A guide to the roles and responsibilities of the wonderful staff who take care of your baby in the NICU
When you step through the door of a neonatal intensive care unit, you enter a foreign country. This alphabetized guide will help acquaint you with the many experts who populate the NICU and who may look after your baby or help you.
For more information to help familiarize you with the NICU, be sure to click on the related guides that cover equipment, tests, and common problems.
Case manager/discharge coordinator: A professional who facilitates the discharge or transfer process to ensure that the baby's needs for care at home and/or in the step-down unit are met. This person also coordinates the ongoing communication between the hospital and the insurance provider regarding your baby's care.
Chaplain: A member of the clergy who is available at the hospital to help those struggling with illness issues. This person can assist you with the tough job of getting through your child's serious illness or hospitalization.
Early interventionists: A multidisciplinary team of people who specialize in education, developmental disabilities, and various therapy disciplines. This team of early interventionists is charged with providing services for children from birth to 3 years old who are at risk for developmental difficulties. They provide referrals, gather information, and participate in discharge planning. The EI team will be helping you and your infant at home after discharge, so in many cases they will start to get to know you during the hospitalization.
Medical specialists: Experts who, depending on your baby's difficulties, may be called in to evaluate a specific problem. Usually these individuals are trained in pediatrics and then in a particular area of expertise. Listed below are some of these doctors and their specialties.
- Behavioral and developmental specialist (often a pediatrician): behavior and development problems
- Cardiologist: heart problems
- Endocrinologist: gland and growth problems
- Gastroenterologist: bowel, liver, and digestion problems
- Hematologist: blood, bleeding, and certain immune-system disorders
- Infectious-disease specialist: complex infections
- Nephrologist: kidney problems
- Neurologist: brain problems (including seizures)
- Pulmonologist: lung and breathing problems
Neonatal nurse practitioner: A registered nurse who has advanced education (usually a master's degree) and certification in working with premature and sick newborns. The nurse practitioner works under the direction of the neonatologist and/or neonatology fellow, can perform many procedures, and helps direct your baby's care. Neonatal nurse practitioners are often in charge of continuing care and discharge planning for infants in the NICU.
Neonatologist: The doctor in charge of the NICU. He or she is a pediatrician (children's doctor) with advanced training in the care of sick newborns and usually has board certification in this area. There may be several neonatologists in the NICU because of the unit's 24-hour-a-day schedule.
Neonatology fellow: A fully trained and certified pediatrician who is receiving advanced training in the care of sick newborns. This doctor may direct the minute-to-minute work of the resident staff and report to the neonatologist in charge. A neonatology fellow may rotate to other hospitals or areas every four to eight weeks.
Occupational therapist, physical therapist: Health professionals who deal with the ways in which immaturity or illness affects behavior. The occupational therapist tries to improve functioning in the newborn with various interventions. The physical therapist looks at muscle tone, strength, and motor activities. Both offer valuable input about supportive care in the nursery and at home.
Pediatric resident: A doctor who is receiving training in pediatrics; he or she generally works three to six weeks in the NICU.
Registered nurse: A health professional who has passed a written examination after graduating from a college or hospital nursing program. Registered nurses in the NICU have experience in caring for sick newborns. These RNs are also known as neonatal nurses. In most units one nurse will be designated "primary" for your infant, meaning that he or she will be the nurse most responsible for your infant's care. Although many others will care for your infant at night, on the holidays, etc., the primary nurse will know your baby and you the best. Away from training centers, some neonatal nurses are qualified to do many procedures that are handled by residents and fellows in larger units.
Respiratory therapist: A health professional trained to use the medical equipment needed for babies with breathing problems. This therapist may be in charge of blood oxygenation tests and certain other procedures.
Social worker: A professional who helps you cope with the emotional and social aspects of your baby's NICU stay. The social worker can help you obtain information from your baby's doctors, provide you with other sources of information on your baby's medical problems, help you deal with financial difficulties and stress, and help you make special arrangements you may need for your baby's discharge and follow-up care. Sometimes social workers lead groups of families in supportive therapy sessions.
Speech and language pathologist: A person who is trained in speech and language concerns but who often works with newborns in the NICU to help with feeding problems. Some infants who show delays in language in the first year of life and beyond may need the services of a speech pathologist after discharge.
Surgical specialists: If your infant requires an operation, a specialized surgeon may be called in to advise on the matter or to perform the procedure.
The list below describes different kinds of surgeons and their areas of expertise.
- Cardiothoracic surgeon: care of the heart, blood vessels, and often lungs
- Ear, nose, and throat (ENT) surgeon: care of the ears, nose, and throat, plus some airway problems
- General surgeon: bowel problems, hernia repairs, and placement of arterial and venous lines
- Neurosurgeon: care of the brain, spinal cord, and nerves
- Orthopedic surgeon: bone and joint problems, including deformities
- Plastic surgeon: head and neck deformities, certain skin problems, and some hand and foot concerns. Some of this work can also be done by an orthopedic surgeon.