What Every Rehab Manager Needs to Know about OT, PT, & SLP in the NICU

We receive this email frequently at NANT:

“I work in a hospital and see [adult, pediatric] patients and am asked to cover the NICU. The therapist that used to cover the NICU is gone so I don’t have direct access to a mentor. I want to be confident that I’m doing the right thing. How can I improve my skills and knowledge about the NICU? My boss doesn’t understand that I need special training to work there. What can I tell [him, her] to explain why it’s important?”

To the therapists that find themselves in this situation and the rehab or NICU managers that must provide therapy coverage but do not have anyone trained to do so – see below – help is here.

Therapists must receive NICU specific education and mentoring because (a partial list):

  1. According to NANT, AOTA, APTA and ASHA the NICU is a specialized area of practice that requires knowledge, skills, and training specific to the neonatal population.
  2. High-Care Level Facilities should have, among many other Guidelines for Perinatal Care by AAP/ACOG:
  • At least one occupational or physical therapist with neonatal expertise
  • At least one individual skilled in evaluation and management of neonatal feeding and swallowing disorders (eg, speech-language pathologist)

NOTE: The above guidelines use ‘neonatal’ versus ‘pediatric’ to describe expertise. This distinction cannot be overlooked.

  1. The infants seen by OT, PT and SLP in the NICU are experiencing a critical period of brain development, affected not only by their early entry into the world, but also the experiences which they encounter day after day in the NICU. Therapists working in the NICU must be knowledgeable about preterm infant development and build a practice engrained in the facets of this knowledge to positively contribute to an infant’s development.
  2. Asking a therapist to ‘cover’ the NICU without proper education, mentoring, and guidance is both unfair and unsafe.
  3. Neonates are not just tiny pediatric patients. They have their own set of diagnoses, challenges, precautions and successes. In order to provide trauma-informed, age-appropriate care, therapists must be up to date on all of the above.

So what’s a Rehab or NICU manager to do?

In the past, there was no great answer to this question. Mentors are limited, and there was no single place to send a therapist so they could begin to acquire this needed education and knowledge.

I founded NANT in 2009 partly because of the inconsistencies I noted while traveling as a consultant to NICUs around the country. Some neonatal therapists had been practicing at a high level for 30+ years and had a well-educated team of colleagues. Other therapists were more or less providing ‘pediatric therapy’ in the NICU setting, or there was no therapy presence at all.

Babies and families deserve better. So do therapists.

Rehab (or NICU) Managers, you’re not alone in this either. Here are several ways for NICU therapists to get engaged, stay informed and current, and collaborate with a global network of colleagues:

  1. NANT Member Benefits address the above issues. On-demand access to NICU-specific education, unprecedented access to mentoring, and online access to neonatal therapy colleagues from all over the world. Group Memberships are available for teams of 3 or more working in the same facility.
  2. In-person support and education at our national conference. (The Digital Mastery Pack– which provides instant video access to all consented presentations from NANT 7 is coming soon – stay tuned to acquire this huge resource.)
  3. Participation in the first ever globally accessible neonatal therapy training and mentoring program called IGNITE.
  4. NANT’s Professional Collaborative has also defined this specialized field and available paths for professional growth.
  5. The Neonatal Therapy National Certification Board (NTNCB) created the certification process for neonatal OTs, PTs, and SLPs. The first group of certified neonatal therapists (CNTs) was announced in April 2017 at our national conference.

In the past, resources for neonatal therapists were limited and scrambling to provide specialized coverage in the NICU was commonplace. It’s no longer acceptable.

It’s easier than ever to be part of the solution.

Start today.


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