Download Welcome to Neonatal Intensive Care Unit

Welcome to
Neonatal Intensive
Care Unit
Your baby has been admitted to the Neonatal Intensive Care
Unit (Neonatal ICU), location 8 D 105. The unit looks after
newborn babies who need special care. This booklet outlines
everyday arrangements within the Neonatal ICU. More detailed
information is available from the nurse who is looking after
your baby. A Neonatal ICU isn’t run in the same way as an
ordinary care unit. A lot of special equipment is used, for
example, to monitor and support the babies’ ‘vital functions’,
such as pulse, breathing, blood pressure and temperature. The
nurse who is looking after your baby operates the equipment
and can tell you what it is all for. Because the equipment is
very sensitive, it will give an alarm whenever anything changes.
So please don’t think that there is something wrong with your
baby every time an alarm sounds. If you have any questions,
feel free to ask the doctor or nurse who is taking care of your
baby.
Staff
At the Neonatal ICU, you will find (fellow) neonatologists, paediatricians,
junior doctors and Neonatal ICU nurses, some of whom are trainees.
The doctors and nurses are helped to care for your baby by a team that
includes medical social workers, physiotherapists, pedagogical workers,
pastoral staff, radiologists and laboratory technicians.
The unit’s day is divided into three shifts: a day shift, an evening shift
and a night shift. So in any given 24-hour period, there are three teams
of doctors and nurses on duty. On each shift there will be a nurse with
general responsibility for your baby. This nurse is the person you will
normally be dealing with. He/she will be able to tell you whether any of
the care practitioners mentioned above will be involved in the treatment
of your baby. Within the Neonatal ICU, one person is responsible for
coordinating each baby’s care. In the first few days after your baby
arrives at the unit, your baby’s care coordinator (one of the nurses) will
arrange a meeting so that you can get to know one another and he/she
can explain his/her role. You can also ask to talk to the doctor treating
your baby or to another team member at any time. The nurse who is
looking after your baby will arrange for you to see the person in question
as soon as possible.
On weekdays and during office hours, someone is always on duty at the
reception in the corridor. The receptionist is the person you need to talk
to about anything administrative, such as the name of your insurer and
your insurance policy number. Please give the receptionist the necessary
information as quickly as possible – preferably on your first visit to the
department – so that it can be checked and entered onto the system.
Medical social workers
Whenever a baby has to spend a long time at the Neonatal ICU, the
team treating the baby includes a medical social worker. Medical social
workers work closely with the unit’s doctors and nurses, and use their
specialist experience to help parents deal with problems linked to their
babies’ illness or treatment. You may be introduced to a medical social
worker quite soon after your baby is moved to the Neonatal ICU, so that
you can benefit from his/her specialist knowledge and experience with all
the issues surrounding a prolonged stay.
Further information is available from the nurse who is looking after your
baby or from the Medical Social Work Team on (020) 444 2505.
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Spiritual/Pastoral Care Service
The VU University Medical Center is supported by several Catholic and
Protestant priests and by an imam.
Whatever your religion, if you wish to discuss spiritual or philosophical
issues, pastoral support is always available through the hospital. Both
you and your family and friends may make use of this support. If you
would like a pastoral worker to visit you, please tell the nurse or the
Pastoral Centre. In some cases, a pastoral carer may contact you of his/
her own accord. Where appropriate, a baby can be admitted to your faith
at the Neonatal ICU.
For further information, speak to the nurse that is looking after your
baby or call the Spiritual/Pastoral Care Service on (020) 444 3475.
Lockers
While you are visiting the Neonatal ICU, you may leave your valuables
in a locker. Please use the locker with the same number as your baby’s
incubator number. The lockers are coin-operated: you need to put in
€ 0.50, which you get back afterwards. Please don’t take your locker key
home with you.
Health insurance
When you have a baby, you need to register him or her with your health
insurer within sixty days. We advise you to do so as soon as possible,
because there are often administrative delays.
As soon as you have an insurance policy number for your son or
daughter, please tell us, so that we can make the necessary financial
arrangements with the insurer.
Further information is given in the letter that you will receive from the
Patient Administration Unit on the day that your baby is admitted.
Getting answers to your questions
At the Neonatal ICU, several nurses are on duty at all times of the day
and night. By your baby’s incubator, you will find an IC list, which tells
you who is currently looking after your son or daughter. The nurse in
question will do his/her best to keep you informed about how your
baby is doing. You can also phone the nurse to ask questions, whenever
you feel the need. The phone number to use is given at the end of this
booklet. Information can be given only to parents/guardians, unless
special arrangements have been made with you.
