Guest article by Zita Gross-Wallinger, Dr. Csaba Nádor, and Lívia Nagy of partner parent organisation “Melletted a Helyem Association“.

Year after year, our organisation chooses a specific topic to spotlight for World Prematurity Day in Hungary. This year, we focused on the mental health of neonatal intensive care unit (NICU) nurses, and the reasons for this focus quickly became evident.

© Melletted a Helyem

The NICU is an intense and stressful environment, presenting challenges not only for parents but also for staff. Up to 50% of mothers and their partners experience emotional strain – such as depression, anxiety, or post-traumatic stress – during their NICU journey, with 30-60% continuing to struggle after discharge. Similarly, up to 50% of NICU staff report burnout and emotional stress, compounded by a systemic lack of standardised psychosocial support. Studies indicate that poor teamwork and communication contribute to up to 72% of perinatal deaths and injuries, and feature in 30% of voluntary error reports. Additionally, the teamwork and safety climate in NICUs are closely associated with healthcare-associated infections.

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While the physical care of preterm infants has historically been the primary focus, Infant- and Family-Centred Developmental Care (IFCDC) guidelines have expanded this to include treating the family as a unit. Within family-centred care, parents are considered partners in their child’s healing journey. For NICU staff, this approach adds another layer of responsibility, as their role temporarily extends to primary caregiving and fostering parent-infant relationships. The frequent exposure to crises, combined with the emotional intensity of their work, makes NICU staff particularly vulnerable to secondary traumatisation – a condition that mirrors PTSD, with symptoms such as poor sleep, heightened fear, anxiety, and intrusive thoughts. When coupled with increased workloads and a critical shortage of healthcare professionals, these factors significantly heighten the risk of burnout, threatening care quality and delivery.

© Melletted a Helyem

To address these issues, the “Melletted a Helyem Association”, with the endorsement of the Hungarian Neonatal Society and financial support from the Generali THSN program, organised two mental health workshops for NICU nurses in 2024. The first, held earlier in the year, was designed primarily for department head nurses. The second workshop took place on 14 November at the serene Sarlóspusztai Klub Hotel. Although the themes of resilience, stress management, and assertive communication were consistent with the first session, the second workshop brought new depth to these discussions.

Participants arrived on a foggy Thursday morning and quickly immersed themselves in a full agenda. Topics included exploring prejudice, the impacts of stress, and the development of resilience. Assertiveness training featured prominently, with exercises in understanding and practising different communication styles. Friday’s agenda began with role-playing exercises designed to navigate emotionally challenging scenarios, allowing nurses to voice their daily struggles. The afternoon provided a much-needed respite, with a walk along the sunny Betyárdombi Trail. The day concluded with an intense session on bullying and abuse in healthcare, revealing deep-seated traumas and sparking meaningful conversations about resolution and healing.

© Melletted a Helyem

On Saturday, small group tasks encouraged participants to delve into the causes and consequences of workplace bullying, brainstorming practical solutions to address these issues. The final session focused on burnout, employing humour and thought-provoking exercises to highlight its impact on individuals and their environments. Practical strategies and mindfulness meditation techniques were introduced to help nurses manage stress and foster self-care.

Feedback from the 80 participants was overwhelmingly positive. Many expressed gratitude for the opportunity to reflect, share, and learn, with comments like:

• “Thank you for an enlightening three days! It truly was worth stepping out of my comfort zone. I feel hopeful that we can build a supportive workplace community together.”
• “This workshop was like watering a wilted flower – it revived me completely.”

These workshops underscored the pressing need to prioritise the well-being of NICU staff. By equipping nurses with tools for self-awareness and resilience, we aim to nurture healthier, more sustainable workplaces. We look forward to continuing these efforts in 2025.