Why I Think Primary Nursing Is Important

In St Cloud, we were automatically assigned a primary nursing team. Primary nurses are nurses who are assigned to take care of a particular baby each and every shift they work.

We knew from day one who Jax’s nurses were going to be. We met them all. They all talked with one another to come up with a game plan for Jax’s care. I was able to be a part of “report” during shift change. When the day nurse was giving the report to the night nurse, she would stop and ask me if there was anything I wanted to add. Jax’s primary nurses made us feel as if we were part of Jax’s care team and that we had an important perspective that added value to the team. They did not treat us (as parents) as a burden. Instead, we were treated as the second most important part of the team, aside from Jax, of course!

So, when Jax was transferred to Children’s Hospital in St Paul, we were nervous. We were worried about Jax and how he would handle the ambulance ride. We were nervous because we couldn’t ride with him. We were nervous because we had to meet him in a new hospital. But we were also nervous to meet our new care team. We knew we had an exceptional team in St Cloud and we were keeping our fingers crossed that the team in St Paul would be as inclusive and compassionate.


I’m not going to lie. It took about 3 weeks for us to find a team at Children’s that we felt worked. (But once we did – we were so happy!)

For the first three weeks at Children’s, we had about 20 different nurses. We asked the ones we felt connected to “Will you please be our primary nurse?” Some didn’t know what primary nursing was. Others didn’t want to agree to be Jax’s primary nurse because “they didn’t want to become attached.” (Seriously.) Another didn’t “want to lose her skills by working on only one baby.”

I’m not judging these nurses – I understand why they would not want to sign up to only care for one baby.

But, in my opinion, primary nursing helps to alleviate many of the problems that can occur in the NICU. (Of course, I’m only speaking from my experience and in no way am I pretending that I have any medical training or background.)

Primary Nursing can:

  • make a family feel more comfortable because they see familiar faces each day.
  • help reduce error (a nurse who is familiar with a baby may be more apt to question a dose of medication that is higher than usual, for example.)
  • help identify problems quicker. A nurse who is familiar with a baby will see signs of discomfort or “just not being himself” where a nurse who has not met the baby before would not notice these signs.
  • give the family an advocate. Our primary nurses ended up being our biggest advocates – they helped connect us with services at the hospital, they acted as our liaison to the doctors, they found resources and information they knew we would appreciate. They became our biggest support.

I know that every hospital is different. We experienced that first hand. Jax’s two hospitals were completely different: one has 20 beds, 6 neonatalogists, and a staff of about 30 nurse practitioners and nurses. The other has 62 beds, 20 neonatologists, 85 neonatal nurse practitioners, and more than 500 nurses and support staff. One has open pods, the other has private rooms. One has a March of Dimes Family Support Specialist, the other does not.

But what made both of these hospitals feel like “home” were our primary nurses. And they made all the difference in the world!


In a couple of weeks, I am going to be part of a panel presentation for nurses who are pursuing primary nurse status at Children’s Hospital. The panel will help give the perspective of the family and focus on our experiences in the NICU. I’m excited to share our experiences and thank these nurses for becoming primaries!

I’m curious…did you have a primary nursing team during your baby’s NICU stay? What are some of the advantages or disadvantages that you saw to having a primary nursing team?