Improving NICU Practice Starts With Letting Go

By Sue Ludwig

Remember when we used to tape black and white “visual stim” cards inside the isolette because we thought it was a good thing? I mean, we taped them to the left, right, and top of isolette – the babies couldn’t escape them if they tried.

Remember when we PO fed babies at 3pm because they had an order to PO feed once a shift, not because they were cueing to eat? (Or when we were encouraged to ‘get’ the baby to take the last 7mls even after he was clearly depleted?)

Remember when they were positioned so poorly that you couldn’t tell if they were prone or supine at first glance? (If you’re newer to the NICU, we hope you can’t even picture this.)

Yea. I remember too.

And the thing is, there’s no shame in being where we were at that time. We were operating on the latest information. Or no information. Or sometimes we were following long-standing practices and cultures that had never been questioned.

We feel guilty about these things. We tend to say, “Oh my gosh, what did we do to babies back then?”

The answer is: we did our best with the information that was available to us at the time. The same is true in every patient population.

But we do have to make sure we’re paying attention. We cannot implement what we do not know. We must continue to research. We must continue to attend conferences to ensure we ARE aware of the latest evidence and practices rather than assuming we know. We must listen to patients, families, and their outcomes.

We must learn, evolve, and do better.

What practice(s) do you and your NICU need to let go of? (Every NICU has at least one.)

What’s stopping you from improving?

Don’t let it be shame. Or pride. You come to work to help babies and families. You DO help babies and families. We know you. We know that to be true.

Seek, learn, and do better tomorrow. Someone’s life depends on it.

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