10 • 2024 • Developmental Observer P R O F I L E O F A N I D C A P L E A D E R Heidelise Als has profoundly influenced my professional and personal life. Thank you for being my mentor and inspiration … "We are all connected; we mutually support, teach, learn from, and enrich one another" Heidelise Als I was born in the beautiful city of Porto, Portugal, a city steeped in history and culture. However, my early years were spent outside of Porto and were incredibly rich and varied in experiences as I traversed the globe alongside my family. My “globetrotting journey” was a result of my father's career as a military officer, which took my family to different plac- es, allowing us contact with diverse cultures, languages, and traditions. This period of my childhood left a lasting imprint on me and shaped my future perspective on life. It has not only broadened my horizons but also shaped my values, emphasiz- ing the importance of empathy, understanding, and intercon- nectedness in our global community. I graduated in Medicine at the University of Porto and be- gan working as a doctor at São João University Hospital. In my professional journey as a doctor, this multicultural foundation has proven to be an invaluable asset. It has enhanced my ability to collaborate and work in diverse environments. So as a young paediatrician, I had the curiosity and desire for varied expe- riences that led me to have opportunities beyond the familiar confines of Porto as I undertook several months of hospital internships in London and Paris. Like any young doctor, I was drawn to state-of-the-art technologies that could enhance patient care. The latest ad- vancements on mechanical ventilation captivated my attention in the first years of my career. My Introduction to NIDCAP In the nineties, attending the French Paediatric Society Meet- ing in Reims, France, I chanced upon a workshop presented by an enthusiastic team from the University Hospital of Brest, led by Professor Jacques Sizun. The topic presented, New Approach to Caring for Infants, promised a shift in perspective toward understanding the language and behaviour of babies, with a fo- cus on their development and family, caught my interest. This moment was really a “touchpoint” and marked a true turning point in my professional and personal journey. It challenged conventional medical approaches by placing a spotlight on infants’ behaviour and families, understanding of the infant's needs, and involving the family in the care process. Reading infant behaviours was really a new concept for me, and this paradigm shift made a profound change in my approach to neonatology. Embracing the principles introduced by the Brest team, I began to view each newborn not just as a medical case but as a unique individual with their own language. The emphasis on family involvement also became a cornerstone, recognizing that the well-being of the infant is linked to the support and understanding provided by their family. This new philosophy of care not only revolutionized my professional practice in neonatology but also had a strong effect in my personal life. Bringing NIDCAP to Portugal As I continue my journey as a neonatologist, the lessons learned in France remain embedded in my practice. The fusion of cutting-edge technology with a compassionate, family-cen- tered approach has become the hallmark of my commitment to the well-being and development of every newborn under my care. With Madalena Pacheco RN, a young neonatal nurse and now the Head Nurse of our NICU, we shared a common en- thusiasm for enhancing our understanding of NIDCAP princi- ples. Together, and with the support from Hercília Guimarães, Professor of Pediatrics and Chief of Department of Pediatrics - Faculty of Medicine of Porto University, Neonatology Service Director, we began our NIDCAP journey in Portugal. We successfully secured a scholarship from the Calouste Gulbenkian Foundation to fund NIDCAP training which Fatima Clemente MD Senior Consultant in Neonatology in São João University Hospital São João NIDCAP Center Director and Trainer Member of the NFI Board of Directors DOI:10.14434/do.v17i2.38134 Fatima Clemente with NIDCAP founder Heidelise Als 2024 • Developmental Observer • 11 allowed our team to travel to Boston and had the privilege to meet Professor Heidelise Als and Dr Nikk Conneman. In the year 2008, I was certified as a NIDCAP professional along with Madalena Pacheco RN, Carla Castro RN and Ligia Silva RN, neonatal nurse specialists and the first NIDCAP nurses certi- fied in Portugal. Our team has expanded, now with eight NIDCAP professionals and six more in training, bringing together dedicated professionals who share our passion for enhancing the well-being of newborns and their families. With the support of Dr Graciela Basso, who was crucial in the implementation and integration of NIDCAP care at the Neonatology Unit level and at the hospital system level, and even at the national level in Portugal. With her vast experience and knowledge, she supported the training of our team and its expansion. We realized our dream in 2015: the inauguration of the São João NIDCAP Training Center. This Center became a place where our team's commitment to improving care for infants and families in Portugal could develop. Each mem- ber brought a unique set of skills and dedication to the table, contributing to a collaborative and supportive environment focused on the NIDCAP approach to newborn care. The Future for Developmental Care and NIDCAP Our shared team vision extended beyond NIDCAP profession- al certification – it was about continuous improvement in the care provided to newborns and their families. So, for