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Providing Psychosocial Support in the NICU

Sara Mosher MHA, BSN, RN

Disclaimer

1. My NICU Network educational program received unrestricted financial support from Medela and Prolacta

2. National Perinatal Association, Patient+Family Care and Preemie Parent Alliance may receive some financial gain from educational sales

3. Audience participating is required

4. We are going to have some fun!

Objectives

• Upon completion, participants will be able to describe at least three ways to change their daily practice which will lead to improved long term outcomes for NICU babies and families

• Upon completion, participants will have a clear understanding why there is a need for interactive and engaging education for all NICU staff on how to care for the psychosocial needs of NICU families

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Introduction of Presenter

• Sara Mosher, Bend Oregon

• NICU Nurse since 2001• Bedside nurse, Charge Nurse of NI/Peds, R-Team Lead, Neonatal Critical Care

Transport Nurse, Clinical Practice Coordinator, MOD Family Support Specialist and Training Faculty Member & NICU Manager

• 2004 transitioned to Care Coordination and Population Health• Started Patient+Family Care

Introduction cont…

• Honored award recipient

• Published Author

• Oregon AWHONN Chapter Leader & Conference Chair

• Wife and mother• Over-achiever: Board member, PTA, volunteer, host parties

The Journey begins…… Nursing School

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Nursing School Curriculum

1. Anatomy

2. Physiology

3. Chemistry

4. Pharmacology

5. Biology

6. Chemistry

7. Philosophy

8. Ethics

9. Research

10. Community Health

11. Nursing Theory

12. Statistics

13. Mental Health Nursing

14. Specialty Nursing

15. Leadership & Management

16. Nutrition

17. Alternative Therapies

18. Nursing Lab

19. Clinical Rotations

20. Practicum/Capstone

21. Electives (religion, theology, dance, etc.)

Study, Study, Study

More Studying

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Graduation

PASS

4 Volunteers Needed

Let the fun begin!

New Graduate Nurse

• You come to your job with:• All you knowledge from nursing school – Which is a LOT!!!!!

• Passion and dedication

• Excitement

• An eagerness to learn more

• You also come with:

• No prior experience

• Naïve

• False sense of security

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Begin Working (novice nurse)

• Health System & Hospital Culture, Policies and Practices

• Joint Commission, CMS, Regulatory Requirements

• Department Specific Culture, Policies, Procedures and Practices

• PEOPLE

• Coworkers, Doctors, Administrators, Leaders, Other Department Peers, Pediatricians, Clinic Staff, Parents, etc.

On the Job…… Equipment

• Open Warmers

• Beds

• Monitor

• IV Pumps

• Syringe Pumps

• Ventilators

• Oscillators

• Scales

• CPAP Machines

• ECMO

• ComputersBio Medical Technician

On the Job…… Stethoscope

• Breath sounds

wheezes, crackles, rales, stridor, pneumothorax, etc.

• Heart Sounds

S1, S2, S3, S4, gallop, murmur,

aortic sclerosis, aortic regurgitation,

aortic stenosis, septal defect, ASD,

VSD, coarctation of the aorta, PDA, etc.

• Bowel Sounds

normal, hyperactive, hypoactive, absent

Audiologist

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On the Job…… Airway Management

• Suction

When to suction?

How often to suction?

How deep to suction?

• Maintain Airway

ET Tube

CPAP

Nasal Cannula

• Manage Oxygen

Respiratory Therapist

On the Job…… Radiologic Exams

• What type of film?

• What position?

• What is normal?

• What is abnormal?

• What is artifact?

• How do I interpret?

• How do you explain results to a family?

• How do you treat?

Radiologist

On the Job…… IV access/Lines

• IV lines

• Central lines

• Umbilical Lines

• Lab Draws

Phlebotomist

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On the Job…… Medications

• Preparing Medication

• Verifying Medications

• Administering Medications

How to give it?

Where to give it?

How does it interact with others?

What side effects are there?

How fast/slow do I give it?

Pharmacist

On the Job…… Lactation Specialist/Dietitian• Lactation guru

• Caloric specifications of breast milk

• Caloric additive options for breast milk

• How to help mom’s pump milk

• How to properly store/freeze/thaw/prepare milk

• Formula options

• How to properly mix/prepare/store formula

• How to calculate daily caloric intake

• Bottle options

• NG feeds, OG feeds, Cup Feeds, Finger Feeds, SNS, nipple shields,

• BABY FRIENDLY!

