Family Presence in the NICU

Constraints and Opportunities in the COVID-19 Era

Janelle Bainter; Marybeth Fry; Brenda Miller; Teesha Miller; Amy Nyberg; Alexa O'Dell; Ginny Shaffer; Lelis Vernon


Pediatr Nurs. 2020;46(5):256-259. 

In This Article

Impact of COVID-19

The abrupt onset of the COVID-19 pandemic disrupted hospital and NICU operations 'as usual' and led senior leaders in health care settings to make just-in-time decisions in the interest of staff, patient, and family member safety. Decisions were made out of concern related to bi-directional transmission of the virus and in the context of limited availability of personal protective equipment (PPE).

These decisions, while well-intentioned, were like rocks dropped into a pond, and the ripple effect has been significant. The 'ripples' have negatively impacted family presence in many care settings, including the NICU. Families of premature and ill babies, in the past welcomed into NICUs, now must choose which parent or caregiver can spend time with their baby on any given day. This has contributed to stress, anxiety, sadness, heartache, and frustration among families. Not only has individual family member participation in the care of babies become limited (e.g., only one family member allowed in the NICU) due to restrictions resulting from COVID-19, but family representation at the policy-making table has become almost non-existent. Partnering with bedside nurses became challenging because many staff members felt caught in the middle of enforcing hospital 'visitation' policies that directly opposed the core principles of patient- and family-centered care they have embraced.

The eight authors of this article are NICU graduate parents with a collective 653 days spent in the NICU with their babies. They are also Vermont Oxford Network (VON) paid Family Faculty, with a combined total of 108 years working in NICUs and/or on quality improvement initiatives through VON (see Figure 1). The changes in NICUs resulting from COVID-19 are a major concern for their impact on family-centered care.

Figure 1.

Vermont Oxford Network