Safety: The Foundation of Trauma-Informed Care in the NICU
"Safety in the NICU is the first gift of love we offer—creating a space where healing begins and hope grows." - Mary Coughlin
Today I want to talk about the cornerstone of Trauma-Informed Developmental Care (TIDC) — safety. Safety in the Neonatal Intensive Care Unit (NICU) isn’t just about physical protection; it’s about creating an environment where babies, families, and clinicians feel emotionally secure, supported, and valued. In the NICU, every action we take can either build or diminish this sense of safety, and that’s why it’s so important to weave it into every aspect of care.
Safety for Babies
For our tiniest patients, safety goes beyond medical interventions — it’s about creating an environment that promotes healing without adding to their stress. Babies in the NICU are highly sensitive to their surroundings, and even the smallest disruptions can have a profound impact on their well-being.
What does safety look like for babies?
Gentle Caregiving: Every touch, every moment of care should be slow, intentional, and calming. Gentle caregiving minimizes the stress responses and supports physiological stability.
Minimizing Stressors: Reducing environmental stressors such as loud noises, bright lights, and abrupt changes helps babies feel more secure and fosters their neurological development.
Consistent, Predictable Care: Babies thrive in environments where routines are consistent. Regular mealtimes, diaper changes, and other care activities performed predictably and guided by the infant's wake state provide comfort and reduce stress.
By safeguarding a baby’s emotional and physical environment, we create the foundation for growth, development, and healing.
Safety for Families
Families who enter the NICU are often overwhelmed with emotions — fear, anxiety, and uncertainty about their baby’s condition. Providing them with emotional and psychological safety is just as crucial as the care we provide for their baby.
What does safety look like for families?
Clear Communication: Keeping families informed, active listening, answering questions with compassion, and providing them with clear updates helps reduce anxiety and empowers them to trust the care team.
Emotional Support: Offering families a safe space to express their feelings, fears, and concerns is vital. Emotional safety means families can ask questions, voice concerns, and feel heard without judgment.
Inclusion in Care: Families should be included in their baby’s care. Encouraging them to be involved in small, meaningful ways fosters a sense of control and connection to their baby.
When families feel emotionally supported, they can focus on being present for their baby, and that presence can have a profound impact on their baby’s healing journey.
Safety for Clinicians
Safety isn’t only for babies and families — it’s for clinicians too. In a high-stress environment like the NICU, clinicians often carry the weight of intense emotional and physical demands. Creating a culture of safety within the care team is essential for sustainable, compassionate caregiving.
What does safety look like for clinicians?
Emotional Support: Clinicians need to feel emotionally supported by their colleagues and leadership. Offering peer support, debriefing sessions, and wellness programs fosters a sense of safety and prevents burnout.
Collaborative Environment: A collaborative work environment where clinicians feel respected, heard, and valued enhances team dynamics and improves patient outcomes.
Safe Work Practices: Providing training, maintaining adequate staffing levels, and ensuring clinicians have the resources they need helps them perform their jobs safely and effectively.
When clinicians feel safe, they are better able to provide compassionate, attentive care that supports the well-being of both babies and families.
Safety Is the Foundation
Safety is the foundation on which everything else in TIDC is built. It’s the starting point for healing, growth, and connection. When we make safety — emotional, physical, psychological, and spiritual — a priority in the NICU, we create a sanctuary where babies can thrive, families can find peace, and clinicians can continue their work with passion and purpose.
Let’s continue to put safety at the heart of everything we do, knowing that by fostering a sense of security, we are laying the groundwork for deep, meaningful healing.
With heartfelt dedication,
Mary Coughlin
I’d love to hear your thoughts and experiences about the importance of safety in the NICU. Together, we can continue to enhance our practice and make a profound difference in the lives of the babies and families we serve.
