At a teaching hospital, multiple care providers with varying degrees of training participate in the clinical care of neonatal patients. We are fostering a culture of safety and welcome all members of the health care team to voice concerns. Open communication is the best way to prevent adverse events and provide excellent care. Input from all members of the team should be accepted and valued equally. Occasionally, conflicts and disagreements will arise between members of the team regarding optimal patient management. These conflicts will be resolved in an adult and professional manner without exposing family members to turmoil and confusion.

If a nurse has a question or concern about a patient, he/she should first approach the patient’s primary care team by day or the intern on call at night. If there are concerns about the response, the nurse should then approach the supervising resident also always in-house. If concern persists, a neonatal fellow and/or an attending are always in the hospital 24 hours a day to see patients and address issues, we all welcome input from our nursing staff. Ultimate responsibility and final decision making falls to the patients’ attending physician.

If there are major concerns about a patient’s course or plan of care, or if there are unresolved conflicts with or between neonatal attendings or other medical/surgical services participating in the care of newborns, resources include:

William F. Walsh, MD, Chief of Nurseries, Peter Grubb, MD,  Medical Director Stahlman NICU, Judy Aschner MD Chair Division of Neonatology

Deborah Meloy NICU Nurse Manager and Marlee Crankshaw, RN, MSN, 

Discussed at Nursery Policy & Procedure Meeting 10/20/99.

Updated November 2010