| The Hospital | People In The NICU |
During your baby's stay in the NICU, you will meet many people who will
participate in the care of your child. These professionals have
varying specialties and educational preparation. Their primary
goal is to provide your baby with the best possible care so
he/she can eventually go home with you.NICU care is a team effort and the neo-natologist is the team coordinator of your child's care while in the NICU. The medical caregivers, the neo-natologists, and the nurse practitioner formulate the daily care plan for the baby. There might be other physician consultants involved, as well. In addition, there are many other people who help in the NICU. See any of the specialties below to learn more about these people: Audiologist Most newborns should have their hearing tested before the hospital discharge. There are several types of hearing tests that can be done on babies. The clinical care team will determine the best type of test and the best time for your baby to be tested. An audiologist is trained to test and followup with babies with abnormal hearing. The testing that the audiologist performs may be done in the NICU or after discharge. Cardiologist A cardiologist is a physician that has special training in the diagnosis and treatment of diseases and conditions of the heart and blood vessels. They might be asked to see your baby (consulted) by the neonatologist to help diagnose a heart condition. These heart conditions may include:
Cardiovascular (Heart) Surgeon A cardiovascular (heart) surgeon is a physician that has training as a surgeon, along with specialized training to do surgery to correct or treat defects of the heart. This might include a heart that developed incorrectly prior to birth or abnormalities that occurred after birth. Sometimes, surgery can correct the problem, while at other times total correction is not possible. In these cases, surgery is performed to make the heart work better, even though it still does not have a normal structure. The surgeon will work closely with the cardiologist to care for the baby before and after surgery. Dermatologist A dermatologist is a physician that has special training in the diagnosis and treatment of diseases and conditions of the skin, hair and nails. They might be consulted in the NICU to assist in the diagnosis of a skin lesion or rash. They might also help the NICU team to care for skin lesions or rashes that require special treatment. Aside from examination of the babies, these physicians might obtain a biopsy of a skin lesion. The dermatologist might also work with the pathologist to interpret biopsies. Developmental Pediatrician A developmental pediatrician is a pediatrician that has special training in the evaluation and care of infants who are having difficulty doing what other children their age are able to do. They are trained to evaluate the level of functioning for each infant through a series of developmental tests. They will also help to locate resources within each community to provide therapies to help infants and children in meeting milestones. There might be overlap in what they do with neurologists. Developmental pediatricians work closely with nurse practitioners and/or occupational therapists/physical therapists to decide on the best therapies for each child. Dietician A dietician has special training in nutritional support (feeding). They might also specialize in pediatrics (children). They help evaluate the nutritional status and intake of an infant. They also make recommendations for the many choices of nutrition that can be given via the bloodstream (IV) or through different types of feedings. Endocrinologist An endocrinologist is a physician with special training in the diagnosis and treatment of infants with problems in their endocrine or hormone systems. Endocrinologists might be asked to see infants in the NICU for problems with salts (i.e., calcium or sodium), high or low blood sugars, or abnormal development of the thyroid gland or sexual organs. To help diagnose these conditions, tests, such as electrolytes, thyroid functions, or abdominal ultrasounds might be ordered. Gastroenterologists A gastroenterologist is a physician with special training in the evaluation and treatment of infants with problems of the digestive system (stomach and intestines) and liver. They might be asked to see a baby in the NICU when they have problems digesting food properly or for liver problems, such as hepatitis or cholestasis.To help in the diagnosis and care of these babies, tests, such as x-rays, liver function tests, or abdominal ultrasounds might be ordered. Geneticist A geneticist is a physician with special training in the evalutation and treatment of infants with congenital (inherited) problems, including chromosomal problems or syndromes. To help in the diagnosis and care of these conditions, they might order or use tests, such as chromosomes, metabolic studies, and sonograms. Hematologist/Oncologist A hematologist/oncologist is a physician with special training in the diagnosis and treatment of blood disorders (hematologic system) and types of cancer. They might be asked to see a