The neonatal comfort committee was started after I assessed a need for more focused attention on end-of-life care in the NICU. This committee was started to help patients, families, and teammates with anything surrounding end of life needs. Dr. Clarke-Pounder, a neonatologist, and fellow palliative care advocate, agreed to help me start and run the committee to support our team. At the time, I did not know what all the committee would be capable of, but we wanted to start with making sure our families had enough resources to keep long-lasting memories of their baby and we also wanted to make sure our teammates were supported and educated through the process. After hearing of a comfort committee in PICU/CVICU, I reached out to their chair to see if I could sit in on a meeting and get some ideas for NICU.

We started small, addressing resources we had access to and making sure they were adequately stocked and that our team was educated on how to use them. We also started having monthly meetings where we discussed supplies, resources available, and patient care at the end-of-life. Dr. Clarke-Pounder attends the meetings and makes sure that we understand decision-making processes from the provider side and answer any questions that staff may have about the process. She supports our team and helps bridge the gap between interdisciplinary teams and communication and brings a sense of calm to the stressful parts of bedside care surrounding end-of-life.

The committee was doing very well and started expanding on existing resources. In December of 2019, we added a sibling library after we received a donation from the neonatology provider team. We added books to help siblings understand death at their age level. We added a resource book for reference so bedside nurses would have a step-by-step process for end-of-life care. We wanted to make sure care was streamlined and that every family received any service we have to offer. We added photography equipment for photoshoots, as these will be some of the only photos they will have of their baby. We bought bottles for heartbeats and pieces of hair and one of our teammates and her mother made special small hats for families to cherish.

One of the biggest projects that have come out of the comfort committee is the angel gown program. We have been using angel gowns for quite some time, however, they were stored in bags and boxes in a small closet in our developmental room. I found a room in the back of the west nursery and, with approval, turned it into a bereavement room. We have stocked drawers and a cabinet full of bereavement supplies, including special receiving blankets for holding or swaddling babies. We have a wall of angel gowns on display. Our gowns are now hanging up and nurses can go in and view them all and select a few for the family to choose one they like. There are all sizes to ensure we have a gown for every baby. Kathleen Sharpe, an Atrium teammate, has been instrumental in growing this program and added a seamstress team to help keep us supplied with gowns. We have also added angel blankets as another resource for our families. Angel blankets will be given to all families and will also be supplied to patients who may be too large for an angel gown.

As our program grows, we plan to supply other units in the hospital with angel gowns and blankets. We have started donating to PICU/CVICU with plans to fully supply them with any gowns and blankets they may need. We have been able to fulfill some special requests from families. After hearing about our angel gown program, a family member reached out with a special request. She has a daughter with a cardiac defect and severe congenital anomalies. She is donating her dress to make angel gowns but also wanted a gown for her daughter. We have been able to help this family with their wish for the dress, taking special consideration to have one made for their daughter.

As we move forward and continue to grow, we are also focusing on the culturally specific needs of our patients and families. We are creating a new notebook for cultural reference that will provide insight and guidance for our teammates in caring for different cultures. This will not replace important bedside conversation, but it will help create awareness of the needs of different cultures and their expectations of us as a healthcare team.