Clinician Perceptions of the NICU Infant Experience: Is the NICU Hospitalization Traumatic?

Abstract

Infants cared for in a newborn intensive care unit (NICU) experience pain, parental separation, and stress that may approach toxic levels, thus are potentially traumatic. Lack of accepted clinical terminology to describe the infant experience may result in under appreciation of NICU hospitalization on infant and family outcomes. This study explored NICU clinician perceptions of the infant experience and how the terms trauma/traumatic would impact their clinical roles and practices. Semistructured focus group interviews and thematic analysis were used to describe professionals' perceptions of the infant's experience and terminology. Focus groups were organized by professional role, including NICU leadership, physicians, nurses, and ancillary providers. Six themes emerged from the qualitative analysis: at our mercy, trauma defined and redefined, and now you have broken them too, perceptions of NICU experience change over time, trauma in the NICU: whose trauma is it, and not knowing the infant and family experience. While recognizing potentially toxic infant stress levels, clinicians are reluctant to describe the NICU infant experience as traumatic. Hesitations relate to clinicians' personal concerns that they may be seen as agents of trauma and the impact for families if the NICU experience was described as traumatic by clinicians.