10 Things your NICU Nurse Wants You to Know

"How-to-Survive the NICU" advice for new NICU parents

On an overcast morning last fall, Tracy & Travis* arrived at the NICU to visit their 2 pound 3 ounce baby girl. Tracy was being pushed in a wheelchair by Travis, because she had undergone an emergency c-section just the day before.

It’s hard to describe the way they looked when they came in the room - stunned, nervous, afraid, hesitant, and yet craving to be near their baby.  It’s a familiar look - it's one most parents have when they first enter the world of the NICU. After introducing myself to them both, I started to gently explain everything that I could about their preemie.

Suddenly, Tracy looked up at me from her wheelchair, shaking her head, and declared “I have no idea about any of this. I never thought this would happen to me and I have no idea how I’m going to handle it. I really wish I had even one friend who had been through this who could help.” Tears followed.

Over the months, the new parents grew confident in their understanding of what was going on and what to expect. They became competent at caring for their growing baby girl. But Tracy's words stuck with me, because she was one of the few parents I’ve met who articulated so clearly just how alone she felt.

So if you're feeling lost, as Tracy was and you have no idea how you're going to handle this... give these 10 suggestions a try. They'll get you off to a good start.

* not their real names

The internet may help, but it may stress you out too much

Preemie being held by NICU nurse
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You’re here reading this, so clearly you’re not afraid of the internet. It’s how people cope these days, right?

But when you’re about to go online to look up preemie-related questions, take a moment and ask yourself - "do I really need this information right now?"

If it’s just going to get you anxious when you stumble across preemie stories with negative outcomes, skip it. If you’re going to stress and fret all night long if you read about worst-case scenarios, skip it.

What to do instead? Ask your questions to your doctors & nurses, and ask other NICU parents you meet.

If you must go online to do research because you feel you’re just not getting the answers you need, remember that the scary stuff and the negativity is NOT your baby, it’s NOT guaranteed for every baby. Stay focused on the positives.

Personalize your space

NICU incubator with decorations
Every Tiny Thing

The NICU is not a place that feels like home. Loud machines, plastic incubators, monitors beeping, hospital smells. There's very little that feels "homey," to say the least. It's certainly not what new parents dream of when they dream of their baby's first nursery.

You can change that - if only by a little bit - by bringing in items that help you feel at home. Check with your NICU, but often parents can bring items such as:

  • baby blankets (for swaddling, or for use making the bed)
  • baby clothes (when your baby is ready to be dressed in clothes)
  • NICU Art to decorate the crib
  • pictures of mom, dad, siblings, pets, family, etc to tape to the crib
  • stuffed animals (to place near the bedside, not in bed with baby)
  • items of spiritual significance, such as prayer cards or rosary beads (again, to place near the bedside, not in bed with baby)
  • drawings from siblings, notes from parents, etc

Why bother? Because when you feel a little bit more comfortable in your surroundings, it helps ease your anxiety and makes the time together more enjoyable. Which is very worth it.

All of your emotions are normal. Yep, all of them

NICU mom with depression
Don Bayley/Getty Images

Are you feeling worried because your baby is in the NICU? Well, that makes sense. Nobody is surprised by that emotion in the NICU. Feeling sad? Again, no surprise.

But are you feeling wild, insane jealousy? Jealous of your friends who are still pregnant, of the baby in the bed next to yours who is going home tomorrow, of every single mother who didn’t have to go through the NICU? You’re not alone. It’s natural to feel this way.

And then the next instant, are you feeling terrible guilt? For not being able to carry your baby to full-term, for having a baby who isn’t as sick as the baby in the next bed, for feeling as though you've burdened your baby with faulty genetics? You’re not alone. It’s natural to feel this way, too. 

These are all normal. Every single emotion imaginable has raced through the hearts and minds of mothers and fathers before you. Fear. Anger. Rage. Depression. Anxiety. Hopelessness. Remorse. Grief. Confusion. Countless others. So please don’t feel surprised or alone because of them. They’re normal, and they will fade in time.  But, they do require you pay attention to them and get help with them if they overwhelm you. 

It's very important that you take good care of yourself

NICU Doctor examining NICU baby with stethoscope
DreamPictures/Getty Images

It’s incredible, but NICU mothers and fathers who spend hours and days and months in the NICU are often desperately in need of help themselves, but nobody seems to notice. Some are utterly sleep deprived and anxious 24/7, some are going through postpartum depression, and others are on course to have Post-Traumatic Stress Disorder (PTSD.

It seems a shame, because these very mothers and fathers are surrounded by doctors and nurses day in and day out while in the NICU. But the NICU staff are so completely focused on the baby that it often goes unnoticed.

NICUs are getting better about attending to the emotional strain parents feel, but unfortunately many parents still report that they get no support whatsoever. 

So the responsibility is yours to reach out. Ask the NICU staff if the social workers can help. Ask if there’s a support group for NICU parents (because they really do help). Seek a therapist. Or check out NICU Healing, an incredible resource for dealing with the emotions that come with everything about the NICU.

