Newborn intensive care unit - staff; Neonatal intensive care unit - staff
This article discusses the main team of caregivers who are involved in the care of your infant in the neonatal intensive care unit (NICU). The staff often includes the following:
ALLIED HEALTH PROFESSIONAL
This health care provider is a nurse practitioner or physician assistant. They work under the supervision of a neonatologist. An allied health professional may have more experience in patient care than a resident, but will not have had the same amount of education and training.
ATTENDING DOCTOR (NEONATOLOGIST)
The attending doctor is the main doctor responsible for your baby's care. The attending doctor has completed fellowship training in neonatology and residency training in pediatrics. Residency and fellowship usually take 3 years each, after 4 years of medical school. This doctor, called a neonatologist, is a pediatrician with special training in caring for babies who are sick and require intensive care after birth.
Although there are many different people involved in your baby's care while in the NICU, it is the neonatologist who determines and coordinates the daily plan of care. At times, the neonatologist might consult with other specialists to help with your baby's care.
A neonatology fellow is a doctor who has completed a residency in general pediatrics and is now training in neonatology.
A resident is a doctor who has completed medical school and is training in a medical specialty. In pediatrics, the residency training takes 3 years.
- A chief resident is a doctor who has completed training in general pediatrics and now supervises other residents.
- A senior resident is a doctor who is in the third year of training in general pediatrics. This doctor generally supervises the junior residents and interns.
- A junior, or second-year, resident is a doctor in the second of 3 years of training in general pediatrics.
- A first-year resident is a doctor in the first year of training in general pediatrics. This type of doctor is also called an intern.
A medical student is someone who has not yet completed medical school. The medical student might examine and manage a patient in the hospital, but needs to have all of their orders reviewed and approved by a doctor.
NEONATAL INTENSIVE CARE UNIT (NICU) NURSE
This type of nurse has received special training in caring for babies in the NICU. Nurses play a very important role in monitoring the baby and supporting and educating the family. Of all the caregivers in the NICU, nurses often spend the most time at a baby's bedside, caring for the baby as well as the family. A nurse might also be a member of the NICU transport team or become an extracorporeal membrane oxygenation (ECMO) specialist after special training.
A pharmacist is a professional with education and training in the preparation of medicines used in the NICU. Pharmacists help prepare medicines such as antibiotics, immunizations, or intravenous (IV) solutions, such as total parenteral nutrition (TPN).
A dietitian or nutritionist is a professional who is educated and trained in nutrition. This includes human milk, vitamin and mineral supplements, and preterm infant formulas used in the NICU. Dietitians help monitor what babies are fed, how their bodies respond to the food, and how they grow.
A lactation consultant (LC) is a professional who supports mothers and babies with breastfeeding and, in the NICU, supports mothers with expressing milk. An IBCLC has been certified by the International Board of Lactation Consultants as having received specific education and training as well as passing a written examination.
The medical team may also include a respiratory therapist, social worker, physical therapist, speech and occupational therapist, and other professionals depending on the baby's individual needs.
Physicians from other specialties, such as pediatric cardiology or pediatric surgery, may be part of consultant teams involved in caring for babies in the NICU. For more information see: NICU consultants and support staff.
If your newborn needs to be admitted to the neonatal intensive care unit, or NICU, a group of different medical professionals will be there to help. Here's a rundown of some of the consultants and support staff you can expect to meet in the NICU. Each person who works in the NICU has a different specialty: Your bedside NICU nurses work most closely with your baby, providing care and observing closely for important changes. A neonatologist specializes in the health problems of newborns. They supervise and coordinate care. A cardiologist is trained to diagnose and treat diseases of the heart and blood vessels. If a baby has a heart defect, a cardiovascular surgeon will perform the surgery to fix it. An infectious disease specialist treats babies who have serious infections, including infections of the blood, brain, or spinal cord. A neurologist diagnoses and treats conditions of the brain, nerves, and muscles. You might see a neurologist if your baby has seizures, or is born with a nervous system condition like spina bifida. When the problem needs to be corrected with surgery, a neurosurgeon will perform the operation. An endocrinologist diagnoses and treats hormone problems, such as diabetes. Gastroenterologists are expert at treating digestive problems of the stomach and intestines. A hematologist-oncologist treats blood disorders and cancer. An infant might see this type of doctor for a problem with blood clotting. A nephrologist focuses on diseases of the kidneys and urinary system. If your baby was born with a kidney problem, you will talk to this doctor about treatments, and possibly the need for surgery. Pulmonologists treat newborn lung problems, such as respiratory distress syndrome. You might see this doctor if your baby was born with a breathing condition. Then you'll work with a respiratory therapist to treat the problem. If you had a very high-risk pregnancy, you'll work with a maternal-fetal medicine specialist. This doctor can help if your baby was born prematurely, or you had twins or other multiples. Babies who are born with eye defects see an ophthalmologist, a doctor who diagnoses and treats eye problems. If your newborn needs x-rays, an x-ray technician will take the test, and a radiologist will read the results. Sometimes babies are born with or at risk for developmental delays. If that is the case, a developmental pediatrician will test your child, and help you find the right care once you leave the NICU. The pediatrician may recommend that you see an occupational or physical therapist to assess your baby's reflexes, movement, and feeding. While you're in the NICU, you'll also see a neonatal nurse practitioner. This specialist will work closely with your doctor to make sure your baby gets just the right care. Being in the NICU can feel scary and new at first. Don't be afraid to ask questions. Your NICU medical team is there to care for your baby, and to make sure you're prepared to take over that care once you get home.
Raju TNK. Growth of neonatal-perinatal medicine: a historical perspective. In: Martin RJ, Fanaroff AA, Walsh MC, eds. Fanaroff and Martin's Neonatal-Perinatal Medicine: Diseases of the Fetus and Infant. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 1.
Sweeney JK, Guitierrez T, Beachy JC. Neonates and parents: neurodevelopmental perspectives in the neonatal intensive care unit and follow-up. In: Umphred DA, Burton GU, Lazaro RT, Roller ML, eds. Umphred's Neurological Rehabilitation. 6th ed. St Louis, MO: Elsevier Mosby; 2013:chap 11.
Last reviewed on: 9/29/2019
Reviewed by: Kimberly G. Lee, MD, MSc, IBCLC, Clinical Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.