For those of you who couldn’t attend the NANT Conference, I want to share 2 videos with you – one this week and one next. This is the video that opened the conference. Thanks to all the parents, therapists, nurses and babies who allowed us to include them here!

You were there. At the NANT Conference.

You met a bazillion amazing people and learned new practices. You gained knowledge and have some surprising statistics to take back about everything from the late pre-term infant to thickened feeds.

You step foot into your NICU and it’s like you’re wearing new glasses. You’re relieved to see your NICU does a lot of things really well. AND you see the gaps immediately.

You think of all the talks you attended and become so overwhelmed about where to begin that it’s nearly depressing. I call this ‘post conference re-entry’.

Here’s the good news. To combat the overwhelm….

Choose just one thing.

Like I said in my keynote, we tend to start 10 projects and complete about 50% of each of them, then become frustrated that we haven’t moved forward.

Instead choose one topic from which your unit could benefit.

Break it into small doable steps. If you don’t know all the steps, make a rough outline. Pretend there are no obstacles. (Really, humor yourself with this. Intend that it will work as planned.)

Look at step 1.

Maybe step 1 is scheduling a meeting with your team?

Your first task is then the act of scheduling the meeting. Schedule it now- as in, minimize the NANT Newsletter and email them now. (Remember you can even schedule the meeting for 3 weeks from now AS LONG AS you schedule it!)

And LOOK- you just completed step 1!

Get your key players, schedule your timeline and go. As slowly or as quickly as you wish. But move forward.

Intend a smooth ride. Prepare for a roller coaster.

Bring your clarity. Let go of what no longer serves.

Gather the team. Set aside the ego.

Celebrate every small step of the way.

(And keep me posted!!)

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Thanks again to our NANT 365 Corporate Sponsors: GE Healthcare, Philips Children’s Medical Ventures and KC Biomedix and to all of our exhibitors.

Exchanging the knowledge, passion and products that aid our patients is mutually beneficial. Your support helps us provide an amazing conference experience. This was definitely a team effort! Thank you for participating!

If you attended the Special Topic Call last week, or have watched it since, you heard Dana Fern speak about how incredibly important NANT is for her and for all neonatal therapists. We laughed, saying that one day we’ll be the ‘old women’ who keep saying, “You young people are so lucky to have this…when WE started in the NICU we were completely alone.” And the funny thing is, that’s still the most prominent type of email I receive from you as a group. “There’s no one else around to ask…”, or “I didn’t receive any real mentoring in the NICU…so can you tell me…”

And the results of the NANT survey (that we’ll share at the conference) will confirm how many of you were self-taught. Or you’re like me and had great mentoring initially but then were left to figure it out alone for several years without a lifeline or professional collaboration.

The most exciting part of this is that the isolation is over. It’s simply over.

And the avenues for mentoring and education are better than ever.

The longer-term excitement stems from the fact that neonatal therapists have strong convictions about how some aspects of care could vastly improve in the NICU. These convictions are made clear through your emails, mentoring call questions and Professional Support Network posts. You’re frustrated and ready for change.

And now that we’re a group, we can work on these issues together. There is power in this group. The kind that comes with specialized knowledge, experience and our unique viewpoint.

Shortly, there will be more ways to be involved with NANT at a higher level. We’re going to put your passion to work and fuel change in our little corner of the world.

Stay tuned. We’re just getting started!

American Express called me the other day. NANT uses American Express for all of our transactions. The woman on the line just wanted to make sure I understood all of the benefits they had to offer.

As part of her routine questioning, she asked me what NANT did and who we served. As I explained our vision in one or two sentences, her ‘telecommunication’ voice softened. You know where this is going right? Because you’ve had this experience.

She told me briefly about good friends of hers who had very premature babies (twins I believe). And how amazing the nurses and therapists had been both in the NICU and in the follow-up they continued to receive after discharge.

