The debate concerning the optimal approach
to environmental neonatal intensive care unit
(NICU) care continues. In 1994, our team published
an article in JOGNN on fetal/neonatal sensory
development, theoretical underpinnings of
the provision of the nursery environment, and applications
to clinical practice (White-Traut, Nelson,
Burns, & Cunningham, 1994). In that publication,
we argued for a nursery environment that protected
the infant from excessive light and sound
to reduce infant stress and provide developmentally
appropriate sensory stimuli. We also advocated
for clinical nurses to take on management
of the NICU environment because nurses provide
round the clock care and are in the unique position
to teach parents how to support their infants’
neurobehavioral capacities to reduce stress. In
essence, nurses are primarily responsible for supporting
overall infant health and development.
What is the best NICU environment? Nurses walk
a fine line between protecting their small patients
from too much sound and light in the NICU
and promoting development through appropriate
touch and sound. What is developmentally appropriate?
All infants live in an environment that is multisensory.
However, it is a challenge to provide an
optimal NICU sensory environment that benefits
the infant (White-Traut et al., 1994). Nurses deal
with this challenge on a daily basis, sometimes
from shift to shift, and often on a minute-to-minute
basis. Admissions of new and often critically ill
infants change the pace in the NICU and alter
well-laid plans for managing the NICU environment.
The question over the last several decades
has been what sensory inputs are acceptable and
support development versus what are excessive
and not supportive? Nurse researchers and clinicians
and other professionals are still trying to
reach consensus on these issues. Many hypothesize
that human contact and social interaction are
optimal, especially for preterm infants.