Teaching project on discharge for preterm infant parents

Julius Seizure · Nov 13, 2017

I think your topic is a little vague (early vs. late preterm, as many have pointed out, is very different). I think you need to narrow it and work from there. Late preterm would be easier and would largely be similar to just "regular" new baby teaching.

Focus on safety and on baby's main activities: eating, peeing, pooping, sleeping. What would a brand new first-time parent need to know about what to except from their baby in those 4 areas? As far as safety, three big things come to mind off the top of my head: child abuse, sleep safety, car seat safety.

If you haven't already, check out KidsHealth for some good teaching topic ideas.

And no games. You don't need games.

jennylee321 · Nov 13, 2017

Also a resource to include would be whatever NICU is teaching parents. Maybe you will identify some gaps but you don't need to reinvent the wheel. NICU is a key stakeholder because they will have a longer relationship with the parents. I also don't recommend showing any before or after photos of prem because you have no idea what there prem will look like, and this will depend on their course in NICU. Focus on expressing milk, this is so important and although NICU will help with this, assignments get busy and the nurses don't always have time to assist with this

KelRN215, BSN, RN · Nov 14, 2017

I agree with the 2 previous posters who said no games and no before and after pictures.

A mother who just delivered a very preterm infant (again, you haven't defined "preterm" for your project) is in crisis, may feel incredibly guilty, may be in denial or another stage of grief and likely will have no interest in playing a game. Not to mention, she's dealing with her own post-partum hormones, she might not be able to hold her baby, she's pumping breast milk for a baby who may never drink it, she'll be discharged home without her baby. Games could be perceived as insensitive.

Before and after pictures may set unrealistic expectations/lead to people developing false hope. Are there miracle former micropreemies who have few complications? Yes. Are there also micropreemies who have MANY complications and either die in the NICU or go home trached, vented, on TPN, tube fed, with hydrocephalus from bilateral brain bleeds, vision loss from severe retinopathy of prematurity and may never walk or talk? Also yes.

I haven't ever worked NICU but I watched my best friend deal with her daughter being in one for nearly 5 months- during that time, she developed bilateral brain bleeds after her first dose of indomethacin to close her PDA, developed retinopathy of prematurity, developed NEC and have several bowel perforations requiring emergency surgery, was intubated then on BiPAP then oxygen then finally room air, was dependent on TPN, then an NG and finally able to eat orally. It was never certain that she would come home. There were times when they were told to consider whether or not they wanted to withdraw care.

I did once participate in a conference that was sponsored by parents whose child had a particularly bad outcome and they were not pleased with the way his poor outcome was communicated to them. At the time I was working pediatric neurology and neurosurgery. The NICU and staff from my floor were involved in it. There were paid actors playing the parents of the baby in the NICU. There was a simulated team meeting attended by Social Work, the NICU and Neurosurgery. I believe the situation was that the child had developed post-hemorrhagic hydrocephalus needed a subgaleal shunt. During the discussion, the parents were asking questions and the Neurosurgery NP, thinking only about the hydrocephalus that her team was consulting for and not the larger picture of what else was wrong with the baby, assured the pretend parents "you'll be able to take him home." Every NICU staff member in attendance gasped when she said that because they knew that there was a chance that this baby would never go home.