PATIENT EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT Allison Murphy Health Communication Dr. White October 8, 2014 Application Exercise #2 PATIENT EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT 1. Of the types of social support that Jennifer received as a new mother with a baby in the NICU, the most beneficial was emotional and reactive support from close family in person and friends via email. Her husband and mother visited constantly, relying on each other for support in order to support Jennifer during the process (Hull). According to our text by Wright, Sparks, and O’Hair, emotional support can be felt when people are “simply ‘being there’ during a time of need,” which Jennifer experienced when her loved ones offered their help and positive thoughts before, during, and after her pregnancy (Wright). While the in-person contact worked well for her, she didn’t want everyone to visit her in the hospital because her room was small and it’d be overwhelming, so she communicated with friends and other family members on her own terms. This was accomplished through email, because she could answer questions and concerns at her own leisure and pace without dealing with social media or constant contact with others (Hull). Jennifer also said that she prayed quite a bit, turning to her faith as a way of social support through a difficult time. This support from family, friends, and faith let her know that she was cared about without it being too overwhelming for her during a difficult period. 2. The type of social support that was least helpful for Jennifer as a parent with a child in the NICU was enacted support. This type of support deals with “conditions under which communication facilitates beneficial outcomes for people facing stress” (Wright). Jennifer did not receive this from some of the nurses who worked in the hospital. While she said that the neonatal nurses were phenomenal in keeping her updated and comfortable, some nurses before and after birth were rude, seemingly uncaring, and PATIENT EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT disorganized. Her information white board wasn’t always updated, and information wasn’t given to her in a respectful manner (Hull). Jennifer was a new mother with a tiny, premature baby arriving early, and she was frightened and confused by the situation. Jennifer said that she wished the nurses understood that she wanted information to help relieve her stress and anxiety, but in a delicate way; she wanted to know if the baby was going to be okay, and what it meant that she was arriving at 32 weeks instead of 40. The uncertainty of how being premature would affect her child later on and when she could take her home only added to the stress of the situation. Had some of the hospital staff and nurses taken her fears into concern, I think that a lot of her feelings of being overwhelmed would have been calmed. 3. The coping strategy that Jennifer most heavily used during her experience in the NICU was problem-focused coping, when one directly tries to fix or help a negative situation (Wright). Despite being put on bed rest for weeks following her early labor to help her daughter develop a little more, Jennifer was positive in wanting to be proactive in her negative situation. She wrote emails to family and friends, kept herself busy, and became good friends with the nurses who worked with her (Hull). Jennifer found herself in a situation where she had little knowledge of solutions and control, but she made the most of it and tried to remedy problems as they came to her. I think that a coping strategy she and the hospital might have used more of is emotional-focused coping. While Jennifer did talk to close family members and kept friends outside of the hospital updated using technology, she said that she felt very alienated and scared since none of her friends had been through a similar situation. One way this problem could have been solved is if the PATIENT EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT hospital, nurses, or NICU unit put her in contact with other mothers who gave birth to extremely premature babies to relieve her concerns and give her someone to relate to. Jennifer said that her good NICU nurses kept her updated and calm during scary situations, but she just wanted someone like her to relate to. 4. Jennifer made some social comparisons as a parent with a baby in the NICU to others in similar situations, but she said she primarily felt alone and couldn’t relate to her friends with full-term babies (Hull). I think she used upward comparison the most, because she never planned on having a premature baby and didn’t know anything about the situation or what to expect, and she was shocked and scared when she looked information up online. Upward comparisons can “produce feelings of frustration” and make a stressful experience worse if one feels they are coping with a situation worse than someone else in a similar situation (Wright). I also believe that Jennifer thought she wasn’t handling the situation as well as she could’ve, especially since when they visited their daughter in the NICU, her husband was more familiar with the sanitation rules and habits of the NICU (Hull). Had Jennifer been put in contact with and talked to other parents with premature babies to feel more comfortable and relieve some of their anxiety regarding the situation, I think that lateral comparison would have helped normalize the situation and allow them to cope better. Lateral comparison helps reduce uncertainty (which both Jennifer and her husband needed at the time) when dealing with their neonatal health concerns (Wright). 5. After listening to Jennifer speak about her experience in the NICU with a premature neonate, I would definitely recommend creating social support opportunities for parents PATIENT EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT in similar situations to cope more effectively. While Jennifer did everything she could before and during her situation, there was a lot of uncertainty and questions about how her daughter would be doing and when they could take her home. This caused stress and anxiety levels to rise simply because she was confused and inexperienced in this situation, so it would’ve definitely helped her to meet other parents who had gone through a similar experience. Jennifer also didn’t know how to be an advocate for her family and child, especially because she had no experience with that type of situation and felt like the nurses knew how to care for her daughter better than she did. The nurses knew her baby’s schedule and information best, so she felt that they were in a better position to make decisions on her behalf (especially with their knowledge and experience). By creating social support for parents of neonates to talk and support each other, as well as creating better opportunities for all nurses to communicate with parents, anxiety and uncertainty would be reduced, and Jennifer’s experience in the NICU would have been a little better. She learned from her own situation to really focus on keeping yourself positive by taking [Starbucks] breaks, praying and talking to loved ones, and knowing that things would get better even if they were scary (Hull). PATIENT EXPERIENCE IN THE NEONATAL INTENSIVE CARE UNIT References Hull, Jennifer and Zachary White (September 24, 2014). Experience in the NICU. Speech. Wright, K. B., L.W. Sparks, and H.D. O’Hair, (2013). Health Communication in the 21st Century (2nd ed.). West Sussex, UK: Blackwell.