How to Understand the Hierarchy in NICU

The NICU, or the Neonatal Intensive Care Unit, is a special unit for babies that need extra assistance. Premature babies, babies born with disabilities and babies who have poor health during the first few days of life usually go to the NICU. If your baby is the NICU, you may be confused about the staff hierarchy. Read on to learn how to understand the hierarchy in NICU.

Instructions

Difficulty: Moderately Easy

1. Talk to the staff. Depending on the hospital, each different step up the hierarchy ladder in the NICU may have a different color scrub. Doctors may be differentiated from nurses based on coats, and different lengths of coats may differentiate medical students from residents from specialists. Don't be shy about asking the staff who they are and what their positions are, how to tell them apart and what they do to help your baby.
2. Ask many questions, even if you're repeating yourself. If your baby is in the NICU, you are probably recovering from your birth and will be worried about your baby. Don't be shy about asking people you've already met what their names are and how they're helping your baby. The staff won't get upset; they're used to it.
3. Differentiate the different levels of nurses. There are charge nurses (the nurse in charge of the nurses on shift), the primary nurse (the one who's job is to take care of your baby) and the clinical nurse specialist (a nurse with special training in neonatology). The charge nurse is probably in charge of the nurses during that shift and highest on the nurses hierarchy ladder. If you have any problems with the nursing staff, ask to speak to the charge nurse.
4. Figure out the doctors. There are many different doctors in the NICU, including the neonatologist (a specialty trained doctor who is in charge of the medical team), medical students (lowest in the hierarchy) and residents (these are various levels of doctors who are learning about neonatology) and various specialists such as cardiologists and surgeons. The neonatologist is usually in charge of everyone, including the nurses.
5. Learn the other specialties. This is going to include physical therapists, nutritionists, lactation consultants, lab technicians and pharmacists (prescribing medicine for your baby). Each of these people answer to their own bosses and also to the neonatologist in charge of your baby. You also may meet a social worker and a chaplain. These two specialists are outside the hierarchy for the most part since they have almost no medical responsibilities.