Supporting Families of Our Most Critically Ill Patients Join Danielle Key, an infant-family psychologist, for a day in her life working with our smallest patients and their families

Preterm and critically ill newborns are some of the most vulnerable children we care for. Through the generosity of donors, Sala Institute for Child and Family Centered Care provides specialized psychological support to families whose infants are receiving critical care at Hassenfeld Children’s Hospital.

Danielle Key, PsyD, an infant-family psychologist, kept a journal of her experiences, observations, and feelings throughout a workday as she cared for families and newborns in three critical care units: the Neonatal Intensive Care Unit (NICU), the Pediatric Intensive Care Unit (PICU), and the Congenital Cardiovascular Care Unit (CCVCU).

What follows are Danielle’s journal entries, edited for clarity.

9:00 am 

I arrive at my office. I review the medical records of the roughly 20 patients I’m currently seeing in the NICU, CCVCU, and PICU. I also find one new consult placed overnight. I call the mom to introduce myself and the Infant-Family Psychology program. We make a plan to meet at her baby’s bedside this afternoon.

Danielle Key, PsyD, provides specialized psychological support to families with infants in the Neonatal Intensive Care Unit at Hassenfeld Children’s Hospital.

10:00 am 

I log in to provide virtual therapy to another mom because her NICU social worker brought me in to address symptoms of maternal anxiety. Up to 10 percent of birthing parents will experience postpartum anxiety, the symptoms of which are stress and worry related to pregnancy, birth, and the health of the newborn. The rates of this type of anxiety can be even higher for parents of infants admitted to the NICU, as infants are most often admitted for prematurity and medical complications, which can be extremely anxiety-provoking for caregivers.

This mother is anxious about the health of her premature infant and feels helpless. During our therapy session, we identify things that are within her control today, since so many aspects of her two-week-old daughter’s NICU admission feel out of her control. She identifies that preparing her baby’s room at home as within her control, and I encourage her to focus on nesting in her daughter’s nursery today to regain a sense of control and perhaps even experience some joy and excitement during this time of stress.

11:15 am 

I arrive at the CCVCU and knock on the door of a patient room. I enter to see an adorable five-month-old baby happily sitting in her hospital bed. I first met her as a newborn, when she was receiving the first of several planned cardiac surgeries. Now that surgery number two is behind her, I check in with her parents, who share that their baby will be discharged home tonight. We discuss how they’ve felt throughout this hospital admission: stressed, anxious, and now, relieved. We schedule a follow-up call for next week to check on their mental health. 

1:00 pm 

I stop to chat with a group of nurses who are sharing funny stories from their early days in the NICU while they keep a close eye on their assigned babies’ monitors. I am thankful to hear some quiet laughter in the hallway today; it’s been a hard week. Supporting our incredible nursing staff is an important and vital part of my role.

Danielle Key, PsyD and Samantha Reid, RN

3:00 pm 

I grab a seat at a computer next to the occupational therapist and speech therapist. We have several shared patients, and it’s important that we coordinate care. I can get a better understanding of how caregivers are handling their NICU admission when I hear about their interactions with other providers; likewise, I find that I can provide suggestions for how other providers can best approach caregivers based on my understanding of their current emotional well-being and mental health. I type up my patient notes while listening intently as they share their experiences checking in on patients this morning. 

4:00 pm 

In the NICU, I spot the mother I met virtually this morning and introduce myself in person. She shares details with me about the birth and NICU admission of her baby boy, whose name I spot on a beautiful name tag created by our child life specialist. Mom identifies that she is experiencing symptoms of sadness and stress, which are common symptoms of postpartum depression. Postpartum depression impacts 15 percent of birthing parents, and perinatal depression is the most common complication of childbearing. It is important that I assess for these symptoms and help caregivers address them, as caregivers are better able to bond with and advocate for their new babies when they are receiving appropriate mental health care.

We make a plan to meet weekly to discuss and address her symptoms—and we can meet more frequently, if needed. I’m thankful to have this flexibility in my schedule to meet each caregiver’s needs.

5:00 pm 

An attending neonatologist tells me that a baby I’ve followed for three months is finally getting discharged! Using a Cantonese interpreter, I share with the baby’s mom and dad how thrilled I am for them. I remind Mom about the list of Cantonese-speaking therapists I gave her, and she shares that she’s already set up an appointment for next week. I’m thrilled to hear that she will continue receiving mental health support. It’s something that every caregiver deserves. 

6:00 pm 

I finish my notes and check the bus schedule for my commute home. As I step outside of the hospital, I realize that it’s still sunny and warm. I decide to take the advice I frequently give staff and parents, and instead walk the 35 minutes home to enjoy my alone time and process my day.