Understanding NICU Staff: Caring for Your Baby

Walking into a neonatal intensive care unit (NICU) can feel overwhelming since you're stepping into the unknown. To help ease your mind, here's an A-to-Z guide to better understand the roles and functions of the many NICU workers who are there to care for your baby and support you.

If you want to learn more about the NICU, be sure to check out these helpful guides on equipment, tests, and common problems.

Who Works in the NICU

Case Manager/Discharge Coordinator. A professional who helps coordinate your baby’s discharge or transfer, ensuring all their care needs at home or in a step-down unit are met. They also handle the ongoing communication between the hospital and your insurance provider regarding your baby's care.

Chaplain. A member of the clergy available at the hospital to support those dealing with illness. They can help you navigate the tough emotions that come with your child's serious illness or hospitalization.

Early Interventionists. A multidisciplinary team specializing in education, developmental disabilities, and various therapy disciplines. They provide services for children from birth to 3 years old who are at risk for developmental difficulties. This team will assist you and your baby at home after discharge, and they often start getting to know you during your hospital stay.

Medical Specialists. Experts who may be called in to evaluate specific problems your baby is experiencing. These doctors are usually trained in pediatrics and then specialize further.Some of these specialists include:

• Behavioral and Developmental Specialist (often a pediatrician): Addresses behavior and development problems.

• Cardiologist: Focuses on heart issues.

• Endocrinologist: Deals with gland and growth problems.

• Gastroenterologist: Handles bowel, liver, and digestion issues.

• Hematologist: Manages blood, bleeding, and certain immune-system disorders.

• Infectious-Disease Specialist: Takes care of complex infections.

• Nephrologist: Focuses on kidney problems.

• Neurologist: Addresses brain issues, including seizures.

• Pulmonologist: Deals with lung and breathing problems.

Neonatal Nurse Practitioner. A registered nurse with advanced education (usually a master's degree) and certification in caring for premature and sick newborns. They work under the direction of the neonatologist, can perform many procedures, and help oversee your baby's care. Neonatal nurse practitioners often handle continuing care and discharge planning for infants in NICU hospitals.

If you have any questions about kangaroo care (when your baby is placed on mom or dad’s bare chest), what clothes to buy for your preemie, or which preemie diapers are right for your little one’s weight and size, a neonatal nurse is the perfect person to ask.

Neonatologist. The doctor in charge of the NICU workers and department. They're a pediatrician with advanced training in caring for sick newborns and usually have board certification in this area. There may be several neonatologists in the NICU to cover the unit's 24-hour schedule.

Neonatology Fellow. A fully trained and certified pediatrician receiving advanced training in caring for sick newborns. They may direct the day-to-day work of the resident staff and report to the neonatologist in charge. A neonatology fellow might rotate to other hospitals or areas every four to eight weeks.

Occupational Therapist/Physical Therapist. Health professionals who address how immaturity or illness affects behavior. The occupational therapist works to improve functioning in your newborn with various interventions. The physical therapist looks at muscle tone, strength, and motor activities. Both provide valuable input about supportive care in the nursery and at home.

Pediatric Resident. A doctor receiving training in pediatrics, generally working in the NICU for three to six weeks.

Registered Nurse. A health professional who has passed a written examination after graduating from a college or hospital nursing program. Registered nurses in the NICU have experience caring for sick newborns and are also known as neonatal nurses. In most units, one nurse will be designated as the "primary" nurse for your baby, meaning they will be most responsible for your infant's care and NICU monitoring. Although others will care for your baby at night, on holidays, etc., the primary nurse will know your baby and you the best. In some hospitals, neonatal nurses are qualified to perform many procedures that are handled by residents and fellows in larger units.

Respiratory Therapist. A health professional trained to use medical equipment needed for babies with breathing problems. They may be in charge of blood oxygenation tests and certain other procedures.

Social Worker. A professional who helps you cope with the emotional and social aspects of your baby's NICU stay. The social worker can help you obtain information from your baby's doctors, provide other resources on your baby's medical problems, assist with financial difficulties and stress, and help make special arrangements you may need for your baby's discharge and follow-up care. Sometimes social workers lead supportive therapy sessions with groups of families.

Speech and Language Pathologist. A specialist trained in speech and language concerns who often works with NICU babies to help with feeding problems. Some infants who show delays in language in the first year of life and beyond may need the services of a speech pathologist after discharge.

Surgical Specialists

If your baby requires surgery, a specialized surgeon may be called in to advise or perform the procedure.Here are some types of surgeons and their areas of expertise:

• Cardiothoracic Surgeon: Care of the heart, blood vessels, and often lungs.

• Ear, Nose, and Throat (ENT) Surgeon: Care of the ears, nose, and throat, plus some airway problems.

• General Surgeon: Bowel problems, hernia repairs, and placement of arterial and venous lines.

• Neurosurgeon: Care of the brain, spinal cord, and nerves.

• Orthopedic Surgeon: Bone and joint problems, including deformities.

• Plastic Surgeon: Head and neck deformities, certain skin problems, and some hand and foot concerns. Some of this work can also be done by an orthopedic surgeon.