In a recent blog, we discussed how COVID-19 visitor restrictions may be negatively impacting the sensory support of babies in the NICU. But how is it impacting parents?
Earlier this month, Jill Beck, MSN, RNC-NIC, C-NNIC discussed Parental Uncertainty in the Time of COVID-19 with Dr. Kathryn J. Malin, RN, NNP-BC, PHd, in the latest installment of NANNCast, a podcast launched by the National Association of Neonatal Nurses (NANN). Dr. Malin’s research focuses on how the stress and anxiety surrounding being a parent of a baby in the NICU can manifest as post-traumatic stress disorder. As Jill points out during the podcast, even at our pre-COVID baseline well over half of parents who experience a NICU hospitalization of their infant will develop PTSD. With the added stress of visitation restrictions and overall uncertainty regarding the COVID-19 pandemic, Dr. Malin discussed how parents are experiencing new levels of fear, stress and anxiety.
So how can nurses help?
Dr. Malin and Jill discuss several strategies that nurses can employ to help make a positive impact to buffer these stressful times. Here are just a few highlights:
Take the time.
As NICU nurses we spend countless hours meticulously assessing our patients, but what about parents. Take the time to fully assess how parents are feeling and try to understand where they are coming from so that we can better help them to cope with their baby’s illness.
Help them create their narrative.
Dr. Malin discusses how creating a personal narrative can help people experiencing PTSD, including NICU parents. Nurses can help parents create their birth and NICU narrative through open conversations and facilitating journaling.
Help them be in the moment.
Parents can often have a knee-jerk reaction to their feelings of uncertainty surrounding their baby’s illness. Engaging them in care, taking temperatures, changing diapers, etc… can help to ground them and calm those feelings.
Dr. Malin and Jill went on to discuss so many more wonderful strategies that we as NICU nurses can utilize to help parents navigate through uncertainty. You can check out the full podcast here: http://nann.org/publications/nanncast
So we know that COVID-19 is increasing fear and uncertainty in our NICU families, but could there be long term effects for neurodevelopmental outcomes?
The impact of parental involvement on short and long term outcomes in the NICU has been examined in the literature and the effects are clear.
The quality and quantity of parental involvement makes a difference in babies’ lives with short term benefits such as better weight gain and improved feeding tolerance, and longer-term benefits such as improved neurodevelopmental… Click To Tweet
Check out this 2018 study by Dr. Roberta Pineda, PhD, OTR/L, at the Washington University of St Louis NICU on the short and long term impacts that engaged and present parents can have in the NICU: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856604
I know that personally as a NICU nurse I am struggling with feelings of moral distress regarding visitor restrictions. Actively separating parents from their babies feels wrong at my very core. All families play a vital role in their baby’s development, and policies in place restricting parent’s access to their baby are undoubtedly having a negative impact on our patients and their families.
“All families, even those who are struggling with difﬁculties, bring important strengths to their infant’s experiences in the NICU. Parents must be viewed as vital members of the caregiving team and as partners in the care of their infant, rather than visitors to the NICU, and should be given 24-hour access to their infant.”
– Altimier & Phillips, 2013 Full Article
We’d love to hear your thoughts on COVID-19 visitor restrictions in your unit! Email us at email@example.com.