3 Ways to Improve Your Communication in the NICU

By Sue Ludwig

“That’s just too many words.” – Jake Ludwig, age 9

One day, when my son was just 9 years old, he came home from school 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. (I know you’re the same way. That’s why I love you guys.) He’s a super-intelligent kid, yet recalling multiple-step auditory directions has always been a challenge.

So remembering to write down the directions for homework each day in every class was a slippery task. More often than not, 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. Please write in cursive.”

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

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

So why should this matter to you?

Here’s the thing:

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

Then during your 17-minute lunch you may watch TV, scroll through social media, or have 30 text messages from friends and family. I used to find myself driving home from work with the radio off, craving uncluttered quiet space. You’ve been there.

However, this lesson is often forgotten when you create a PowerPoint, educate a NICU parent, or talk to your kids.

How do you know if you’re using too many words? Look in their eyes. Your colleagues, the attending, your spouse, the NICU parent, your kids. 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. They start looking for the door, the computer, or their phone.

We know premature babies use gaze aversion to show us stress. Similarly, our 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, start to notice when you’re delivering it, whether you’re presenting in rounds, speaking at the NANT Conference, or talking to your 16 year old.

Learn to recognize the glaze, because it means you’re not connecting anymore.

3 Ways to 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. Use pictures or videos in your presentations.

When I see a PowerPoint slide that’s packed 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 retains 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 giant paragraphs long, no one will read it. Trust me.

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

But not for the bedside.

If your plan involves multiple steps break them out into short numbered phrases with lots of white 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.

So, 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’.

Adapt your message based on the situation and notice the glaze. This is a skill that develops over time. Start today.

*Yes, there is documented research that women use many more words than men. We are verbal beings. It’s why we (should) save our long stories for our female friends. This seems to work out to everyone’s advantage. Just sayin.

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