Who Works in the Neonatal Intensive Care Unit (NICU)?

The neonatal intensive care unit, also called the NICU, is an area in the hospital that provides care for premature infants and seriously ill babies. Preemies and sick newborns need a lot of very special care and it takes many people with many different job titles to provide it.

When you first get to the NICU, it can definitely be overwhelming and a little confusing.

It may help relieve some of the stress if you know and understand the role each person has in the care of your child. Of course, you can always ask your baby's nurse to explain who each person is and what they do. But, for additional information or a quick list you can reference, here's an overview of the members of your premature baby's health care team. 

Who Works in the NICU?

Every member of the NICU team has an important job. From the doctors who create the treatment plan to the nurses who provide constant care to the housekeepers who keep the unit clean, these dedicated professionals work together to make sure that your baby (and you) get the best care possible. Here are the NICU staff members you may meet during your stay. 

Neonatologist

A neonatologist is a doctor who specializes in taking care of premature babies and newborns in need of special care after they're born. Neonatologists complete a residency program to become a pediatrician and then continue to train in a neonatal fellowship program for another three years

The neonatologist is responsible for diagnosing the babies in the NICU and making all the decisions about the treatment plan. They also order tests and medications, perform procedures, and manage the medical care of each child.

Pediatrician

A pediatrician is a doctor who specializes in caring for newborns, infants, and children. A pediatrician may be in charge of the special care nursery (level 2) or work with the neonatologists as part of the NICU and Special Care Nursery Team.

Pediatric Resident

A pediatric resident is someone who has graduated from medical school and is learning to become a pediatrician. Residents are doctors, and a three-year residency is how they get on the job training. A first-year resident is called an intern. After the first year, they are second-year and third-year residents. The pediatric residents work under the supervision of the pediatrician or neonatologist.

Neonatal Fellow

A neonatal fellow is a pediatrician who has completed his residency in pediatrics and is now enrolled in a three-year program to become a neonatologist. Fellows work in close collaboration with the attending neonatologists to diagnose and create the plan of care for the babies in the NICU.

Neonatal Physician Assistant

A Physician Assistant (PA) has a master's degree and advanced medical training. They work under the supervision of a doctor to provide medical care. Neonatal PA's usually complete their residency program in the NICU. They can examine patients, prescribe medication, and help to develop plans of care.

Neonatal Nurse Practitioner

A Neonatal Nurse Practitioners (NNP) is a nurse who has a master's degree and advanced training in neonatology. Under the direction of a neonatologist or pediatrician, the NNP's can examine, monitor, and treat patients. They can also order medications and perform certain procedures.

Neonatal Nurse

The neonatal nurse is the person that you and your child see the most. He or she is right there at the bedside monitoring your child from minute to minute. The neonatal nurse carries out the doctor's orders, gives your baby her medications, makes sure your child is safe and comfortable, and reports updates or any changes in your child's status to the neonatologist.

Your nurse will also answer your questions, help you, teach you, and support you as you adjust to parenting in the NICU and learn to participate in your child's care.

Clinical Nurse Specialist

A Clinical Nurse Specialist (CNS) is another type of advanced practice nurse with a masters degree or higher. They provide staff with ongoing education, lead research projects, and help to develop policies, procedures, and improvements in the NICU. The unit's CNS may even run patient education or parent support groups. 

Other Nurses

Besides the staff nurses that take care of your baby every day, there is a charge nurse on each shift who supervises the activities of the unit and provides additional help and support whenever it's needed.

The Nurse Manager of the unit oversees the day to day operation of the NICU. A nurse manager is in charge of the staff, financial concerns, and other paperwork, but they also work with the doctors and the staff nurses to help care for patients and families. 

Respiratory Therapist

A respiratory therapist specializes in treating the lungs and airways. Under the orders of a neonatologist, they take and analyze blood gasses and monitor oxygen levels. Respiratory therapists can put in breathing tubes and give respiratory treatments. They also take care of the breathing equipment and devices that your preemie needs. 

Physical Therapist and Occupational Therapist

Physical and occupational therapists help to build, strengthen, and improve the movement of the body. They will work with your baby to keep his muscles, joints, and nerves growing in a healthy way. 

Social Worker

Social workers coordinate services and connect families with community resources. They help families to get the emotional, physical, and financial support they need during a child's NICU stay and at home. 

Case Manager

A case manager monitors your baby's hospital stay. They work closely with doctors, nurses, social workers, other health professionals, and insurance companies. Case managers organize services and resources to provide your child with quality care while you're in the hospital and once you are at home. 

Lactation Specialist

A lactation consultant or someone with specialized training in breastfeeding supports the NICU staff and parents when it comes to the challenges of breastfeeding or pumping breast milk for a premature baby or a baby with special needs.

Nursing Assistant

The nursing assistant (NA), or patient care technician/associate (PCT, PCA), is responsible for stocking the unit and your baby's bedside with the necessary supplies that the nurses, doctors, and therapists need each day. They may also perform other duties such as taking bloodwork to the laboratory or picking up medications from the pharmacy. 

Unit Clerk

The unit clerk or unit secretary may answer the telephone when you call. He or she organizes paperwork and keeps track of who is coming and going on the unit. 

Housekeeper

The housekeeping staff keeps the NICU clean. They wash the floors and other surfaces, remove garbage and refill the soap and towel dispensers. All of these actions help prevent the spread of germs and infections. 

Other Medical Personnel

You may also meet x-ray technicians, ultrasound technicians, pharmacists, and other medical professionals during your time in the NICU. 

Students

In teaching hospitals, you may notice medical students, nursing students, and students entering any of the fields listed above observing and learning in the NICU. 

Other Pediatric Physicians and Surgeons

Many doctors can be called in to help care for your baby depending on your child's needs. Some of the other specialists that may work with the neonatologist to provide care for your child include: 

• Cardiologists: Heart doctors
• Neurologists: Physicians who treat brain and nervous system issues
• Nephrologists: Kidney doctors
• Urologists: Doctors who treat problems related to the urinary tract
• Gastroenterologists: Doctors who deal with the stomach and intestines
• Pulmonologists: Lung doctors 
• Hematologists: Doctors who specialize in blood disorders
• Medical Geneticists: Physicians who deal with genetics and congenital disabilities
• Surgeons: Doctors who perform heart surgery, brain surgery, or other types of surgery depending on their specialty

The NICU Staff and Your Premature Baby

You may only meet a few of the NICU specialists if your baby's stay is short. However, if you spend a few weeks or months on the unit, you'll probably get to meet quite a few staff members on this list. As you get to know them, you'll find that these people who choose to work in the NICU don't only take care of your baby, but they care about you and your child. They will be there to support you as you go through the ups and downs of your NICU journey. They will cry with you, laugh with you, and celebrate every milestone with you.

While the NICU can be a scary place sometimes, it's also a special place filled with special people. These are the members of your premature baby's health care team.