She said the babies are flourishing. She guessed that it must be great to have such a rewarding job. And I agreed – it is.

We continued our conversation and in less than 5 minutes had established enough rapport that we wished each other well at the end of the call.

You’ve been there. You’re at a party, or on an airplane, and someone asks what you do for a living. About 90% of the time, the other person responds softly – they know someone, or were someone – someone whose baby (or babies) spent time in the NICU. They thank you for doing what you do.

It’s moments like this that remind me of the scope of prematurity.

The obvious toll it takes on families and friends. The celebrations that happen with every new milestone, both in the NICU and for years after.

I tuck those moments away so that when I’m in the thick of everyday life in the NICU – the stress, the schedule, the joys and sorrows – I can access that little place that says, “Look around. This is an amazing place to be. What we do comforts, advances and celebrates life.”

Then I place my schedule back into my scrub pocket, head to the next bedside and begin again, a little clearer than before.

The half million babies in the US born prematurely each year need a legion of advocates.

If you’re one of the thousands reading this, you’re among them.

Thank you.

Every workplace has a unique set of repetitive tasks. The NICU is no exception. As therapists we know that repetitive tasks without the support of a great ergonomic design, lead to repetitive injuries.

Many of you, like me, have been asked over the years to help NICU coworkers with neck pain, tendonitis, and back pain. I’ve released many a trigger point in a NICU coworker – especially in those upper traps and rhomboids from years of having forearms in an incubator while looking ‘down’ at patients. Some incubator designs support us more than others.

And I’ve consulted my friend, a great CHT, regarding the best treatment for ‘tennis elbow’ (i.e. from years of manipulating and taping tiny instruments without adequate proximal support) to make sure recommendations haven’t changed.

These are ‘unofficial’ consults for us – and we’re glad to help.

What I want us to consider is this – how can we help on a bigger scale?

How can we help design a better space for NICU staff? What about all that time spent computer charting – are our rolling workspaces ergonomically designed? Should the engineers that design everything from suction catheters to incubators consider consulting OTs and PTs who know how to assess real life workspace?

And let’s not forget the chairs we sit in for sometimes hours a day while we feed babies.

(Admittedly it took me quite a while to realize that the way I sat when I fed babies – no stool under my feet because the stools were too high – led to raging plantar fasciitis. My short self in our large reclining chairs was not a great fit ergonomically!)

Some of you already do this for your NICU. I know you’re out there! Consider what that would look like on a bigger scale.

Big changes start with simple ideas.

Lead the charge.

"Ergonomic Recommendations for the NICU" – Sounds like a great presentation for the 2013 Conference – just sayin.

Many of you have a pool going at work right? For March Madness- the NCAA Basketball Tournament that consumes much of the nation every spring.

By now, you’re either cheering or throwing your crumpled brackets in the trash. How is it that the woman you work with that chose her teams according to her favorite colors is beating you?! She doesn’t even know what it means to set a pick. And yet somehow, that’s the beauty of this tournament. It’s just plain fun.

While watching the 4 Ohio teams in the Sweet 16 (just sayin) last week, it made me realize we could learn a lot from these players and from this game.

“We” meaning healthcare.

Not that we’re going to take hospitals and put them into brackets and see who’s best in the end. Although, that’s not far off from where healthcare is turning. Patients are going to have more and more information about hospital outcomes and be given more choices about which hospital to use based on that information. Uh-oh.

This is a whole new game.

And while it poses interesting challenges for those of us at the bedside, it’s also information we want as consumers of healthcare. Would you want to have surgery at the hospital with the highest infection rate in your city?

As I watched several basketball games in the past few weeks I was reminded of why sports are such a great analogy for life. In this case, life as healthcare.

3 Things Healthcare Could Learn from March Madness

Good Defense:

The primary goal of any defense is to prevent the other team from scoring. To protect the team from intrusion, to defend their end of the court, prevent anything from going into their basket.

What’s our defense in the NICU? How do we protect this infant I’ll call Charlie?

