31Aug

Neonatal Therapists: Team or Territory?

By Sue Ludwig

I’m sitting at my 10 year old daughter’s basketball practice and one thing is crystal clear. There is no one-most-important person on this team. If they don’t communicate and have a sense of each others’ abilities, they aren’t effective.

If there is an error on one girls’ part, and the rest of the team reacts with negativity, it’s contagious. If the same error is taken in stride, the team swoops in, recovers, and the play continues, sometimes with even better results.

It’s also obvious that not everyone can have the same role. You can’t have a team of 3-point shooters and no one to rebound. And most obviously, no matter how skilled the player, she cannot play the game alone.

So why the heck am I talking about basketball?

Because sports rule in defining the notion of team.

And we need a little more team in the NICU.

When I began writing this article, I had a whole section on how incredible it is when all disciplines in the NICU collaborate. NICUs that have great teams deliver amazing care. And it’s obvious to anyone who walks in the door.

But as therapists, I hope we already understand that our survival in the NICU depends on our ability to work as a team. Our very access to our patients depends on our communication with nursing. And we can thrive, or not, with mutual support.

But I want to talk about us. About being a team with other therapists. Yes, even though territory, history and charge codes can cloud our vision.

No One Likes a Ball Hog

If you’ve ever played sports or watched your kids play sports, you know how painful it is to watch someone hog the ball.

Or maybe you’ve attended a conference or meeting where a speaker runs over her allotted time by 30 minutes? Yep, ball hog. This sort of attitude never serves a team.

So here’s the thing:

Do OTs own rights to the sensory system? And PTs the motor system? And do SLPs own space north of the suprasternal notch?

Are we bored with that mindset yet?

Our neonatal SLP works PRN in our unit right now, primarily due to her responsibilities to other populations. She was amazed when our PT and I first approached her with the idea of taking advantage of her previous neonatal experience to expand our coverage in the NICU.

She said, “I can’t believe you’re going to let me work up there! Usually OTs don’t want SLPs up there in their territory.” We both laughed out loud. Being territorial has never been my thing. But I also know her statement to be true (and vice versa) in many places, and between OTs and PTs as well.

I’m not implying that we should minimize or dilute our discipline-specific skills, just our boundaries about sharing knowledge and ideas, and access to the NICU itself.

A New Vision

Consider this: There is room for everyone. Our differences make us stronger and deeper as a team.

There isn’t room for numerous non-specialized therapists who ‘cover the NICU’ without extensive training. BUT there is room for specialized, knowledgeable, collaborative practitioners from each discipline.

The units that exemplify teamwork will shake their heads and think I’m making this up. But I’m not going to pretend this isn’t an issue. It’s one that needs to be resolved as we move forward as a clear and focused group. There’s so much work to be done.

Let’s begin here.

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