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While your baby is at the Neonatal ICU, he or she will have a nursing
record file. This file is used by the nurses. In it, they record the care your
baby has received and the observations they have made. If you wish to,
you may look at the file in the company of a nurse.
Visiting arrangements
At the Neonatal ICU, we believe that it is important for parents/guardians
to be able to spend as much time as possible with their babies. When you
want to see your baby, first you need to use the intercom at the entrance
to identify yourself by giving your name and your baby’s name.
Once you have come through the main door, you will find yourself in an
anteroom that acts as a ‘lock’ between the unit and the outside world. In
the anteroom, please take off any coat, watch, bracelets and rings that
you may be wearing (although it is best not to leave valuables there).
Then disinfect your hands with the alcohol rub and let them dry in the
air. If you can’t get your rings off, you will need to put on a pair of the
gloves that are available by the entrance. These precautions are needed
to minimize the risk of your baby acquiring an infection (see also the
section of this booklet headed ‘Infection risk’). Parents are welcome to
visit at any time of the day or night, except when the doctors are making
their rounds. Unfortunately, we cannot have visitors when the doctors
are making their rounds, because the doctors need to be able to discuss
cases without confidential information being overheard by people visiting
other patients.
The times when we cannot accept visitors are displayed on the notice
board at the entrance to the unit. Other family and friends are welcome
to visit between 11:00 and 13:00, and between 16:00 and 19:30,
provided that they are accompanied by one of the baby’s parents. Visits
can be made at other times by prior arrangement – again, provided that
visitors are accompanied by a parent. Please do not bring more than two
people at a time with you into the unit.
Naturally, your baby’s brothers and sisters can visit, but age restrictions
do apply, as explained in the section headed ‘Infection risk’.
Unfortunately, we cannot allow children other than brothers and sisters
into the unit if they are under the age of twelve. More generally, undertwelves are not allowed to move around the hospital unsupervised. A
free crèche for babies and young children is available between 8:00 and
16:00 in the outpatients’ clinic. For details, call (020) 444 0808.
Please respect the privacy of other parents and babies: do not stop and
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look into other incubators, and ask your guests not to do so either. While
you are visiting, nursing care and treatment will continue as normal.
From time to time, an urgent case may need extra space and attention,
or we may need to set up and use X-ray equipment. If so, you might
be asked to leave the unit for a while and wait in the specially provided
seating area in the hall.
On the ninth floor, you will find the VU Kids’ City, complete with large
play area, sitting room, Ajax players’ home and much more besides. The
VU Kids’ City is a place where sick children can play, relax and forget
about their problems. Visiting brothers and sisters are also welcome,
provided that they have a parent with them.
Infection risk
In hospitals, precautions always have to be taken to prevent infection.
This is especially important at the Neonatal ICU, because the newborn
babies we care for have less resistance to infection.
For this reason, we do not normally allow brothers and sisters to visit
if they are less than seven years old. Brothers and sisters aged between
seven and twelve are allowed in, provided that they have already had
chicken pox.
In special circumstances, younger brothers and sisters may visit by prior
arrangement. To arrange a visit, please talk to the nurse who is looking
after your baby. If you are at all unsure about anything connected with an
infectious illness, please call and talk to a doctor or nurse before visiting.
It is also a good idea to talk to the staff before visiting if you have a
temperature, a cold sore, flu, diarrhoea or anything similar. Illnesses
such as these can be very dangerous for our young patients.
When you arrive at the unit, any coat, watch, bracelets and rings that
you may be wearing should be taken off in the anteroom (the room
between the corridor and the Neonatal ICU itself). You then need to
disinfect your hands with the alcohol rub and let them dry in the air. If
you can’t get your rings off, you will need to put on a pair of the gloves
that are available by the entrance. Coats cannot be worn in the unit;
please hang them in the anteroom. However, we would advise you not to
leave valuables there. Because touching can lead to infection, it is best if
only parents touch the baby. You should disinfect your hands using the
alcohol rub immediately before and after each time that you touch your
baby. You are also asked to disinfect your hands again as you leave the
unit.
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Parent participation
Provided that your baby is well enough, we want you to be involved
in caring for him or her as much as possible. Although as parents/
guardians you can visit at any time you like, you should bear in mind that
it is important for your baby to get plenty of rest. It will not help him or
her to be woken frequently between the times that he or she is scheduled
to receive attention. The nurse can tell you what those times are, so
that you can visit when you can help attend to your baby. Please make
appropriate arrangements with the nurse. It can be nice for your baby to
have something from home – a small cuddly toy, music box or comfort
blanket, perhaps – in the incubator.
However, for hygiene reasons, we do ask parent to take home and wash
cuddly toys and comfort blankets once a week or when visibly dirty. If
you give your baby a dummy, the nurse will sterilize it every day.