Hand washing. Sterile procedures. Incubators. Antibiotics. Hand washing. Avoiding exposure to direct bright light and loud noise. Single-family rooms. Hand washing. To name a few.

Sometimes, like in basketball, we do everything we can to play a great defensive game and the other team still scores. It happens. Sometimes Charlie has an infection or stress despite our best efforts.

And just like in basketball, we must work as a team to make sure that the trend is toward allowing fewer intrusions. Someone must be the coach, standing back and seeing the whole picture. Where did the defense break down? How can we regroup and play better next time?

But what we don’t do, if we’re a winning team, is to continue to do things the exact same way against every opponent and think we’re going to win.

We must strive for excellence. Even when we’re tired and a little beaten. Because in the end, fiercely protecting that space, and Charlie, is our job.

Good offense:

No one wins games without a good offense. There must be points on the scoreboard.

A good offense is a combination of many things- strategy, timing, the ability to read the defense, preparation, and the mindset that we’re moving forward, positively adding to what was already there.

In the NICU, our offense consists of anything that promotes health and normal development. Anything that puts more points on the board for Charlie. Skin to skin holding, breastmilk, developmental care, parental bonding, good nutrition, supportive oral feeding practice, neonatal therapy.

Much of our offense is perfected at the bedside. It’s up to us to teach the parents about skin to skin holding. Do we? Even when we’re busy or tired?

Is neonatal therapy part of the offense or does it occur just a few days or weeks prior to discharge?

Because here’s the thing – we won’t win with ONLY a good defense. We must execute our offense. Charlie needs all the points he can get.

Seamless Teamwork:

It’s obvious in any sport that no one player wins or loses a game. Unsupportive teammates break down the fabric of the team resulting in more losses and less passion.

And we’re no different.

NICUs often consist of hundreds of staff members. We can choose to find a way to be a team. We can choose to only look out for ourselves. But whatever we choose will show in our outcomes. Their outcomes. Charlie’s outcome.

And in the happiness and fulfillment we receive from our work – or not. It’s up to us.

True teamwork always feels better. Working toward a common goal is primary to our human experience. It inspires us.

And when we do it really well- offensively, defensively, and as a unified team, it’s a slam dunk.

Just ask Charlie.

He’s your biggest fan. He’s the reason you lace up and play the game.

Thanks to our Sponsors!

We’d like to thank our NANT 365 Corporate Sponsors for their generous year round support. We appreciate the time, expertise and resources you bring to our members and the vital products and services you create for all NICU babies. Can’t wait to see you at the conference!

GE Healthcare Maternal-Infant Care

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Philips Children’s Medical Ventures

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KC Biomedix

“That’s just too many words.”

T Jake Ludwig at age 9

Several years ago when my son was just 9 years old, he came home from a day in the 4th grade with another yellow slip. The dreaded yellow slip meant he’d forgotten to do a portion of his homework.

This wasn’t shocking. We could’ve wallpapered his room in yellow that year.

Being a therapist, I of course had a “sensory integration/processing” view of this issue. (You’re the same way, right?!) He’s a super-intelligent kid, yet recalling multiple-step auditory directions was a challenge.

So remembering to write down the auditory directions for homework each day in every class was a slippery task. The details fell through the cracks.

To ‘test’ my observation I asked him what he’d do if I was a teacher and said, “Take out a piece of loose leaf paper. Put your first and last name in the top right-hand corner. Number it 1-10 and skip a line between each number. And please write in cursive.”

He simply responded, “That’s just too many words.”

I’ve thought about that statement many times since. I’ve even found myself quoting it when I hear someone using “too many words”, clearly losing an audience, classroom or NICU parent.

So why should this matter to you?

Here’s the thing:

We’re completely bombarded by sensory input right? Especially when working in the NICU. Monitors, phones, conversation after conversation, rounds, email, ventilator alarms, computer screens, orders etc.

