How NICUs Have Adapted During COVID-19

July 20, 2020

Having a baby in the neonatal intensive care unit (NICU) is difficult and stressful at any time. Having a baby in the NICU during COVID-19 only amplifies those feelings of fear and uncertainty as parents worry about what will happen if they get sick, or if they or a staff member unknowingly infect their baby.

NICUs around the country have had to adapt their procedures quickly to rapidly changing information and recommendations. We spoke to our Family Support Specialists who serve families in our partner hospitals in Austin, TX, and with Rhonda Reed, Director of NICU and Neonatal Transport at St. David’s Medical Center in Austin, TX (and Hand to Hold board member), about the changes NICUs have made to ensure families and staff are safe from COVID-19. (Procedures may vary by region or hospital.)

Visitor screenings

Hospital are rigorously screening people before allowing entry. Some hospitals are limiting visitors to one entrance, and names must be checked against a roster of approved visitors. Once approved, visitors have their temperature checked and a mask issued. Some hospitals give visitors wristbands daily to indicate they have been screened. Upon entering the NICU, temperature may be taken again (depending on the hospital) and additional screening questions asked. Masks are mandatory at all times for staff and visitors.

Once in the NICU, parents are expected to wash and sanitize their hands as usual, and some units have stations to sanitize phones.

Visitation restrictions in the NICU

In many hospitals across the country, NICU visitors are restricted to the parents only (or to the mother and partner), and only one at a time. Exceptions are given for day of admission into the NICU, care conference with the medical team, surgery days, and in the devastating event of a loss.


Waiting and lounge areas closed

It’s likely that the waiting area or lounge in your hospital will be temporarily closed during this time. Reed notes that it’s difficult for staff to monitor congregating. Christine Tester, Family Support Specialist serving families at St. David’s Medical Center, notes that with visitation restrictions only allowing one parent at a time, that parent is most likely to be at the baby’s bedside. However, waiting areas, lounges, nesting rooms, etc. are likely closed.

Masks are mandatory

It’s not surprising that masks are mandatory in the NICU. Cristal Carrasco, Family Support Specialist serving families at Ascension Seton Medical Center Austin, says masks must be covering the nose and mouth at all times. Visitors who cannot or will not keep a mask covering the nose and mouth as asked to leave.

Families and staff react to the “new normal”

Tester and Carrasco all agree that families appreciate that the strict procedures have been put in place to keep everyone safe. Most families in the NICU by now have not known any different, as they were admitted after protocols changed.

Yet a sadness lingers. Tester says parents are sad that their baby has never seen their face without a mask. Carrasco says parents hear stories of the pre-COVID-19 days of support groups and lunches and are missing that connection. They miss having the support of having their partner with them, especially when hearing difficult news or if their baby is not doing well.

Reed admits that for NICU staff, it is stressful as well. “There is always an underlying level of anxiety,” she says. “It is hard to wear a mask for 12 – 14 hours. But, the general feeling from the NICU staff is that they are grateful to work in the NICU.”

How can families stay connected?

It’s imperative that parents receive emotional support during their NICU stay and after discharge. In the absence of in-person support groups, families can stay connected virtually through Hand to Hold’s free virtual support groups (offered Monday – Friday, with Spanish-speaking groups available), private Facebook communities, and peer support network.

Are you in the NICU during this pandemic? Let us know what your experience has been like.

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Join us Monday through Friday for virtual support groups, from the comfort and safety of your own home. Learn more.