Many new parents have worries and concerns, especially if their child is in the Neonatal Intensive Care Unit (NICU). This is a support for those parents of infants in the NICU . I hope you find this information helpful.

Friday, April 1, 2011

Social Workers in NICU



I have been curious about how social workers interact in the NICU and I found some helpful links about what social workers do in the NICU:

Comprehensive Social Work Services in a NICU

Strategies for NICU Providers

For NICU Providers: Be HELPFUL

Believe in the parent’s ability to survive this event.

Empathize with NICU/ICN parents.

Have hope

Encourage communication.

Loving thoughts and actions.

Patience with the healing and growing processes.

Find inner strength- faith, spirituality

Understand your partner, staff and baby.

Lighthearted. Remember that it is ok to find moments of laughter amidst the tears.

Strategies from NICU Parents to other parents

Ways to care for your infant:

Ask questions about your newborn.

Get involved with caring for your newborn

Familiarize yourself with how the NICU works

Ways to Care for Yourself

Learn about the common response to grief

Take time for yourself- eat, rest, exercise

Don’t let the pressures get you run down

Learn relaxation techniques

Give yourself permission to take time off

APGAR Scores

About the Apgar Score

The very first test given to your newborn, the Apgar score occurs right after your baby's birth in the delivery or birthing room. The test was designed to quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for extra medical or emergency care.

Although the Apgar score was developed in 1952 by an anesthesiologist named Virginia Apgar, you may have also heard it referred to as an acronym for: Activity, Pulse, Grimace,Appearance, and Respiration.

The Apgar test is usually given to your baby twice: once at 1 minute after birth, and again at 5 minutes after birth. Rarely, if there are concerns about the baby's condition and the first two scores are low, the test may be scored for a third time at 10 minutes after birth.

Five factors are used to evaluate the baby's condition and each factor is scored on a scale of 0 to 2, with 2 being the best score:

1. activity and muscle tone

2. pulse (heart rate)

3. grimace response (medically known as "reflex irritability")

4. appearance (skin coloration)

5. respiration (breathing rate and effort)

Doctors, midwives, or nurses add these five factors together to calculate the Apgar score. Scores obtainable are between 10 and 0, with 10 being the highest possible score.

Apgar Scoring

Apgar Sign

2

1

0

Heart Rate
(pulse)

Normal (above 100 beats per minute)

Below 100 beats per minute

Absent
(no pulse)

Breathing
(rate and effort)

Normal rate and effort, good cry

Slow or irregular breathing, weak cry

Absent (no breathing)

Grimace(responsiveness or "reflex irritability")

Pulls away, sneezes, or coughs with stimulation

Facial movement only (grimace) with stimulation

Absent (no response to stimulation)

Activity
(muscle tone)

Active, spontaneous movement

Arms and legs flexed with little movement

No movement, "floppy" tone

Appearance
(skin coloration)

Normal color all over (hands and feet are pink)

Normal color (but hands and feet are bluish)

Bluish-gray or pale all over

What Apgar Scores Mean

A baby who scores a 7 or above on the test at 1 minute after birth is generally considered in good health. However, a lower score doesn't necessarily mean that your baby is unhealthy or abnormal. But it may mean that your baby simply needs some special immediate care, such as suctioning of the airways or oxygen to help him or her breathe, after which your baby may improve.

At 5 minutes after birth, the Apgar score is recalculated, and if your baby's score hasn't improved to 7 or greater, or there are other concerns, the doctors and nurses may continue any necessary medical care and will closely monitor your baby. Some babies are born with heart or lung conditions or other problems that require extra medical care; others just take a little longer than usual to adjust to life outside the womb. Most newborns with initial Apgar scores of less than 7 will eventually do just fine.

It's important for new parents to keep their baby's Apgar score in perspective. The test was designed to help health care providers assess a newborn's overall physical condition so that they could quickly determine whether the baby needed immediate medical care. It was not designed to predict a baby's long-term health, behavior, intellectual status, or outcome. Few babies score a perfect 10, and perfectly healthy babies sometimes have a lower-than-usual score, especially in the first few minutes after birth.

Keep in mind that a slightly low Apgar score (especially at 1 minute) is normal for some newborns, especially those born after a high-risk pregnancy, cesarean section, or a complicated labor and delivery. Lower Apgar scores are also seen in premature babies, who usually have less muscle tone than full-term newborns and who, in many cases, will require extra monitoring and breathing assistance because of their immature lungs.

If your doctor or midwife is concerned about your baby's score, he or she will let you know and will explain how your baby is doing, what might be causing problems, if any, and what care is being given. For the most part, though, most babies do very well, so relax and enjoy the moment!

A Definition of Faith

A Definition of Faith- Patrick Overton

When you have come to the edge of all that you know,

And are about to step into the darkness of the unknown,

Faith is knowing one of two things will happen:

There will be something solid to stand on or

You will be taught to fly

Discovery Health

Neonatal Intensive Care Unit Television Show on Discovery Health- http://health.discovery.com/tv/nicu/

Baby Health

Discovery Health Television created a TV show about the NICU. This 10-episode docu-drama serious goes behind the scenes of top NICUs, showing the day-to-day care required to sustain the smallest of lives. NICU follows real families as they experience the rollercoaster of emotions that come with having a premature baby and features doctors and nurses from leading Hospitals in Baltimore, San Diego and Cleveland, as they work around the clock to ensure the survival of their tiny patients.