Maybe you don’t feel you can or should focus on your own emotional health when your baby is suffering. But by focusing on keeping yourself healthy, you are caring importantly for your baby.

The NICU will be hard on your relationships

Two dads with their son at the park
David Jakle/Getty Images

The NICU is undeniably stressful on relationships. Each partner has a different way of handling the intense emotional strain, and this difference often causes friction.

Do what you can to take care of your relationship - your baby will benefit from it. Take walks together every once in a while, talk honestly about your emotions, and be extra patient with each other. Try your very best to honor the way your partner needs to cope with this, and at the same time honor the way you need to cope.

The NICU also strains relationships with other children in the family. It can feel as though you can't possibly meet everyone's needs. You can only do your best, remembering that everyone in the family is feeling the strain.

If your relationships were strained to begin with, or if you're feeling it getting too uncomfortable, now’s the time to get some help. A qualified marriage & family therapist can really help.

There is no right or wrong way to parent in the NICU

NICU mom holding preemie with NICU nurse
Barrett & MacKay/Getty Images

I can't tell you how often I've heard parents fretting over whether they're visiting too much, not often enough, whether they're asking too many questions, or not being involved enough. They're worried they're not "doing it right."

There is no right or wrong. So don’t try to do it “right” if it’s not what feels “right” to you. Just try to do what feels best to you.  If you want to visit your baby often, great. If you want or need time away from the NICU, that’s fine too. If you want to quietly read stories to your baby or sing lullabies, go for it. If you want to be included in more of your baby’s care, speak up and let the nurses know. 

If you meet resistance from the staff, try to work together with them but be clear about your parenting goals

Stay informed and speak up

NICU nurse and NICU mom talking
Dan Dalton/Getty Images

Ask lots of questions. Right from the beginning, and throughout your stay. The doctors and nurses are working for you. Their job is not only to care for your baby but also to help you understand what’s going on and why.

If you’re confused or worried or frustrated and you don’t speak up, the staff will never know. They will most likely think you understand everything that’s going on.

So ask. Trust me, we’ve heard it all, and there are no dumb questions.

If you think about it, many different types of families come through the NICU. The staff really have no way of predicting what anyone wants. Don’t wait for the nurses or doctors to ask - if there’s something you want, please speak up.

And if you ever see something that makes you feel afraid for your baby, or if you believe mistakes have been made, definitely do not hesitate to speak up. Your baby is counting on you to advocate. 

Insist on kangaroo care as much as possible

NICU mom holding preemie skin-to-skin
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Every NICU does it differently, but skin to skin holding is undeniably beneficial, for babies and for parents. It’s great for your baby’s weight gain, temperature stability, oxygenation and more. It’s beneficial for parents, too, by enhancing bonding and providing a sense of being a needed and important part of your baby’s life. 

Sometimes nurses are very busy, and if parents don’t ask specifically to do skin-to-skin holding, they’ll skip it. Sometimes as babies get older, they’ll be dressed in clothes so it gets forgotten. But it’s beneficial, and worth asking for throughout your NICU stay.

If you meet resistance, feel free to quote this article or this research. If you still meet resistance, speak to the charge nurse or your baby’s doctor.

You CAN ask for the nurses you like and refuse the nurses you don't like

NICU nurse holding preemie baby
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If you love one nurse in particular, you can ask about having that nurse be your baby’s primary nurse. Some hospitals don’t do primary nursing, but it never hurts to ask. Sometimes they’ll do it even if they typically don’t.

On the flip side, if you don’t like a particular nurse, you can ask not to have that nurse assigned to your baby. It is perfectly acceptable, and it happens all the time. The nurses are most likely not offended, not surprised.  And regardless, this is your baby, you should feel comfortable with the people caring for him/her. The NICU journey can be a very long one, so make the most of it by asking to have the caregivers you truly like.

There are positives if you look for them

Preemie baby smiling with oxygen cannula
Michael DeLeon/Getty Images

It may take super-human effort, but try. Look for something good in all this.

I know, many of you will say “How can there be anything good about my baby struggling to live?” There’s not.

And yet.... there are little bright moments in most days - a day of fewer bradycardia spells, or perhaps a tiny little weight gain? There is good in doing a diaper change for the first time, even if you felt terrified. There is good in the new friendships you make with other NICU parents. There’s the first time your little baby can wear clothes, or takes a first full feeding. There’s feeling her tiny hand in yours. There's the strength you're gaining by getting up day after day and being there for your child.

It’s up to you to decide - will you focus 100% of your attention to the difficulty all around you, or can you spare a little energy looking for the good? If you can, you’ll feel a whole lot better.  Give yourself permission to cherish these little joys. Give yourself permission to find reasons to smile and laugh and celebrate. I hope you’ll try.

Hang in there!

Good luck with your journey. Please take good care of yourself, and give yourself permission to make the very best of this brand new parenting experience. If you have any advice you'd add to the list, let us know!

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