Communication in the neonatal intensive care unit: a continuous challenge

Abstract

Aim: Communication between the healthcare team and the parents in Neonatal Intensive Care Unit (NICU) is very important, and may affect both trust in medical team and the health of premature babies. The aim of this study is to confirm that a good relationship with families can be obtained if all the healthcare team adopts a good common communication scheme. Methods: We have implemented a communication strategy that works through three stages: (1) Training in Communication: a course about general problems with communication for medical and nursing staff. (2) Communicative Algorithm: various guidelines to follow during the most common scenarios in the NICU. (3) Communicative Case Sheet: a notebook used to record any problem or discomfort that occurs during communication. We applied the strategy for a 12 months trial period. Results: A Systemic Counselling Institute of Medical Psychology tested families’ satisfaction at the end of the period. The test showed that in 75% of cases, satisfaction with communication was very good and in the remaining 25%, parents perceived communication as good, but improvable. Conclusion: In NICU, communication between the members of the team and the newborn’s parents may be improved by specific tools.

Keywords::

• Communication
• family
• newborn
• NICU

Declaration of Interest: The authors report no conflicts of interest.

Appendix

Communicative case sheet (page 1)

Date 23-08-2009Staff member name: (Doctor)

Patient name: JS

Reason for the communication

To inform the parents regarding the clinical condition of the newborn.

Target of the communication

To verify the parents’ understanding of the clinical message.

Parents’ questions/answers

The father states that the dialogue must be kept only with him without talking to, nor looking at the mother.

Given information

I accept the father’s statement and I reply that the baby needs her mom to improve the babies’ respiratory condition (kangaroo mother care).

Observed reactions

The father nods in agreement, whereas the mother seems to be uninterested to the conversation and looks elsewhere.

Stressed critical points

I show myself respectful of the father’s will, even if I don’t agree with him.

Objectives to share

To care for a family, notwithstanding severe differences in culture.

Communicative case sheet (page 2)

Date: (Two days later)Staff member name: (Head nurse)

Patient name: JS

Reason for the communication

To get acquaintance with the couple, father and mother.

Target of the communication

To inform parents of the nurse caring for their baby.

Parents’ questions/answers

The father asks information about the Unit timetable (breastfeeding, kangaroo mother care, visits etc.).

Given information

I answer all the questions and I begin to explain the advantages of kangaroo mother care; I add that this will be realized in a different way separated from other mothers.

Observed reactions

The mother smiles during the explanation of kangaroo care; the father is very focused and positive regarding the procedure. We therefore arrange it.

Stressed critical points

The mother does not understand the Italian language, she glances shyly at me and then she lowers her eyes.

Objectives to share

Need to begin this relationship very carefully.

The kangaroo mother care was performed aside, in agreement with the parents. Since then, the parents started smiling and collaborating.