Managing the impact of neonatal work

We talk a lot about the challenging nature of a neonatal admission for parents. What is less talked about is that it can also challenge us as staff. When we talked to families, we often describe admission as an emotional rollercoaster. As staff members you walk alongside families riding this rollercoaster, and inevitably it will feel up and down for you too. You may also be juggling other work tensions or issues and may be working under pressure. If you find it hard sometimes, you are not alone.

Looking after yourself

If you work on a neonatal unit you may also feel a whole range of things. The work can be amazing, frustrating, interesting, distressing and hard. And beyond the work, the logistics of work and the culture you work within may be at times supportive and at other times feel hard to manage. Staff shortages and the pressure of work can sometimes feel a bit much.
We also work alongside parents experiencing big feelings and babies who can be in pain or distressed. All of this has an impact on us. Everyone needs support with their emotions at times.

Why do I feel this way?

Having a new baby always brings a whole range of emotions (not to mention the hormones which can also make parents feel all over the place). When your baby is born too early or is unwell this adds so many more feelings and so many more issues to deal with. Being around sick babies and parents who are distressed can also be challenging and impact us. We know that the environment on any kind of intensive care provision can be very intense (as the name suggests). We know that people do get stressed doing this work, and because we are also juggling the challenges of our lives alongside work.
When our brains are worried, upset or stressed it can be hard to even think.

What can I do?

First, just get yourself to stop, just for a minute, and take a breath. If you are short of time, you can do this whilst sitting on the loo or getting a nappy out of the bag.
Next, ask yourself ‘What am I feeling right now?’ Try to name your feelings. We know this makes a difference to the bits of your brain that are working.
Then, do something that you know will help, something you’ve used in the past when you are stressed. It might be talking to someone, going for a walk or writing down your feelings.

What can help me?

  • Name your feelings to yourself (I feel really anxious today or I don’t know how to name this feeling in my chest). This helps us make sense of what we are going through.
  • Talk to someone. A colleague, a friend, another member of staff, a partner or family member. This helps you and them, as it shows that everyone can get big feelings
  • If your unit has a Psychologist or psychotherapist talk to them. Talking to them doesn’t mean you have a problem, they are just the person whose job it is to support people.
  • Breathe. When you don’t have time for anything else, you still have time to slow your breathing.
  • Use strategies which have worked in the past. If going for a walk has been useful, do that. If you like doing a yoga class, do that. If singing/reading/running/talking has helped before, try it again.
  • Get sleep when you can. This can be difficult if you’re working shifts, managing other children or have a lot of big feelings. Try and nap or get yourself into a routine which allows you to rest. Plan your routine when you are working nights so that you allow your body enough time to rest and recuperate.
  • Write down how you’re feeling or even just what is happening every day. This helps our brain process what we are going through. This can be in the form of a diary, a blog or notes on your phone.
  • Find a book which is helpful, and normalises how you are feeling (Link to booklist for parents and clinicians)

How can I help other adults?

  • Where you can, be kind. Remember sometimes people are unreasonable, illogical or rude when they are struggling. This includes your colleagues and the parents you work with.
  • Look after yourself. To be compassionate we need to be ok in ourselves.
  • Notice when someone is struggling. Say ‘I wonder how you are because I’ve noticed that…(you look sad/you seem angry/you aren’t yourself today)’
  • If you don’t know what to say or how to help, say that too. It’s better to say something than ignore someone in pain. They will be grateful for your honesty. Remember people don’t always want help or solutions, sometimes they just want to be seen and heard.

What helps babies?

  • Encourage parents to be near them. They can hear and smell their parents and this helps them feel calm
  • Talk calmly and gently to them when you are about to do something.
  • When you can, stroke, touch or hold them. This regulates their big feelings. Facilitate skin to skin with parents whenever possible.
  • Spend time just watching them. This will give you clues as to what stresses and calms them.
  • Help parents to grow into their parent role, identifying for them the unique contribution which parents bring to their baby, which no one else can do. Remember that different parents will be at different stages in their journey with this and they need gentle, compassionate support to understand what they have to offer and how they do things for and with their baby.

Where can I get support?

Is there someone you know who is a good listener? Can you give them a call? Often the best people to help us are already in our lives. Connect up with people who are supportive and feel helpful.

If your unit has a psychologist or psychotherapist, they are a great place to start too. They understand just what it is like to work on a neonatal unit and will be able to support you, or signpost you onto someone who can. They are there for everyone on the unit and lots of people find it helpful to have someone to chat to. Whether you feel you are coping fine or feel you are really struggling, or anything in between, they are here for you.

Your GP is a really good place to start if you are looking for support. They will be aware of the offers available locally and how you connect into them. Here are some other places you could try:

The staff self check tool
This is a tool to just see how you are doing. It can be helpful if you’re not sure and wonder if it would be helpful to get some further support Check my wellbeing – Self-assess your psychological and emotional wellbeing (leadershipacademy.nhs.uk) The tool is totally confidential and has details of crisis support should you need it

Trust Staff support
If you are a member of staff, you could try the staff support offered by your trust. Some also have arrangements with other trusts or organisations. Look on the trust intranet for more information.

National NHS staff support service
If you need someone to talk to there is a confidential text support service. Text FRONTLINE to 85258 any time of the day or night. This service is for anyone working in the NHS who has had a tough day, is feeling worried or overwhelmed, has a lot on their minds or just wants to talk some things through

Staff mental health and wellbeing hubs (sometimes called resilience hubs)
These were set up to provide rapid access to assessment and local evidence-based mental health services and support where needed. The hub offer is confidential and free of charge for all health and social care staff.  NHS England » London hubs

The NHS health and wellbeing programmes
There are a number of NHS programmes and access to apps and support which you might want to have a look at. It may be worth checking these out, even if you’re not finding things hard. Always better to be think ahead when we can, given the stressful nature of the work we do. NHS England » Health and wellbeing programmes and look here (scroll down) to see support for specific groups and training opportunities NHS England » Support available for our NHS people

Increasing access to psychological therapies (IAPT)
IAPT teams are available to anyone (staff, parents, family) who might need support around their mental health or wellbeing. Often you can refer yourself, but you can also ask your GP for help finding out about them. They tend to offer virtual support via the phone, messaging and video calls as well as some face to face work (very often at health centres or GP practices).
https://www.healthylondon.org/our-work/perinatal-mental-health/psychological-support-services/
https://www.nhs.uk/service-search/mental-health/find-a-psychological-therapies-service/

If you’re struggling, reach out and ask for help. It’s a brave thing to do and most people are glad they did.
Whatever you are going through, you are not alone.
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