Then during our 17 minute lunch we may hear from family members or have 30 text messages from our friends who are off work that day.

I find myself driving home with the radio off craving uncluttered quiet space. You’ve been there.

Yet often we forget this when we create a PowerPoint, educate a NICU parent, or talk to our teenagers.

The best way to know you’re using too many words is that your colleague, child, patient, spouse, audience – well, their eyes start to glaze over! You know the look. The one where no one is present in those eyes anymore.

They’ve stopped taking in information. They’re trying to remember if they have any plans – and start looking for the door.

We know premature babies use gaze aversion to show us stress in their state system. Similarly, our state system is showing stress when we glaze over.

Since you know what it’s like to be on the receiving end of all that sensory input, I want you to develop GLAZE AVERSION. Whether you’re presenting in rounds, speaking at the NANT conference or talking to your 16 year old, start to recognize when you’re using too many words.

Learn to hate the glaze. Because it means you’re not connecting anymore.

3 Ways to Master Glaze Aversion and Improve Communication:

1. Become Your Own Observer

Have you ever wondered what it’s like to be on the receiving end of your communication style?

When presenting in rounds are you vague and rambling or do you succinctly present a few clear points? Do people start fidgeting when you speak? Does your spouse pick up the remote?

Pay close attention to the social cues people are giving you. Eye contact or glaze? Attentive posture or I-want-to-turn-and-run-posture?

Observe and respond. It keeps the glaze at bay.

2. When possible, use pictures or video.

When I see a PowerPoint slide that’s full of words, I immediately glaze over. You’ve lost me. You’re talking AND there are lots of words on the screen.

Show pictures or video when able. Ahhhh. It’s a relief. Pictures also foster emotion. Your audience, family, and NICU parents retain more when emotionally engaged.

3. Edit. Edit. Edit.

I think we’ve all been guilty of hanging a plan up at the bedside that was too elaborate. We had great intentions. There were lots of things to communicate.

The thing is, if that plan is 4 paragraphs long, no one will read it. Trust me.

There is a place for paragraphs and explanations. It may be in a text people need to review before the next competency. Or an article that everyone must read to understand your new QI project.

If your plan involves multiple steps break them out into short numbered phrases with lots of space between them. Otherwise “it’s just too many words” and the glaze begins.

Edit everything you post at the bedside. Every email you write. Every slide you create.

Create space between your valuable thoughts. Because we want them to be heard, retained and acted upon.

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As you go through your day today, make a game of this. Pay attention to how people respond in rounds, at the bedside and at home when there are ‘just too many words’.

Master glaze aversion. It’s the first step to effortless communication.

Would it be possible for you to attend the NANT Conference if your tuition was covered? If you’ve already registered on your own, would it help you significantly to be reimbursed for your tuition?

GE Healthcare, a NANT 365 Corporate Sponsor, is committed to supporting neonatal therapists. GE Healthcare is offering 2 tuition scholarships for the Second Annual NANT Conference. This is so exciting! If you’ve already registered – great. You can still take advantage of this opportunity.

If you haven’t registered, don’t wait to do so either! We have just 30 spots left before this conference is sold out!

Here’s the scoop:

The theme of the Second Annual NANT Conference is "Launching Best Practice for Neonatal Therapy". In the spirit of that theme and goal, we want to honor 2 of you who have been making strides toward best practice.

Now, there are MANY of you making such strides. We can choose just two. How will you be chosen?

Start by completing the following steps ASAP:

1. Click here to access the Scholarship Submission Form.
   
   
2. Complete this form and click ‘submit’ at the bottom – quickly – Deadline: Friday March 16th at midnight Pacific.
   
   
3. You’ll be notified quickly, less than one week later on Wednesday March 21st.

If you haven’t already registered for the NANT Conference and you want to be sure to secure one of the last 30 spots, click here to register now!

Thanks again to GE Healthcare for making this possible!

See you soon!
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