Ethics and etiquette in neonatal intensive care

When parents voice their dissatisfaction with the neonatal intensive care unit (NICU), it is often not because they think their baby has not received good medical care. Instead, it is often because their needs have not been addressed. Policy statements and pedagogy alike urge professionals to be empathetic, compassionate, honest, and caring. However, these theoretical concepts are generally endorsed without practical suggestions on how to achieve these goals. Negative encounters for parents are generally not about the caregivers' technical expertise or knowledge and often reflect a failure in a different domain. Simple rules of etiquette are not always applied in a busy NICU or in the hospital at large. The investigators of the POST (Parents from the Other Side of Treatment) group are health care professionals who regularly communicate with parents of sick children and who were also "NICU parents." We have developed an etiquette-based systematic approach to communication with families in the NICU. These specific and practical recommendations may help parents feel well treated and respected as they go through a challenging NICU stay.