1. Section Editor(s): Witt, Catherine L. MS, RN, NNP-BC

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When working in a neonatal intensive care unit (NICU), it is easy to become somewhat isolated. This is especially true if the NICU is located in a hospital that also cares for adults. The shift is spent in a unit that is usually secure from unannounced visitors and that is full of equipment and procedures that may seem alien to our colleagues who work with adults. Often, breaks are spent in the nurses' lounge on the unit (if they occur at all). Many hospital policies do not apply to neonatal patients, and the equipment used in the NICU may be different from those used in the rest of the hospital. Although it is true that NICU patients and families are special, is it good for NICU nurses to be isolated from what is going on in the rest of the nursing world?

Catherine L. Witt, M... - Click to enlarge in new windowCatherine L. Witt, MS, RN, NNP-BC

Nurses are living and working in a time when we are facing profound changes in how care is delivered to patients and how it will be paid for. Nurses are responsible for knowing vast amounts of knowledge and for keeping up with rapidly changing technology. We are being held to a standard of care based on scientific evidence and we must be vigilant about keeping abreast of that evidence. The days of getting a job near our home, learning the basics of that job, and settling in for a long career there are over. Merely working somewhere for 20 or 30 years does not make anyone an expert and will not protect professionals who fail to keep up-to-date with what is new. All nurses must be accountable for your knowledge. This cannot happen in isolation. It happens first by building relationships.


Those who think that professional associations are no longer relevant fail to take into account that new knowledge does not develop in a vacuum. Development of knowledge and dissemination of that knowledge require relationships. Relationship building takes time. It does not happen without meeting people and having conversations. While you may have hundreds of friends or contacts on your social networking sites, how many of them do you really know? Face-to-face time is important for building and nurturing relationships and for sharing knowledge and ideas. List serves and blogs can aide in exchange of knowledge, but they are not a substitute for personal contact and face-to-face interaction. Humans are social beings, and we need social interaction for true development of knowledge and ideas.1


Where do you start? You can begin by asking yourself how many people you know who work in different departments in your hospital. If you have not ventured off your unit to get involved in your hospital, that is one place to begin. While it might seem that much of what happens in the adult world does not apply to the neonate who is not the case. Evidence on central line infections, ventilator-acquired pneumonia, and skin breakdown is being generated in the adult population, and much of that has translated to neonates as well. Decisions made on equipment, supplies, and policies often affect the NICU, and without input on our needs, we may find in the stockroom items that are not useful in our work. There is only 1 way to have influence on what happens where you work. You must become involved and most importantly you must begin by building relationships with the people surrounding you.


You also stay up-to-date by building relationships outside your hospital, in your community, your state, and your profession.2 How many people do you know that you can call on for contacts, referrals, and opportunities? A study that looked at attributes of women and nurse executives defined the ability to establish and maintain relationships as an essential skill.3 Leaders identified the ability to network-to establish relationships with other professionals as a key to their success. This requires getting not only off your unit, but out of your hospital and most likely out of your hometown. Belonging to a professional organization and attending a conference are among the best ways to begin to meet people outside your immediate circle of friends and colleagues.


If you have thought about attending a conference, there is no time like the present. Have you made plans to attend the National Association of Neonatal Nurses meeting this year in Palm Springs, California? Posters and presentations present the latest research and knowledge in neonatal nursing. Vendors are present to demonstrate the newest equipment that can help you take care of your patients. Most important, you will be part of a conference of hundreds of neonatal nurses and leaders with whom you can exchange ideas, discuss problems, and find out about new opportunities. There are small group networking sessions, social functions, and multiple ways to become involved and meet others who have the same interests as you.


All of us have a responsibility to be involved in our profession. We cannot depend on others to keep us informed and up-to-date. Professional associations such as the National Association of Neonatal Nurses exist to provide opportunities to keep informed and up-to-date. They also provide an opportunity to be involved in our work on a deeper level that leads to more satisfaction and a sense of accomplishment. I would encourage you to take those steps-first out of your unit, then out of your hospital, and be a vital part of your profession.




1. Waller-Wise R. Conversations with colleagues. Growing collegial relationships. AWOHNN Lifelines. 2006;10:34-38. [Context Link]


2. Owens LA, Young P. You're hired! The power of networking. J Vocat Rehabil. 2008;29:23-28. [Context Link]


3. Carroll TL. Leadership skills and attributes of women and nurse executives. Nurs Adm Q. 2005;29:146-153. [Context Link]