On becoming an NICU

Over the past 20 years, there has been a dramatic change in the way nursing care is delivered in this 52-bed community hospital NICU. In the early 1970s, technologic and medical innovations produced a significant improvement in infant survival. The nurse's role at that time was to deliver the various prescribed treatments and master the array of new gadgetry. This approach escalated until the mid 1980s, when it was recognized that something very important was missing from nursing practice. This realization began an internal process in a small group of nurses that eventually expanded to include the majority of staff. The process is outlined in the text, and the outward changes that resulted from the internal process are outlined in the tables.