In appropriate circumstances, the nurse who is looking after your baby
may also suggest that you bring your son or daughter some clothes from
home. If so, we advise you not to bring white clothes, which are easily
mislaid amongst all the other white washing at the laundry. Another nice
idea is to get a diary or notebook for your baby; in it, you can write down
your own thoughts, and/or ask for contributions from other visitors or
the nurse.
Contact with your baby
Your baby is in the Neonatal ICU because he or she needs extra care.
This may be for a few days, a few weeks or longer. While your baby is at
the unit, doctors and nurses will provide the care that he or she needs
for his/her physical welfare. However, your baby also needs the special
security and attention that only you can give. Physical contact between
parents and baby is very important, both for the baby’s growth and
development, and for bonding. Motherly or fatherly feelings need time
to develop through contact. Some parents find it difficult to touch their
new babies in the unit, because they are scared to form an attachment.
However, your baby really needs physical contact. If the baby is well
enough and the nurse is happy with the idea, you can have your son or
daughter on your lap or lay him/her on your chest. This will enable the
baby to get used to mum and/or dad through direct skin contact.
We are happy for parents to nurse their babies like this until 22:00.
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Transfer to another hospital
When your baby no longer needs our intensive care, he or she will be
moved to a hospital closer to home or back to the hospital he or she
came from. Because we have only a small number of IC incubators, we
sometimes need to move a baby at very short notice to make room for
another very ill baby to receive specialist care. If we think it is best to
move your baby, the doctor will discuss the arrangements with you in
advance. After leaving the unit, our paediatricians continue to keep an
eye on some youngsters through the outpatients’ clinic. So you may
be invited to see a paediatrician at the outpatients’ clinic shortly before
your baby leaves the unit. If it isn’t possible to make arrangements
before the baby leaves us, we will write to you at home to make an
appointment.
Follow-up outpatient care
All children who need intensive care continue to see our paediatricians
from time to time as outpatients. National figures show that children
who need intensive care when they are newborn are more likely than
other children to have development problems later. Keeping an eye on
their progress helps us to evaluate the intensive care provided soon
after birth. In the Netherlands, the necessary check-ups take place in
various government-designated and government-funded centres that have
neonatal intensive care facilities. The system means that in the future we
will be able to see how effective treatment has been. You may be given
your first outpatient’s appointment when your baby leaves the unit, or
we may write to you at home about it later. If the proposed appointment
is inconvenient, simply call us to change it – the number to ring will be on
the letter. If you cannot make an appointment – perhaps because your
baby is still in hospital – please let us know. We would like to see you and
your baby for these special check-ups about the time your son or daughter
would have been born if birth had not been premature, and then about
three, six, twelve and twenty-four months after that.
Staying at the hospital
We do not have facilities for parents to room in with their babies.
However, if your baby’s condition makes it appropriate, or if you are
not up to travelling home, you can make use of the Ronald McDonald
hostel facilities attached to the university. The hostel is next to the VU
University Medical Center, at no. 627, Amstelveenseweg. As well as
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putting up parents, the Ronald McDonald hostel can, for example, take
brothers and sisters for the weekend. Rooms cost € 12.50 per night
(April 2009).
The nurse who is looking after your baby can find out whether a room
is available. For more information, ask for the [Dutch-language] leaflet
about the Ronald McDonald hostel or call (020) 301 3333. If the hostel is
full, we will try to find you a room in the guest accommodation.
Guests can make use of various facilities, including a kitchen and (for a
small charge) washing, drying and ironing facilities. Details are provided
in the [Dutch-language] leaflet Logeren in het Gastenverblijf. We do ask
guests to pay a surety deposit at the start of their stay. Some health
insurers will reimburse the cost of staying at the Ronald McDonald hostel.
Food is available from the hospital’s self-service restaurant in the central
hall. Alternatively, you can use the staff restaurant, which is on the
ground floor at location 0A. Payment is by means of a ‘chipknip’ card
(electronic wallet).
Parking
Paid parking is available at various places around the VU University
Medical Center. If your baby needs to spend more than three days at
the unit, you can buy a pass for the underground car park located
beneath the outpatients’ clinic. Please ask the nurse who is looking
after your baby for a pass application form early in your baby’s stay.
The completed form should be handed in at the reception desk by the
Medical Center’s main entrance, where the staff can also answer any
questions you may have about the arrangements.
Parents’ sitting room
A special sitting room is provided for parents, between Towers C and
D on the 8th floor. You will need a security code to open the door; the
nurse can tell you what it is. The sitting room has a drinks machine,
but smoking is not allowed there (or anywhere else in the hospital).