Boobologist

On the Job…… Artistic Skills

• Understand color and texture

Skin

Abdomen

Stool

Urine

Oral/gastric secretions

Assessment Guru

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On the Job…… Operating Room Skills

• Prep patients for surgery

• Accompany patients during surgery

• Recovery patients for surgery

OR Nurse

On the Job…… Education (peers, students & families)

• Unit policies

• Who’s who

• NICU terms

• NICU equipment

• Medications

• Gestational norms

• Gestational milestones

• How to care for neonates

Teacher/Educator

Moving on up….. Becoming a Manager

• Manage People

• Manage Budgets

• Capital purchases

• Inventory

• Staffing

• Staff competencies

• HR Policies

• Hire/Fire

• Unit Policies/Procedures

• Complaints

• Regulatory Requirements

• Executive Expectations

• MEETINGS!• Attending & Organizing

• Forecasting and projecting

• Marketing

• Assisting Staff

Leader Extraordinaire

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Can’t forget about personal life….. YOU!

• Spouse/Partner/Relationship

• Children

• Parents

• Committee

• Board Involvement

• Friends

• Pets

• Home

• Bills

• Grocery Shopping

• Daily chores

• Exercise

• Hobbies

• FUN!

• Life Changes:• Marriages

• Divorce

• Deaths• Trauma!!!

How do you manage it all?

And still look graceful in front of families and peers?

How do you manage it all?

When I often feel like this!

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What about supporting families in crisis?

What about supporting families in crisis?

What about supporting families in crisis?

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What about supporting families in crisis?

It’s An Expectation!

• Patients

• Families

• Providers

• Nurses

The reality is……

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Unique Educational Program is Available!

• On-line• Interactive & Engaging• Based on the published Best

Practice Recommendations on how to provide Psychosocial Support to NICU families

• CEU/CME

What makes this special?

14 Graduate Parent Organizations

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Plus 100+ Parent Voices

Content – 7 modules

• Emotional Support

• Communication

• Family Centered Developmental Care

• Peer-to-Peer Support

• Discharge/Follow Up

• Palliative/Bereavement Care

• Supporting Staff

Unique Features

• Developed by professionals and experts by experience

• Expertly designed with multimedia platforms • Written content

• Video Clips

• Audio Clips

• Quotes by parents & staff

• Interactive Questions

• Over 80 Downloads

• Resource Rich

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Sneak Peek: Main Course Page

Sneak Peek: Key Points in each Module

Sneak Peek: Audio Clips

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Sneak Peek: Discussion Questions

Sneak Peek: Open Dialogue

Sneak Peek: Evaluation for CEU/CME Credit

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Extras!

• Can be customized to individual unit policies/procedures/family resources

• Customized reports on areas of focus can be provided to unit leaders

• Consultation services are available from the technical lead team

Who’s already participating?

• Children’s Hospital of Philadelphia• 60 MD’s and 30 NNP’s• 11 Neonatal Centers coming soon

• University of Mississippi’s Medical Center *• 200+ nurses

• St. Johns Regional Medical Center *• 40+ nurses, 2 MD’s

• St. Charles Health System• 40+ nurses, 3 MD’s, 3 NNP’s

• McLeod Regional Medical Center• ?

*QI Participant

Benefits:

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Benefits:

Literature

“Few NICUs offer staff education that teaches optimal methods of

communication with parents in distress. Limited staff education in

how to best provide psychosocial support to families is one factor

that may render those who work in the NICU at risk for burnout,

compassion fatigue and secondary traumatic stress syndrome.

The goal is to deliver care that exemplifies the belief that

providing psychosocial care and support to the family is equal in

importance to providing medical care and developmental support

to the baby.”

Hall, S. L., Cross, J., Selix, N. W., Patterson, C., Segre, L., Chuffo-Siewert, R., . . . Martin, M. L. (2015). Recommendations for enhancing psychosocial support of NICU parents through staff education and support. Journal of Perinatology, 35(S1). doi:10.1038/jp.2015.147

What students are saying……

“Thank you for providing a well-rounded view of the emotional needs of NICU parents.”

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What students are saying……

“This lesson helped to cement my current knowledge base and affirm the importance of including the parents as team members. Communication is the basis for all things and can always be improved upon.”

What students are saying……

“I just completed the on line training program and it was great! I loved everything. Well done.”

What students are saying……

“I found it user-friendly and informative! The multimedia aspect as well as the input from different perspectives (parents and staff) made it interesting and less like a standard required course. I kind of just got lost in it. Thanks so much!”

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Good News!

Family Advocate and

Supporter

How can you learn more?

Visit www.mynicunetwork.com

Email sara@mynicunetwork.com

www.mynicunetwork.com