Communicating in the NICU

Parents vary in how much information they want to have about their baby’s medical picture. Perhaps you want just the basic facts about what is happening right now, or maybe you want to know every detail. Likewise, health care practitioners vary in how much information they tend to share, and your style may match better with some than others. For instance, if you just want to know the bottom line, you may feel more comfortable with practitioners who don’t mention all the details, uncertainties, possibilities, and worries. If you feel barraged with information and ponderings, you can explain that you appreciate their candidness, but to cope, you want to know only what they are certain is happening today and what it means.

If, on the other hand, you want to know all the details and possibilities, you may feel more comfortable with practitioners who believe in divulging everything they know and are thinking. So if a practitioner is reticent about sharing information, explain that you want to know all that’s going on and what staff are thinking because it helps you cope. Being fully informed may help you feel more involved with your baby and included in the health care team.

Working with medical caregivers who match your communication style may feel easy. When caregivers don’t match you, ask for what you need so they can be responsive to your style and pace. Even so, dissimilar styles can make communication challenging at times.

Bridging Communication Barriers

Communication barriers are practically inevitable in the busy, highly charged intensive care setting. Naturally, many parents cannot absorb information as quickly and efficiently as their health care teammates might like. Some parents do well with verbal information; others need written materials to take home, pictures, or audio-visuals. Sometimes, personalities clash. Holding different perspectives can hamper communication. And some parents simply want more or less information than they are being given. To overcome these barriers, it is especially important for parents and medical staff to work together, to appreciate each other’s contribution to the problems and the solutions.

Regarding medical practitioners, you may find it immensely helpful when they can:

  • Have care conferences where there is ample time to talk about what is going on and then stay with you as you face feelings and formulate questions.
  • Answer your questions directly and honestly, at the level of detail you prefer.
  • Provide information in ways that match your learning style.
  • Remain open to answering questions, even ones you’ve asked before.
  • Recognize that you may need to hear information more than once to absorb it and the implications.
  • Provide the hard answers openly and compassionately and listen as you process feelings.
  • Watch your reactions and encourage you to seek clarification when you need it.
  • Keep the lines of communication open over time, to give you the chance to work through your thoughts and crystallize your unformed questions.
  • Say what they mean, avoiding exaggerations to make a point or representing guesses as facts.
  • Reassure you when, in the context of the intensive care unit, your child’s condition is considered normal or even mild, or if your child’s medical course is common.
  • Respect your role as a loving parent who is involved and an advocate for your child

For your part, it is important to abide by the following:

  • Realize that your teammates cannot read your mind—you must ask for what you need.
  • Keep track of your questions—and the answers—so that you can make the most of your meetings and conversations.
  • Ask the questions that most trouble or embarrass you, and the ones you fear are “too stupid.” Doing so informs your teammates about what kinds of reassurance you need, and their gentle responses can also help you trust their ability to take care of your baby.
  • Know your learning style, so you can request information in the forms that you need. For example, you might ask for written materials to take home, or permission to record conversations so you can review the information later.
  • Stay informed about topics of concern by other means. Ask your teammates to recommend resources, such as books, DVD’s, and reputable websites.
  • Give practitioners the benefit of the doubt. Instead of assuming that they are withholding information, assume that it’s an oversight and ask them to tell you what you need to know.
  • Make it clear (especially if you feel you are being kept out of the loop) that for you, facing the truth with their support is easier than being protected from it.
  • Seek out multiple ways of meeting your emotional needs, rather than relying only on the medical team. Talk to a counselor, social worker, or member of the clergy; lean on trusted friends and family; go online or join a support group.
  • Consider yourself to be your child’s most important caregiver. Holding that perspective should reduce feelings of suspicion, competitiveness, or timidity, and you’ll be less likely to wrongly project unkind motives onto your teammates.

When you and your baby’s medical practitioners can approach each other with respect and sensitivity for each others’ perspectives, you can form relationships that are collaborative and supportive. This “relationship-based” approach can help you navigate your baby’s time in the NICU, which can include challenges, uncertainties, hopes, and possibilities. With support, you can cope with the attendant fears and sorrows, and nurture your little one through any medical crisis.