Mentorship Moment: Navigating Overshooting in the NICU

As a head neonatologist and someone passionate about mentoring, I'm always looking for opportunities to guide my NICU team towards best practices. Today, I want to discuss a common challenge: out-of-range test results due to overshooting treatment as an opportunity for mentorship.

The Scenario:

Imagine a situation where a newborn's test results indicate a potential issue. The initial reaction might be to escalate treatment to address the concern. This might lead to more abnormal test results in the opposite direction, carrying its own risks and could be more harmful (overshooting) due to an exaggerated reaction to the initial abnormal test result. But before we do, let's take a step back.

Asking Empowering Questions (using the GROW Model):

• Goal (G): Can you walk me through the specific goals of the current treatment plan for this baby?
• Reality (O): Based on these latest test results, are there any concerns about potential over-treatment in this case?
• Options (O): Have we encountered similar situations where we were able to achieve positive outcomes with a more targeted approach? If so, what were those approaches?
• Will (W): What resources or guidelines do you feel would be most helpful in determining the most appropriate course of treatment going forward?

By fostering a conversation through these open-ended questions framed around the GROW model, we can collaboratively:

• Encourage critical thinking about the situation and the baby's overall goals.
• Explore alternative treatment strategies based on current realities.
• Arrive at a solution that addresses the baby's needs while avoiding over-treatment.

This approach empowers staff to take ownership of their decisions and fosters a continuous learning environment within the NICU.

What are your thoughts? Share your experiences in the comments below!