if you're planning on being there to breastfeed, or to let the docs know when to be at the bedside to talk to you, or to know to not change the babies schedule around.

If I'm in with another baby that is probably not the best time to ask me how much your baby weighs today. I am more than happy to answer that question for you but in that moment I like to give my love and attention to the baby I am interating with. Its likely that I don't have that days weights committed to memory and to stop my cares, put down a baby and go look that information up is extremely disruptive.

If I act like it's no big deal that your infant is going back on a nasal cannula, or didn't bottle feed as much as usual, or has a diaper rash it's not because I'm heartless or don't care it's because every NICU baby has a thousand little bumps in the road and I hate to see parents struggle over the many thousand minor and temporary setbacks that are inheritant in any NICU stay. And while this is no excuse, we do develop thick skin as NICU nurses, and having a parent lose it over a fairly typical infant issue such as a small diaper rash is exhausting and energy zapping for us. While I totally understand where that concern is coming from and it is your right to make it as big of a deal as you want to, just know that if we're not acting like it's a five alarm fire on our end it's because we're doing a little self-preservation because if every diaper rash was a huge, big deal to us as nurses we wouldn't be able to get through a day at our jobs.

Please don't make us babysit the siblings of your baby when they come to visit. I know how challenging it is to keep a toddler or child occupied while you pump at the bedside or hold your NICU baby. But please don't bring your other kids to the bedside and just expect us to take on care for them as well. Please and thank you!

Finally, know that we feel honored that you entrust us with your precious baby and that above all we want the very best for your little one.

Shelley Stiansen said...

I hated when we had a certain night nurse who would tell me what they liked when she played with them. It made me feel like she knew them better than me. She was a new nurse and I'm guessing she has learned how that hurts the moms as she has more experience.

Jillien said...

I am a NICU nurse and I appreciate the comments because I use them to improve my own practice. I have been in the NICU for 15 years now and was a NICU parent to twins. I know what it's like to be on both sides. I have started a blog to help parents with babies in the NICU and would love to help anyone with questions or concerns. Check it out! www.nutnbutlove4mykids.com

Robert McMillin said...

September is Neonatal Intensive Care Awareness Month and Jackson Chance Foundation is honoring #NICU nurses with the 1st Annual #OwlGive Awards. Help us say THANK YOU to these super-humans by spreading the word to the community. The recipient of the award wins an all-expense paid vacation. Nominations can be submitted through the month of September at jacksonchance.org/owlgiveaward. #NICUAwareness #OwlGive #JacksonChance #Nurses

victoria eden said...

Thank you for sharing. Its informative and full of information.
Medical Careers

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