Wrapped up a busy teaching year at Johns Hopkins in Baltimore, where they
have an amazing inpatient team that services infants and children from
neonates to children with burns to those admitted for psych issues. I had the opportunity to meet the staff and tour the pediatric wards. What a dynamic and well-integrated PT-OT-ST team!
Pediatric therapists from around the US joined me
and my colleague, Theresa for a dynamic 5 days of problem-solving,
learning and networking.
My colleague Theresa and I were pleased to welcome therapists from across the United States and Canada to our seminars in Dallas Texas. Children’s Medical Center has several campuses in the Dallas Metroplex and provides services for a wide range of infants and children. Our Children’s House and Specialty Clinics are unique and serve populations in need of specialized expertise in swallowing and feeding. We continue to be amazed by the critical thinking of the therapists we meet at our seminars. Problem-solving case studies and learning from each other provides opportunities for clinical growth and networking. We look forward to returning to Texas in October 2018 for our seminars in Austin!
Just returned from teaching at Blythedale Children’s Hospital in Valhalla, NY. What an amazing program and staff they have, servicing a wide range of children from post-NICU through school age, with multiple complex co-morbidities. The pediatric therapists attending included those from Barcelona Spain and Australia, and we all appreciated the opportunity to problem-solve our patients and service delivery across settings. The grounds are beautiful and covered with animal topiaries that greet the children and their families. My colleague Theresa and I enjoyed their hospitality and the opportunity to share our passion for helping children with feeding and swallowing problems, and their families. Here we are in front of the hospital.
Just returned from a wonderful week in Denver teaching at Colorado Children’s Hospital. What an amazing facility with a world class team. No wonder they continue to be in the Top Ten Children’s Hospitals in the country.
Those attending came from across the US and Canada. It is always such an opportunity for all of us to learn, when we can network with such a large group that reflects perspectives from many teams and cities.
A few pictures below of me with my colleague, fellow instructor and friend, Theresa Gager, at the entrance by their logo, on our arrival.
Denver was beautiful, especially the mountains and skies. Just being out side was refreshing, especially for me coming from hot humid Orlando !
We also could not resist this iron sculpture of rabbits with long ears so here we are having fun. Life is so short we have to have fun along the way at every opportunity.
June 2, 2015 by Catherine Shaker, MS/CCC-SLP, BCS-S
If you answered yes to any of the questions in my first post about wanting to work with acute care infants, then read this follow-up!
The NICU is an intensive care unit: Infants in the NICU are critically ill or were in the recent past. These most fragile patients can become physiologically unstable at any time—and it might happen during your therapy. The emotional roller coaster of NICU leaves families fragile, too.
It’s not easy to practice in the NICU environment: Quick and constant losses and triumphs cause emotions to run high. An infant’s status can change at any time. Caregivers are highly skilled and passionate, which sometimes leads to strong opinions and respectful disagreements. The SLP needs to thoughtfully collaborate, yet at times take a stand.
The NICU SLP requires advanced practice skills: It’s not just knowing what to do, but what not to do. We often support feeding/swallowing, so the risk for compromising an infant’s airway is significant. Essential skills include solid critical reflective thinking, the ability to complete a differential, and broad, multi-system knowledge about preterm development and swallowing/feeding. Your preparation should include solid experience with the birth-to-3 patients, as well as continuing education, mentorship and guided participation with many infants in both the newborn nursery and the NICU. The NICU is too demanding to be an initial independent placement after graduate school.
The NICU evidence base is rapidly evolving: Read, read, read as much professional neonatal literature as possible. Sources are not just within our field but also in medical, nursing and OT/PT journals. Our role is not only to understand the evidence base, but to bring it to the NICU team. Neonatologists and neonatal nurses will ask “why?” and we must be able to discuss the research-based evidence along with our clinical wisdom: For example, if you recommend changing from “volume-driven” to “infant-guided” feeding.
