The fact that in spite of being a Nursery with a very unfavorable nurse to infant ratio (1:4-5 in intensive care), the staff has been able to make a qualitative step forward in delivering care that is developmentally supportive for the infant and family. The staff has felt pride in the fact that they “did not settle for less”, and in shifting their thinking that more humane and family oriented care was just not possible in the prevailing staffing conditions. They are proud also that an “unknown” NICU was able to make a big step towards world-wide standards of developmentally supportive care and show excellence in many of these standards. There is also a great feeling of pride in knowing that this NICU has made pioneer work towards a developmental approach to care in Israel.
One significant change has been the top-down effect created by the Certification process: the NNCP encouraged the whole staff to get involved with the process in some way. It was not only a “top” initiative any more, brought by the leaders or the managers, but a process and a goal that involved everyone working in the NICU. The staff, especially the Nursing staff, had a very unique opportunity to feel that their work was actually seen, in detail, in depth. In our milieu, nurses do not often have such an opportunity to show their work, and to share their approach to other professionals that really know their work and are familiar with it. That brought a great sense of pride to the nursing staff, which is not a trivial thing at all given the tough working conditions prevailing in this NICU (see “ratio” above). The NNCP process was a booster for interdisciplinary involvement and interaction as well. The NNCP process demands high-level interdisciplinary collaboration, which was indeed enhanced at the Meir Medical Center NICU, and this was an important by-product of the process.
Some environmental improvements were put in place such as a more welcoming entrance corridor to the Unit with baby’s and families photos running on flat screens; and reclining chairs for skin to skin care. A weekly bedside multidisciplinary Round with Parents was implemented during the last three years. This is one more way to support parent participation in care. As a result of the NIDCAP Nursery Certification process the focus on the family is more broadly emphasized and practiced by the staff, more staff has become aware of the importance of this focus. A graduate parents volunteer group to support parents at the NICU was created and its representatives arrive weekly to talk with parents (peer support). This parent group together with the staff is broadening its activities and working on more areas of advice and collaboration- such as design of brochures, lectures by parents in professional meetings, a NICU Newsletter, and now working towards the creation of a Parent-Staff advisory team.