Question:

I’m getting more and more discouraged at the lack of support we get from nursing in our unit. I’ve had 2 families ‘defer’ OT multiple times in the past 2 weeks only to then be told that they feel the feeding team ‘hold babies back’ and we are the barrier to discharge. The wording and behavior is not something you would hear parents say so I can only think where they are getting this message.  These families are getting mixed messages and then there is mistrust which I worry causes further mistrust and lack of follow up on discharge. Any suggestions appreciated.

Catherine’s Answer:

Sadly, this is not uncommon. All we can do really is build relationships with families, with our nursing colleagues and neonatologists, learn along with our nursing colleagues via guided participation, have engaging conversations that reflect our respect for their contribution/perspective, share our key learnings in a collegial way, and always look for opportunities for cross-fertilization of knowledge.

Helping the parent or RN take the perspective of the infant, e.g., “mommy, please give have more time to breathe; I’m not quite ready to suck right now” then explaining how the infant communicated that important message (e.g., by what the caregiver saw, heard or felt), and the change in communication following the caregiver’s infant-guided intervention, always seem to change the conversation. It really is about the infant and so taking it back to that foundation helps others really understand that “every feeding experience matters”, as I like to say.

I have found over the years, in a large Level IV (160 beds) and as I teach across the country, that, like any other situation in life, we often cannot change others, but we can change how we respond and what we expect of ourselves along the way. I always say that life in the NICU is a journey not a destination. It requires us to pick ourselves up and dust ourselves off every day. Hang in there and focus on the good that you do, my friend.