Book Description

The experience of walking into the neonatal unit for the first time is frightening to parents, doctors, and nurses. The beautiful decorations, elegant furniture and the gracefully dimmed lights are not seen, as if they are not existing. What matters for parents is their baby, and they see nothing but their baby. For new nurses and doctors, the tension and stress of the unfamiliar environment pulls a cataract-like blinds across both eyes. Then comes the next challenge: the Jargon and unique phrases in common use in NICU. The team, in every neonatal unit, has adopted hundreds of peculiar and unfamiliar terms as part of their daily language. They always make some efforts to explain themselves, only to divert back to their tested and trusted language. I, like many other colleagues, have struggled on many occasions to keep away from the medical jargon while talking to parents or relatives. There are countless references, books and internet sites which give tables of NICU abbreviations and terms and their counter words or phrases. This book is not intended to add to these useful resources, as they are far from perfect. The mere provision or listing of the abbreviations and their meanings, does not provide the parents or beginners with the backbone of knowledge, upon which they could assimilate in depth exploration of the challenge in question. On the other hand, there is plethora of neonatal conditions which make thorough explanation of each and everyone of them, an impossible and daunting task. Any book, in that scenario, will be comprehensive but not practical due to its length. This book, (NEW TO NICU), tries to introduce NICU to all newcomers: parents, nurses, and doctors. It highlights the essential structure of NICU and how to approach it by those who are new to it. It introduces NICU family with a brief description of their roles. Then the book goes in detail to explore the majority of day-to-day NICU language. This is coupled with summary to the situations behind phrases or abbreviations. There are some areas where the explanations are intentionally detailed, while in other areas, a brief description is offered. The communication with the neonatal team is irreplaceable and face to face discussions are the gold standard of successful dialogues. The information about the baby condition, current status, medications, nutrition, and growth are normally conveyed by the nursing staff. The questions about why (Causation), what (Condition), when (Anticipation) and how the future looks for the baby (Prognosis), are best discussed with the Doctors. Consistent and factual information build the trust between parents and the managing team. There is a place for emotions in all the interactions between staff and parents, but emotions should not colour facts to deal with the short-term outcome or long-term prognosis. New nurses and doctors joining NICU find themselves out of their depth in the first few days-weeks. This is not related to their inexperience or ignorance, but only because they are not able to follow conversations riddled with mines of abbreviations in every single sentence. I remember vividly in my first job in UK, when a nurse phoned me to tell a baby’s cannula is tissued. I felt very embarrassed (Being an experienced Registrar coming from overseas), that I could not even ask for the meaning of this phrase. I replied by saying “Thank You,” to which she replied: “Are you coming now?” I put the phone down after I said Yes!! I immediately rang my sister who is a radiologist in London, who was even more surprised that I did not know the meaning of “Cannula is tissued.” This is just one example of many which may look trivial but the accumulation of these gaps in conversations are difficult to live with. Ward rounds in particular are stressful times for those who are not familiar with NICU jargon. The jargon and abbreviations infiltrate every aspect of communication in NICU: Handovers, day to day care, resuscitation, non-emergency procedures and even offering the baby breast milk obtained from the mother! The use of abbreviations is unacceptable to many people but is the bear reality in each hospital department, and NICU is not an exception. The staff are advised to use the approved abbreviations which are published by each hospital governance body. The use of non approved abbreviations may lead to dire clinical and legal consequences. Furthermore, the staff should make every possible effort to explain to parents, in simple language, what is meant by an abbreviation or a commonly used phrase. I hope this book helps newcomers to NICU including parents, nurses, and doctors.