The NICU is rewarding: After almost 30 years working full time in the NICU, not a day goes by that I don’t learn something, make a difference in an infant’s life or experience the joy of a grateful “thank you!” from a family. The appreciation from nurses and neonatologists when an infant can now feed safely and, therefore, go home, makes your day. With such rewards, however, comes great responsibility. In our hands lies the potential to influence parent-infant relationships through positive neuro-protective feeding experiences that wire the brain toward feeding and build future connections.
If you are thinking about moving into NICU practice, you will find lots of information on my website. Stay tuned for more tips to guide your journey! Catherine S. Shaker, MS, CCC-SLP, BCS-S, works in acute care/inpatient pediatrics at Florida Hospital for Children in Orlando. She specializes in NICU services and has published in this practice area. She offers seminars on a variety of neonatal/pediatric swallowing/feeding topics across the country. Follow her at http://www.Shaker4SwallowingandFeeding.com or email her at firstname.lastname@example.org.
I am an official blogger for ASHA regarding infant feeding and swallowing and acute care pediatrics. Follow me there too!
Inaugural Recipients of the Pioneer in Neonatal Therapy Award
Pioneer in Neonatal Therapy Award – Inaugural Recipients (left to right)
Betty Hutchon, Lourdes Garcia Tormos, Kara Ann Waitzman, Lynn Wolf, John Chappel,
Chrysty Sturdivant, Robin Glass, Rosemarie Bigsby, Jane Sweeney, and Cathie Smith.
(Recipients not pictured: Elsie Vergara, Catherine Shaker and Jan Hunter)
The above recipients have worked for decades to advance our presence and purpose in the NICU and have contributed immensely to educating us all. It was past time to honor them.
You may be tempted to believe that they ‘have arrived’, that they are finished learning, that they no longer understand what it’s like to be you, your first year or 10th year in the NICU, trying to wrap your brain around all the knowledge you need to work there.
What you may not know is that these pioneers fully understand how much there is to learn. They stood on that stage at the NANT (National Association of Neonatal Therapists) Conference BECAUSE they never stopped learning and they never once assumed they had arrived. They have elevated the experience for patients and families (and for all of us) for decades. It is only because of their trailblazing efforts that NANT was a conceivable notion for me.
Once they were all present on stage, I turned and saw them smiling broadly ear to ear, truly grateful to be in each other’s presence. Funny thing was, I thought to myself, “Wow, this group is a reflection of the bookshelf in my office.” Articles, notes, books with many dog-eared pages, presentations – they have truly led the way for decades.
Pioneers: we cannot thank you enough for your dedication – fierce and enduring – to the babies and families we serve, and to the thousands of neonatal therapists all over the world for whom you have forged a path. Your immense contributions are deeply appreciated.
*For the sake of disclosure- just know that the Pioneers (both nominated and awarded) were submitted by a global international audience and chosen by NANT members. I nominated no one – the results are due to your input and enthusiasm in submitting your support for each pioneer.
Loss is difficult, loss of a job, a dream or someone you love.
Sadly, by the very nature of working in a hospital, we see heartache and sorrow on a daily basis. Yes, in the NICU there are struggles about feeding, what nipples to use, getting everyone on the same page. But sometimes, we are all on the same page. Our volunteer musician and greeter for our Children’s Hospital wrote the following:
I strolled through the Neonatal ICU and noticed the mood was somber, actually it was just plain sad. One of the nurses told me her little preemie patient had just died. The nurses were struggling, as they continued their work, they weren’t able to take time to grieve; yet their hearts were hurting.
Music is healing for me so I took out my ukulele and began singing, “Somewhere Over the Rainbow.” As I started to sing, emotions poured out. I watched as the nurses hugged each other tight, tears in their eyes. I kept singing but watched in awe. These wonderful nurses had lost babies before and know the heartache they feel, every time, but they still open their hearts to each little life that comes their way.
No matter how raw the pain, the NICU team is a “family,” supporting each other in the times of joy and sadness. Without each other, the team would crumble in the rough times, but they don’t. Their bond of love and support keeps them strong.
Our staff should be applauded for their kindness and love but most of all for not losing their humanity in an industry that sees life come and go on a regular basis.
Its times like this that you feel honored to be a part of the NICU.