The parents’ sitting room is not very big, so if you are with a group of
people, please consider other parents and make use of the central hall
by the main entrance. Public telephones are available on the ground floor
in the central hall; you will need a phone card to use them. The use of
mobile phones isn’t allowed in most parts of the hospital because they
can interfere with equipment. So please remember to switch your phone
off before you enter the building.
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The VU University Medical Center does have a number of mobile phone
calling locations, however, which are identified by special signs.
Your baby’s medical records
All the information about your baby that we record while he or she is at
the unit is securely saved in electronic form or on paper. This enables
us to look back at your baby’s records if he or she ever needs our
help again. The data may also be used for scientific research by one or
more paediatricians attached to the unit. Finally, other people (outside
paediatricians, midwives, gynaecologists) may refer to the data when
assessing or looking for ways of improving the quality of midwifery care
or neonatal care. If your baby’s data are used in this way, no names will
be included, so that the researchers cannot tell who the information
relates to. In other words, your privacy, your baby’s privacy and that of
the paediatricians will be completely protected. For quality assessment
purposes, data concerning your baby will also be passed on to the
National Neonatology Registry, which forms part of the Dutch Perinatal
Registry (along with the National Midwifery Registry). To prevent babies
being counted twice, the data passed on to the registry does usually
include names.
If you do not want data concerning your baby to be used for scientific
research, registration or quality assessment, please let us know. We will
then make sure that the data we hold is used only to help us care for
your son or daughter in the future, and not for any of the other purposes
described.
Scientific research
Scientific research can often be carried out only with the help of patients.
So you might be asked whether you are willing for your baby to be
included in a study.
We will never let your baby be included in a study without asking you and
giving you the chance to ask questions before you make up your mind.
A [Dutch-language] leaflet about the scientific research carried out at the
centre is available from the doctor. This leaflet explains what taking part
in a study is liable to involve. It is also possible that you and your baby
will be invited to a lecture room where medical students are learning
about neonatal care. By agreeing to come along, you will be helping us to
advance medical science and to make sure that in the future other babies
receive the best possible care. So we hope very much that you will agree,
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but you can always say ‘No’. If you decide not to take part in a study or
attend a lecture, it will not make any difference to the way the doctors
behave towards you or to the treatment that your baby is given.
Patient information point
In the VU University Medical Center outpatients’ clinic there is an
information point, where patients and visitors can get assistance or make
suggestions. The information point staff will answer questions themselves
whenever they can. Otherwise they will make enquiries on your behalf or
tell you where you can find the information you need. Details of the
various patients’ associations – including leaflets, booklets etc published
by the larger organizations – are available from the information point.
You can also raise any issues that you aren’t happy with there. The
patient information point is in the central hall of the outpatients’ clinic
building and is open Monday to Friday, 9:00 to 16:30. You can also call
the information point on (020) 444 0700.
Rights and obligations
Information is something that every patient (or parent) has a right to.
The VU University Medical Center has produced a [Dutch-language] leaflet
Rechten en plichten setting out what patients’ rights and obligations are
in relation to privacy, use of personal data, access to medical records,
professional confidentiality and making complaints. Copies are available
from the unit and from the patient information point.
Patients’ associations
Numerous patients’ associations are active in the Netherlands. A patients’
association is a group that works on behalf of people who have a
particular illness. There are also several organizations that represent
patients in general. Patients’ associations are often a good source of
information. They also bring together people with similar problems,
enabling them to share experiences and support one another.
Information about associations such as The Association of Parents of
Children in Intensive Care is available from the patient information point
and from the receptionist or nurse at the Neonatal ICU.
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Finally
If you have any questions, please feel free to ask the nurse who is
looking after your baby or the nursing team leaders at the Neonatal ICU.
A team leader is on duty every weekday between 7:30 and 16:30. The
nursing team leaders’ room is next to the administrative reception desk
in the corridor.
Further information about what happens when a child is admitted to the
Paediatric Unit is provided in the [Dutch-language] booklet Opname in de
kinderkliniek. If you would like a copy, please ask the receptionist.
Site address
VU University Medical Center
De Boelelaan 1117
1081 HV Amsterdam
Tel. (020) 444 4444
Postal address
VU University Medical Center
[insert baby’s name and ward where he/she is being cared for]
Postbus 7057
1007 MB Amsterdam
Unit phone numbers
Neonatal ICU, location 8D105
General: (020) 444 3020
Unit 1 (8 D 109): (020) 444 3025 or 444 3026
Unit 2 (8 D 101): (020) 444 3030 or 444 3031
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888014E
VU University Medical Center©
Juni 2009
www.VUmc.nl
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