baby in the NICU for blood cell problems. This could include bleeding problems due to low platelets. To help in the diagnosis and care of these babies, tests, such as a CBC or clotting studies, might be ordered. Infectious Disease Specialist An infectious disease specialist is a physician with special training in the evaluation and treatment of infections. They might be asked to see babies in the NICU when they develop unusual or serious infections. Infections in babies can include blood infections or infections of the brain and spinal cord (meningitis). Tests, such as a CBC, blood cultures, CRP, and spinal taps, might be ordered to help evaluate an infection. Maternal-Fetal Physician/Perinatologist A maternal-fetal medicine physician or perinatologist is an obstetrician with special training in the care of pregnant women having problems (high risk). They can care for mothers with problems, such as premature labor, multiple pregnancy, hypertension in pregnancy, or diabetes. Neonatal Nurse Practitioner Neonatal Nurse Practitioners (NNPs) are expert neonatal nurses who have obtained a graduate degree (or certificate), with emphasis in caring for the needs of critically ill newborns and their families. The NNP works in collaboration with a neo-natologist to diagnose and treat the conditions of babies in the NICU. The NNP also performs procedures to aid in the diagnosis (e.g. spinal taps) and management (e.g., chest tube placement) of medical conditions. Neo-natologist A neo-natologist is a pediatrician with special training in caring for babies that are sick and require intensive care after birth. They coordinate the care for the majority of babies in the NICU. At times, the neo-natologist might consult with other specialists to help with your baby's care. Although there are many different people involved in your baby's care while in the NICU, it is the neo-natologist who determines and coordinates the daily plan of care. Nephrologist A nephrologist is a physician with special training in evaluating and treating problems with the kidneys and urinary system. They might be consulted for problems due to abnormal development of the kidneys such as hydronephrosis, or to help care for a baby when their kidneys are not functioning correctly. Nephrologists might order tests, such as an electrolytes or abdominal ultrasounds, to evaluate these problems. If a baby has abnormal development in the structure of the kidneys which requires surgery, the nephrologist will work with a surgeon or urologist. Neurologist A neurologist is a physician with special training in the evaluation and treatment of disorders of the brain, nerves and muscles. They might be asked to see infants that have problems, such as seizures or bleeding in the brain. The neurologist might order a head ultrasound, electroencephalogram (EEG), or CT Scan to help identify the cause of the problem. If the infant has an abnormality in the brain or spinal cord that requires surgery, they might work with a neurosurgeon. Neurosurgeon A neurosurgeon is a physician that has training as a surgeon with more specialized training to operate on abnormalities in the brain and spinal cord. These abnormalities might be due to abnormal development prior to birth, such as spina bifida or from complications that happen after birth, such as a skull fracture or hydrocephalus. In addition to the neonatologist, the neurosurgeon might work closely with the neurologist for the management of certain conditions. NICU Nurse The NICU nurse has received special training in caring for babies in the NICU. Nurses play a very important role in the continuous monitoring of the baby and the support and education of the family. Of all the caregivers in the NICU, nurses usually spend the most time at a baby's bedside caring for the baby, as well as the family. A nurse might also be a member of the NICU Transport Team or become an ECMO specialist after special training. Obstetrician An obstetrician is a physician with special training in the prenatal care and delivery of women who are pregnant or are trying to get pregnant. As well as caring for the normal pregnancy, the obstetrician might follow women with such problems as diabetes or decreased fetal growth. They might consult with the perinatologist and/or the neonatologist. Occupational Therapist/Physical Therapist Occupational/Physical Therapists (OT/PT) are professionals with advanced training in working with infants with developmental needs. This work includes neurobehavioral assessments (postural tone, reflexes, movement patterns, and responses to handling). In addition, the OT/PT professionals will help determine a baby's nipple-feeding readiness and oral-motor skills. They also provide family education and support. Ophthalmologist An ophthalmologist is a physician with special training in evaluating and treating eye problems. They might be asked to see a baby in the NICU for birth defects of the eye. They evaluate premature infants for retinopathy of prematurity (ROP). They perform examinations of the inside of the eye, called retinal exams. These exams are very similar to what older children and adults get in an