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5 Leadership Lessons I Learned in the NICU

Photo by Kiana Bosman on Unsplash

From July 2017 through June 2018, my husband and I spent nearly every day walking in and out of a hospital. During that period, I’d forgotten what life outside of a hospital actually felt like.  It all started on the morning of my 35th birthday when I woke up with back pains. I knew something was wrong.

Based on the advice of my midwives, I asked my husband to take me to the emergency room. I was 23 weeks pregnant with twins, which made my pregnancy extremely high risk. Not to mention, my husband and I conceived our twins after many procedures I had to correct secondary infertility. I was super anxious and on edge throughout my pregnancy.

I would arrive at the ER, and things would quickly spiral out of control. One second we were talking steroids and magnesium shots to protect the babies’ lungs and brains, the next I was told I would not be returning home. Before I knew it, a neonatologist came to see me and began walking me through the nuances of having babies in the Neonatal Intensive Care Unit.  

I could not believe what I was hearing.  The doctors tried everything they could to prevent my babies from coming, but two days later on July 24, 2017, at 8:47 pm entered two of the tiniest humans I'd ever seen. Fingers, toes, and facial features perfectly formed, but not ready to enter the world. At 23 weeks and two days, Emmanuel and Sophia had a 5% chance at survival.

My husband and I decided we would fight that fight. Little did we know that in taking on the battle to save our babies, our lives and we as individuals would be forever changed. Throughout the course of the NICU, I paid close attention to the behaviors of the doctors, nurses, social workers, and everyone we encountered.

Being a social worker by training, I observed and listened to the entire way through. Through our journey, I learned a great deal about myself, my leadership style, and what it really takes to be effective in times of crisis.

Here are 5 leadership lessons I learned in the NICU:

1. When in crisis, nobody cares about your credentials.

Dear leader, nobody cares about your title. Aside from the recruiter and hiring manager, that is. No one cares that you went to Columbia or that you have over 19 years of experience. No one cares how many awards and accolades you’ve received for your work.

In the midst a crisis, the only thing people care about is whether or not you can help them. It seems odd, but I remember a particular neonatologist entering my room a few short days after delivering my children and listing off all of his credentials before asking me to include my children in a study he was running. He even gave me his business card.

I stared at him, thinking, “Do you think I care about your credentials? I need help saving my babies!!” He seemed utterly unaware that he was talking to two first time parents who felt like their lives were falling apart. Don’t get me wrong, credentials are critical because they signify knowledge and give others a sense of confidence in knowing you are qualified--but they don’t actually matter in a time of crisis.

What matters is compassion, decision making, and a plan. If you must lead, please leave your title, credentials, and ego at the door.

2. Your number one skill as a leader should be listening.

Yup. Zip it and listen. I remember the week before my daughter Sophia passed away. I could tell something was off. I mentioned it to a few doctors and nurses, to which they brushed me off saying she was “just being a baby.”

On the day she passed, my spirit was uneasy the entire morning. Imagine the shock on my face when I walked into my child’s NICU room to find more than five medical professionals trying to revive my 29-week old child before they passed her to me muttering, “We did everything we could.”

Sophia took her last breath in my arms. Yes, they did everything they could, except listen. They forgot to listen. They and I will have to live our lives wondering what the outcome might have been if they'd only listened. If you want to lead, I beg of you, please learn to listen.

3. Communication is THE key.

One of the doctors explained to me that most errors in the NICU were a result of miscommunication. What I didn’t realize at the time was that my child would become part of those errors. After Sophia passed away, I became an over communicator. I wanted every detail, every blood level count, every saturation level -- EVERYTHING.

If a number was slightly off, I insisted on tests until I was confident our surviving twin Emmanuel, was ok. Emmanuel had many complications, so many that we received several phone calls about Emmanuel not likely making it to the next day.

When it came time to make a difficult life-altering decision for Emmanuel's care, I was floored to hear that the medical specialists had never met collectively to discuss my son. I requested a full team meeting and ended up leaving the meeting feeling “underwhelmed” by the lack of cohesion and coordination of care on such a complicated case.

If you are a leader, it is your job to ensure everyone communicates, especially in a crisis! Some communications can take place over email, but in an actual bind, people need face to face contact, not telephone charades.

4. Be kind.

There was one ray of light in what felt like the worst experience of my life. One of the directors, perhaps the most experienced doctor in Emmanuel’s first NICU (yes, there were 2), was one of the kindest souls I’d ever met.

He was smart, but more importantly, he was kind. He was seasoned and kind. He was experienced and kind. He had MANY awards and came from a long line of doctors…but more importantly, he was kind. Before long, I would only speak to the doctors I perceived as kind.

I didn’t care where they went to school, or how many years they had in the game. What mattered most to me was the fact they listened and were kind. In the NICU, I learned that it was nice to be smart, but more important to be kind.

5. Cultural competence is not optional.

In my story, the only thing worse than losing a child and spending 11 months in the hospital was dealing with microaggressions and bias as I tried to cope and stay healthy. My last name is Nigerian, and my husband has a Nigerian accent.

For some reason, these two factors led several doctors and nurses to believe we were uneducated or unaware of the severity of our son’s condition. On one occasion, one of the doctors flatly told us our son was dead and that she would not revive him if his heart stopped. This same doctor would say outright offensive and biased statements in every conversation I had with her thereafter.

Guess where this doctor went to school? She had two Ivy League degrees, but I really didn’t care how book smart she was because of her cultural incompetence. If you must lead in the 21st century, you must learn to understand and communicate with people from other cultures and assume you have something to learn.

This is the abridged version of lessons from the NICU. As a result of everything we encountered in the NICU, my husband and I started a small organization called Manny's Village. Feel free to visit and learn more about what we do!

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