The Premature Baby's Health Care Team

Nurse holding preemie near isolette
Who makes up your premature baby’s health care team?

If your premature baby is being treated in the Neonatal Intensive Care Unit (NICU), she will be receiving care from a number of health care professionals. These are very skilled and caring people who are committed to family-centred care and respecting the individual needs of the premature baby and her family.

How do you tell who's who at the hospital?

It can be very difficult to tell by the clothes health care professionals wear what they do at the hospital. Many health care professionals wear scrubs or white coats, not just nurses and doctors. But all hospital staff are required to wear identification badges that include their name and their area of specialty. If you're not sure what somebody does, don't be afraid to ask them.

Neonatal transport teams

Some premature babies are born in community hospitals that cannot provide the required level of care for these babies. They are transferred to a hospital with the appropriate facilities by a transport team. The transport team generally includes at least two of the following people:

  • a transport physician: a physician with expertise in the emergency transport of premature babies
  • a transport nurse: a nurse with expertise in the emergency transport of premature babies
  • a respiratory therapist with expertise in the emergency transport of premature babies

The transport team stabilizes the premature baby for transport, and delivers neonatal intensive care to the baby during the transfer from the birth hospital to the NICU that can provide the appropriate level of care for the baby.

Medical and surgical teams

The health care professionals who will look after your child usually work in teams, like the medical and surgical teams. They generally include the following people:

  • neonatologist: a staff doctor who specializes in caring for premature and other newborn babies
  • neonatology fellow: a qualified paediatrician training to become a neonatologist
  • paediatric resident: a qualified doctor training to become a paediatrician
  • clinical nurse specialist/neonatal nurse practitioner (CNS/NNP): a registered nurse with advanced education in caring for premature and other newborn babies
  • paediatric surgeon: a staff surgeon who specializes in children’s surgery
  • paediatric surgery fellow or resident: a qualified doctor training to become a paediatric surgeon or a surgeon

There will also be a nursing team and, depending on the hospital, some sort of family support team. They generally include the following people:

Nursing team

  • registered nurse: a nurse who provides direct care to your premature baby at the bedside
  • clinical nurse specialist (CNS): a registered nurse who specializes in caring for premature and other newborn babies and their families
  • clinical support nurse: a registered nurse who assists nurses in caring for premature babies
  • team leader: a registered nurse who leads the team of nurses caring for premature babies
  • clinical leader: a registered nurse who coordinates daily activities in the NICU
  • child health services director: a professional responsible for the management of the NICU within the organizational structure of the hospital

Family support team

Many feelings and stresses can arise when your baby is in the NICU. Along with your premature baby’s problems, you may have trouble dealing with a complex hospital system. The family support team can help you to cope. They may include:

  • social worker: This is a specialist in counselling, therapy, and finding resources.
  • interpreter: This person helps families talk with health care professionals about the baby’s medical condition in their first language.
  • chaplain: Members of the chaplaincy, or spiritual care department, offer spiritual, pastoral, and sacramental care to patients, families, and staff.
  • discharge planning coordinator: This person helps you and your baby get ready to go home, or to transfer to another place from the hospital.
  • bioethics consultant: This specialist can help parents who have concerns about ethical or moral issues having to do with their premature baby’s care.
  • bereavement coordinator: This person provides support for parents who are losing, or have lost, a premature baby.
  • patient representative: This person acts as an advocate on behalf of parents.

If you would like to meet one of these team members, please tell your baby’s nurse. Other support people are also available if you need them.

Other people on the team

You will meet other health care professionals too. These team members ensure a smooth transition between your stay at the hospital and caring for your child at home:

  • respiratory therapist: This person provides oxygen and breathing support to premature babies who have breathing problems.
  • pharmacist: The pharmacist can answer questions about medicines.
  • dietitian: This person knows a lot about the nutrition of premature babies, and can make sure your baby is getting enough nutrition.
  • lactation consultant: This person may be involved in assisting a mother and her baby with breastfeeding.
  • physiotherapist: This person may be involved in assessing your baby’s activity level and how she is developing.
  • occupational therapist: This person also looks at your baby’s development and can help with any feeding issues.
  • speech and language therapist: This person has expertise in human communication and swallowing disorders.
  • geneticist and genetic counsellor: These specialists assess and counsel individuals and families who have a premature baby with a birth defect or genetic disorder.

What is your role on the team?

It is important for families to be a part of planning for how their children are cared for. If you have questions or concerns about your baby, please feel free to ask any member of the team. He or she will make sure you get an update, or will arrange for you to speak with a doctor or other suitable team member.

Andrew James, MBChB, MBI, FRACP, FRCPC

10/31/2009


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