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