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OT, PT and SLP in the NICU – What Every Rehab Manager Needs to Know

We receive this email frequently at NANT:

062414-tow“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 all of the therapists that find themselves in this situation and to the rehab or NICU managers that find themselves in the bind of having to provide therapy coverage in the NICU, but not having anyone trained to do so – here’s some info that may help all of you:

1. According to NANT, AOTA, APTA and ASHA the NICU is a specialized area of practice that requires knowledge and skills 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

(Note: The above guidelines use ‘neonatal’ vs ‘pediatric’ to describe expertise.)

3. 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.

4. Asking a therapist to ‘cover’ the NICU without proper education, mentoring and guidance is both unfair and unsafe.

5. 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 one place to send a therapist so they could begin to acquire this needed education and knowledge.

But things have changed. Part of the reason I founded NANT in 2009 was 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.

Bottom line: inconsistent practice (or presence) breeds inconsistent results.

The babies and families deserve better.

Therefore, I carefully crafted NANT Member Benefits to address these issues. On-demand access to education, unprecedented access to mentoring, online access to neonatal therapy colleagues from all over the world, in-person access and education at our national conference. Not to mention defining this specialized field (via the NPC) and taking on the task of creating a certification for neonatal therapists (in progress).

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

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

Start today.

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