The NICU offers many opportunities for teaching. As a RN in the NICU, teaching is involved in almost every aspect of care. It is also important to note that teaching in the NICU is reciprocal; nurses teach parents, parents teach nurses; NNP (neonatal nurse practitioners) teach nurses, nurses teach NNP’s, etc. Working in the university setting offers numerous experiences with teaching, even at times when you may least expect it!
I will discuss the teaching that occurs between nurses and families of patients in the NICU. To begin, if a child is born 29 weeks gestation of less, we implement the “minimal stimulation” protocol for seven days. This protocol was developed to reduce the risk of intraventricular hemorrhage (IVH) in this population. When a child is admitted and is placed on the protocol, we educate parents about the risks associated with IVH and why we are limiting potential stressors, such as light, sound, and touch. It is very difficult for parents to not be able to touch their child whenever they visit, but most parents want what is best for their child and respond very well to this protocol.
As a child progresses/deteriorates, education is continually provided. We discuss common issues such as patent ductus arteriosus (PDA’s), necrotizing enterocolitis (NEC), IVH, periventricular leukomalacia (PVL), hyperbilirubinemia, and many more. Many families have not experienced a child in the NICU; therefore many of the common things we see are completely foreign to parents. It is essential that we take the time to explain in detail and in a language that is acceptable to allow families to understand and express concerns associated with their child’s care/course.
Before being discharged from the NICU, our parents/caregivers must attend a discharge class. This class discusses the basic care of a child, such as bathing, feeds, diapering, etc. It briefly discusses developmental milestones and provides families with a handout. Finally, CPR is taught using video and demonstration. Parents/caregivers are required to perform the required steps in CPR on CPR doll as well as completion of a quiz. Other topics that are discussed in the discharge class include “back-to-sleep,” the period of PURPLE crying, RSV, car seats, and much more. If parents/caregivers are unable to attend a discharge class, the discharge instructions/demonstrations are performed at the child’s bedside before discharge. It is wonderful for parents to attend this class because at times it is very difficult to perform all of the necessary education at the bedside if the nurse has two other children to care for. It is very time consuming, which is why we continually remind our families to attend the discharge class! The discharge class is taught in English and Spanish due to our high diversity of patients.
As stated above, teaching occurs during every interaction in the NICU at the University of Utah. There is not a day that goes by that I do not learn something new or educate another individual. I believe this is one of the reasons that I absolutely love working in healthcare.
I do not believe that there is any nursing/health care provider role that does not involve teaching in some manner. We can all learn from each other and educate others in the process. In my opinion, if one believes that education is not necessary in the healthcare field, I believe they have chosen the wrong profession! Without the use of education, healthcare would not be where it is today, and it would not be able to grow.