Child Life in NICU...HELP!!

prmenrs, RN · Dec 11, 2005

Do you have an Occupational Therapist? You can accomplish a lot w/an OT assigned to your unit. S/he needs to be a pediatric/infant specialist. They are really awesome! They start by assessing the baby, developing a plan, in which the nurses and parents participate, and deliver services as many times/week as indicated. They often work on oral-motor skills, so can actually do one feeding/day. They do a lot of parent teaching re: development so that when mom and dad come in, they can follow thru on some of the exercises and activities.

The Level III I worked in finally invested in funding the OT from the Unit's budget because the OT/PT department kept usurping our kids.

If you can get that in place, that would go a long way to helping your older babies.

MsJessikia · Dec 12, 2005

our unit needs something too.. but no $$ in the budget :nono:

minniemiteRN · Dec 12, 2005

We do have PT/OT that come and work with our babies but not on a daily basis and unfortunately not even on a weekly basis right now. Their dept is so short handed and they really on have one OT that is really qualified to come and work with the babies. I'm really looking for someone to come work with them on skills like head control, sitting up and more finite details that a bedside nurse with tasks such as charting and care of multiple infants in unable to attend to and sometimes unfortunately a NICU nurse is not interested is working with a "toddler". They work with neonates...preemies...not on infants and toddlers and feel inconvinenced that they require the extra time. Thanks for the suggestion though. :banghead:

BittyBabyGrower, MSN, RN · Dec 12, 2005

We have child life in our unit for the kids that are bigger. We have to schedule time with them, but the peds floors take first dibs. We have OT/PT 3x a week. It is hard to have those older kids and 2 or 3 others with that poor kid...they are bored out of their skulls. I don't think there is an easy answer...and we have tried, let me tell you! We do sit them up a lot, we have videos that they can watch, we have mats we put them down on and toys for them to use. I always feel bad...like I am neglecting them! I hope you can figure something out!

minniemiteRN · Dec 12, 2005

Thanks...I think alot of the issue is budget like with most issues in hospitals. I just have always had a soft spot in my heart for these kids who are beating the odds only to be developmentally delayed simply because of lack of time and resources. I am the primary nurse for our oldest baby right now which is a 9 mos old boy. He is trached and vent dependent and on GT feeds so he's stuck really close to his bed but I put his up in a swing and sit him up in a boppy. He has a ton of toys and a mobile that he loves but we're not allowed to let our babies watch videos anymore. It's really frustrating, a program called early steps blocks us from using the TV but doesn't come up to entertain them otherwise.

prmenrs, RN · Dec 12, 2005

We do have PT/OT that come and work with our babies but not on a daily basis and unfortunately not even on a weekly basis right now. Their dept is so short handed and they really on have one OT that is really qualified to come and work with the babies.

And that is EXACTLY why, after many years of fighting, I mean negotiating, w/that dept, the unit finally decided to fund an OT of our very own! in the NICU's budget. Now OT/PT have no claim on her, can't call her away to go assess an adult somewhere, and, basically, pull her out of the unit. She's one of OUR staff not theirs.

This is not a quick solution--it took literally years to justify getting that in the budget.

When we had a pediatric unit (they merged w/the local children's hospital), we had teachers from the school district to do the Child Life program. Since Early Childhood Intervention (sometimes it's called Infant Intervention) is more specialized, I wonder if you could work w/the school district in which the hospital is located to provide teacher support for those children? Might be an option to look into.

If you can establish a primary team for your older babies--nurses who like to work w/them, are interested in Infant Development after neonatal, that might be a help, too. It might even be possible to provide some education in infant development for them to give some guidance to working w/the older babies.

What about using some volunteers? Our "cuddler" group loved working w/older babies because they're more responsive than the little guys.

I'm just trying to brainstorm to help you.

minniemiteRN · Dec 13, 2005

What about using some volunteers? Our "cuddler" group loved working w/older babies because they're more responsive than the little guys.
I'm just trying to brainstorm to help you.

Okay, here's the plan and you guys can let me know what you think. The problem with our current volunteer program is that they have all been with us with quite awhile and while they are wonderful they are all up in age and tend to fall asleep when they rock babies. So, they do other tasks such as stocking and watching the desk and answering phones.

My plan is to contact our lone Child Life Specialist, speak to our Early Intervention Program and then talk to my PCM to make sure no one has a problem with the idea...which if they do I might have a problem with because our budget doesn't provide for any staff and the current staff are out numbered by the babies by a crazy ratio.

I'm going to go to the college I graduated from and speak to some of my old professors about coming to their classes and talking to their 2nd years about volunteering. As a nurse who is in "love" with my primary I would feel much more comfortable with a nursing student who at least has some knowledge...of course they would still need to be trained on what to look for and when to ask for help. I thought this would both help us out and the students. I know I would have beat the door down when I was a student to get into the NICU because with a locked door it was one of the unknowns and just so happened to be exactly where I wanted to be.

Thanks so much for your ideas...I'm going to pursue the idea tomorrow. I'll let you know how it goes.

rn/writer, RN · Dec 13, 2005

Might some of these children qualify for a state or federal "Birth to Three" early intervention program? If they do, perhaps a social worker or therapist would be willing to see them in the hospital setting and at least come up with a plan that others could work to implement.

I commend you for trying to look at the whole child and not just their medical issues.

Let us know what happens.