“We pay careful and close attention to how the parents’
traumatic experiences are processed, looking for coping
and resilience at each step so that the parents are better
able to engage with their infants, no matter how sick.”
New York-Presbyterian Morgan Stanley Children’s Hospital
In these situations, the two psychologists work to explain
to the staff how people cope under stress, clarifying that what
looks like unreasonable anger is in this instance a substitute
for unbridled anxiety. They also try to help the staff member
understand why information might need to be repeated again
and again.“They’re able to convey that it’s not about me — that
the mother or father may be acting out in response to the fact
that they’re where they don’t want to be and I just happen to be
there when they let it loose,” says Fran McCarthy, a NICU nurse
who has worked with Steinberg and Kraemer since they started
on the unit.
The nurses and physicians also rely on the psychologists to
help families through complicated decision making, particularly
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when a family is faced with choosing whether to continue
medical interventions for a baby whose odds of surviving
and thriving are bleak. In addition, even when Steinberg or
Kraemer are not able to be present for end-of-life discussions
with families, the NICU staff relies on their experience to help
families cope and come to a consensus, McCarthy says.
“When comfort care comes up, they often provide me with
ideas on how to approach the family and share information
about what things they have heard about the family’s history, so
that the family feels heard and understood,” she says.
They also help the staff, who have often spent many hours
caring for a baby, through their own emotions about the child’s
“This is essential because we believe
that our role in ‘holding’ the staff, by
paying attention to their emotional lives
and reflecting on them within ourselves
and with them, enables the staff in turn,
who are in the trenches, to ‘hold’ the
parents,” Kraemer says.
It’s this “quiet presence” in the NICU
— the time they spend learning about the
lives of staff members over the years, their
adeptness at picking up stressors in nurses
and physicians, and their insight into how
to avoid these stressors — that Towers says
she finds helpful.
“I might have once been one of the
physicians who did not feel a psychologist
was necessary in the NICU and that it
would lead to more misinformation,
but with the successful integration of
two senior, incredibly well trained and
practiced therapists, I am convinced
that they are adding enormously and
qualitatively to the successful outcomes of
our families,” Towers says. “Their presence
in our NICU is now invaluable.” n