Occupational Therapy News OTnews January 2019 | Page 41

NEONATAL REPORT in line with toolkit requirements. However, perhaps a lack of awareness of the role is understandable. In a recent benchmarking survey less than half of neonatal units surveyed across the UK provided allied health care professional posts, with 75 per cent of all units stating that AHP provision on their neonatal unit was inadequate. This is very different to neonatal units in US, where neonatal occupational therapy is a well-established, respected and funded role. The National Association of Neonatal Therapists report that there are approximately 1,500 occupational therapists working in neonatal units across the US. I am extremely passionate about neonatal occupational therapy. I truly believe neonatal units and families are served better if they have access to this profession. With this in mind, I embarked on a short study tour to explore how occupational therapy is delivered in New now models state of the art facilities, designed to mimic the nurturing environment of the mother’s womb and reduce stress. Here the NICU was much more spacious, with wide-open corridors. Each room in the NICU cared for one or two babies and there was space for each family to rest, care and get to know their baby. The unit provides a quiet area for parents to share food or relax and a separate space for staff to unwind. This large, ambient space created a much more relaxed, calm environment compared to the smaller NICU on the other side of the city. The care and thought that had been put in to creating the neonatal unit environment was very apparent and truly reflects how the environment impacts on each baby’s development, each family member’s wellbeing and on staff morale. The occupational therapist based at Bellevue is also extremely experienced, however, her role is slightly different to that of a UK occupational therapist. Although she has chosen to specialise as a neonatal occupational therapist, she is also required to supervise all York City, to discover how to raise the occupational therapy profile and to begin to explore appropriate mentoring, support and career pathways within NHS model. In addition, I also attended NANT, a unique conference that provides networking, education and nurturing for neonatal therapists. Lenox Hill is a private level three NICU in the heart of Manhattan. The unit covers a small space within a busy hospital. There are only 20 beds, but the unit has always recognised the value of neonatal occupational therapy and has employed Ms Dana Fern full time for the last 12 years. Dana was kind enough to allow me to shadow her at work. Dana’s day was very similar to a UK neonatal therapist and consisted of working with families to support parenting occupations, completing neuromotor and neurobehavioural assessments, creating age appropriate, individualised developmental plans, while also mentoring and supporting the neonatal team in developmental care. The unit floor space was small, yet each incubator and cot had a family chair next to it. This bought a smile to my face, as it is often the biggest units with the most amount of space that challenge this family-centred care concept. Lennox Hill proved anything is possible. Dana has lead on a number of quality improvement projects over the years to help embed good quality developmental care onto her unit. Dana’s approach to education and sharing up-to-date evidence-based practice was both innovative and creative. She has developed a fun approach where staff participated in quizzes and were invited to snack on developmental care themed food, while attending in-service training. She also regularly updated attractive display boards highlighting the monthly developmental care theme. This dynamic and inspired approach kept the staff and families engaged and motivated to provide neuroprotective, age appropriate care. The second neonatal unit I visited was Bellevue in downtown Manhattan. Bellevue is the oldest public hospital in the US. This 30-bed NICU has recently undergone extensive remodelling and acute occupational therapists within this busy inner city hospital. Therefore, her day might begin with working with a family to hold their baby in skin-to-skin for the very first time and finish with assisting an adult complete safe bath transfers following a road traffic accident. For the most part once a neonatal occupational therapist has set foot in the neonatal unit they become 100 per cent absorbed. They live, breathe and study ways to constantly improve neonatal care for all the babies and families they work with. We are constantly exploring ways to excite our colleagues, get the message across, support families while also providing high quality evidence based care, neuroprotective care. This study tour showed me that this motivation is not just confined to the UK, the occupational therapists in New York were as equally driven, their passion for the job as dynamic as the first day they entered the unit. Neonatal occupational therapists in the UK need to be proactive in talking about our role, to our colleagues, students, commissioners. Neonatal units need to understand and be able to articulate clearly what it is that we uniquely we offer to each unit. The recent neonatal occupational therapy guidelines state that occupational therapy provision should be provided at band seven and above. While I wholeheartedly agree that neonatal service provision requires senior level of occupational therapy, I believe we should adopt a similar model to the US, where a more junior member is part of the team, receiving supportive mentoring and having access to clear career progression. This recent study tour really emphasised that the US understands that you can provide the best medical care in the world, but if you do not support parental wellbeing and development of each baby you will never be able to provide an optimal service. Emily Hills, occupational therapist, Starlight Neonatal Unit, Barnet Hospital. Email: [email protected] OTnews January 2019 41