ophthalmologist's office when being evaluated for glasses. For certain conditions of severe ROP, they might perform laser surgery or other corrective surgery on the eyes. Orthopedic Surgeon An orthopedic surgeon is a physician with special training in the evaluation and treatment of conditions involving bones. They might be asked to see babies who have birth defects of the arms or legs, hip dislocation (dysplasia), or fractures of the bones. To evaluate the bones, orthopedic surgeons might order ultrasounds or x-rays. If needed, they can perform surgery and/or place casts. Ostomy Nurse An ostomy nurse is a nurse with special training in the care of skin wounds and ostomies. An ostomy is an opening in the abdomen through which the end of the intestine protrudes. Ostomies are the result of surgery needed to treat many intestinal problems, such as necrotizing enterocolitis. In some cases, ostomy nurses are consulted to help with the care of complicated wounds. Otolaryngologist/ENT Specialist An otolaryngologist or Ear, Nose, and Throat (ENT) specialist is a physician with special training in the evaluation and treatment of problems with the ear, nose, throat, and airways. They might be asked to help manage infants who have problems with breathing, such as those with a trachea that is ‘floppy' (tracheomalacia) or a blockage of the nose as in choanal atresia. Pathologist A pathologist is a physician with special training in laboratory testing and examination of body tissues. They supervise the laboratory where tests, such as electrolytes and CBCs, are performed. They also examine tissues under the microscope that are obtained during a surgery or an autopsy. Pediatrician A pediatrician is a physician with special training in the care of infants and children. They might do limited care of babies in the NICU, but they are usually the primary care providers for normal newborns. In addition, they provide primary care for most babies after they leave the NICU. Pharmacist/Clinical Pharmacist (PharmD) A pharmacist is a professional with education and training in the preparation of medications used in the NICU. They help prepare things, such as antibiotics, immunizations, and intravenous (IV) solutions, such as Total Parenteral Nutrition (TPN). Phlebotomist A phlebotomist is a hospital staff professional who is trained to obtain blood samples for performing tests as ordered by the physician. In the NICU, the phlebotomist generally gets the blood sample from a heel stick or from a vein. Pulmonologist A pulmonologist is a physician with special training in dealing with infants and children with problems of the respiratory (breathing) system. Even though the neonatologist cares for many infants with respiratory problems, the pulmonologist might be consulted for unusual conditions of the lung. They also help to manage breathing conditions that require significant care after discharge from the NICU. Radiologist A radiologist is a physician with special training in obtaining and reading x-rays and other tests. The neonatologist will usually read most of the x-rays, while the radiologist commonly reads specialized x-rays using radio-opaque solutions, such as barium enemas or ultrasound tests, such as neurosonograms. Respiratory Therapist Respiratory Therapists (RTs) have training to deliver multiple treatments to the cardiopulmonary system (heart and lungs). RTs may administer chest physiotherapy, assist in the management of ventilators, and deliver medications to the lungs. They are actively involved with babies having breathing problems, such as respiratory distress syndrome (RDS) or bronchopulmonary dysplasia (BPD). RTs might also be members of the NICU Transport Team or become ECMO specialists after specialized training. Social Worker Social workers are professionals with special education and training to determine the psycho-social, emotional, and financial needs of families. They help families find and coordinate resources in the hospital and community that will help to meet their needs. Social workers also help in the discharge planning of babies in the NICU. There are currently no Social Workers assigned to NICU Units in South Africa. Preemies For Africa hopes to establish this service in the near future. Surgeon A surgeon is a physician with special training in diagnosis and care of conditions that require surgery. They might be asked to see babies in the NICU with birth defects, or a condition that occurs after birth, such as necrotizing enterocolitis. Surgeons might also be asked to insert central catheters in babies that require long-term intravenous fluids. Urologist A urologist is a physician with special training in evaluation and treating conditions involving the urinary system that might require surgery. They are consulted on infants with conditions that result from birth defects such as, hydronephrosis or hypospadius. With some conditions, they will work closely with a nephrologist. X-Ray Technician An x-ray technician is a professional trained in obtaining x-rays. X-rays can be of the chest or involve the use of solutions to make body parts easier to identify, as with barium enemas. RESOURCE: Pediatrix |