Newborn Care: Neonatal Intensive Care Unit, Newborn Nursery and Delivery Room

PL-1 year: Newborn Nursery

Interns rotate on either the well newborn hospitalist service at Brigham and Women's Hospital or the Birth Place Newborn Care Service at Boston Medical Center. Interns are responsible for the evaluation and management of healthy newborns with the help of nurses and lactation specialists, and under the guidance of an attending pediatrician. Interns also attend didactic lectures, discussion sessions and demonstrations that focus on care of the newborn.

PL1 and Supervisory Years: Neonatal ICU

Interns and residents rotate through the NICU at Brigham and Women's Hospital (BWH) and Boston Medical Center (BMC). The BWH NICU is a 48-bed unit divided into two 16-bed acute care pods, and two 16-bed intermediate care pods. At the BWH NICU, our interns cover an acute care pod, sharing both day and night responsibilities. The acute care interns are supervised by an attending neonatologist and fellow. The transitional pod intern manages common newborn problems in the triage area of the NICU supervised by the PL2 delivery room resident. The NICU rotation at Boston Medical Center is comprised of a 15-bed NICU and a 6-bed intermediate care NICU. The BMC NICU team consists of an attending neonatologist, one senior resident, one junior resident and two interns.

Besides caring for critically ill neonates, residents obtain extensive experience in the resuscitation and stabilization of newborns at high-risk deliveries. At both sites neonatal attendings are on site 24 hours per day to provide supervision and teaching. Residents participate in a comprehensive educational curriculum including daily lectures by attending neonatologists covering common neonatal problems, such as respiratory distress syndrome, necrotizing enterocolitis, hyperbilirubinemia, and nutrition. All residents are trained in the Neonatal Resuscitation Program during intern orientation and then re-certify during their PL-2 year.

During the junior year residents rotate through the BWH NICU as the "DR1" delivery room resident - the first call to all deliveries requiring a pediatrician. The resident is responsible for attending deliveries with a NICU nurse and respiratory therapist, supervising an intern, triaging newborns in the delivery room and well baby nursery, and supervising the care of late-preterm and stabilized infants in one of the intermediate care pods in the NICU. In the BMC NICU, junior residents assume a supervisory role on the NICU team during the day, overseeing the interns on rounds and at deliveries. At night, the junior resident covers the intermediate care pod in the NICU as well as deliveries, with supervision by an on-site neonatologist.

Residents in both years recruit newborns from their newborn rotations to their continuity patient panels.