the past few years, São João NIDCAP Training Center has an import- ant goal: the education in NIDCAP foundation courses like Foundation for Infant Neurodevelopmental Education (FINE), providing the pathway for NIDCAP Training and certifica- tion. In our Portuguese experience with the multidisciplinary training of many professionals in the NICU team with FINE training, it is the fundamental step to establish the foundations for NIDCAP training. It's essential for the team to "speak" the same language and to understand the process of a changing care philosophy under the synactive theory. Through this approach, we intend to meet the evolving needs of the Portu- guese hospitals and NICU professionals. In the last three years with the financial support of the Portuguese Parent Association, we have trained on Develop- mental Care and NIDCAP foundation with FINE 1 and 2 more than 700 NICU professionals across all Portugal, 17% of them are neonatologists. This multidisciplinary participation has an important impact on neonatal care in Portugal, emphasizing the importance of individualized, family-centred approaches. Another of our goals for the future is to initiate basic training in Africa in Portuguese-speaking countries: Angola, Mozambique, Guinee-Bissau, and Cabo Verde. The online training has opened a window of opportunity for decreased costs and the ability to reach more distant hospitals. Fami- ly-centered care is not a reality in hospitals in Africa. The need for families to be in the units 24/24h, to support breastfeeding, kangaroo care, and to support parents in caregiving, is crucial for the survival of premature babies. We intend to integrate developmental care through Portugal's exchange programs that already exist with these countries. Rewarding Experiences My most successful professional experience is working with professionals from different Portuguese NICUs and sharing their journey in learning the language of the infant, caring for the infant, and partnering with families. It is a true privilege for me! Each time, I am grateful to be able to work with ex- cellent and motivated professionals who aim to improve their skills to meet the needs of families and their babies. In a period where we are experiencing a global crisis in national healthcare systems, where hospital resources are often directed towards other more technical aspects, it is surprising that we have so many individual requests for FINE courses and NIDCAP training. This demonstrates the recognition of the importance of developmental care and the need for ongoing skill development to meet the demands of families and infants in increasingly complex situations like cardiac and surgical pathologies that often require specialized care but also special attention to developmental issues due to the complexity of their conditions to optimize outcomes. Working with hospital- ized infants can be challenging yet immensely rewarding. Effective communication and collaboration among multi- disciplinary teams is essential. Therefore, as we work together providing the NIDCAP approach to comprehensive care, the individual needs of each infant and family are considered. It is not an easy task but remains one of our goals in our NICU in Porto. Advice for those doing NIDCAP Training: • Be open-minded! Think of neonatal care from a global per- spective and be ready to learn new concepts. You will move from a traditional task orientated model of care to one built on relationships that uses a reflective process. NIDCAP em- phasizes an individualized approach to newborn care, it can be really challenging, but it will certainly be very rewarding. • Build Relationships! NIDCAP training encourages positive relationships, collaboration and communication among care providers, families, and other stakeholders such as scientific societies, Parents associations and Universities involved in the newborn's care. • Seek Mentorship! Mentorship from your trainer but also from experienced NIDCAP professionals and other train- ees. They can provide guidance, feedback, and support as you navigate the complexities of implementing NIDCAP principles in practice. • Continuously reflect on your practice! Seek opportunities for improvement. You are not alone on this journey. You are part of a Global community that is organized within the NIDCAP Federation International. You can participate 12 • 2024 • Developmental Observer in different NFI committees. You can share your skills and experiences and be part of workgroups, supporting the growth of our organization. Take the initiative and contact the chairs of each committee. You'll find the contacts on the NFI website. • And finally, Be Patient with Yourself! Implementing NIDCAP care takes time and practice. Be patient with yourself as you develop your skills and understanding. Re- member that every interaction with a newborn is an oppor- tunity for growth and learning. Remember it is a journey, and it requires time, but also dynamism and determination. Build a team that supports each other. OUR SPONSORS Dr. Brown’s Medical delivers valuable feeding solutions that help provide the best possible outcomes for all babies. Sponsor of the NFI and the 34th Annual NIDCAP Trainers Meeting. Dandle•LION Medical, the leader in neurodevelopmental care, makes it easy to provide consistent, effective, evidence-based care for hospitalized babies. Our patented positioning aids provide a womb-like experience while our education programs meet ongoing clinical needs. Becoming part of our Dandy Pride of Lions means providing the best care for your patients, support for your clinicians, and value for your organization. Sponsor of the 34th Annual NIDCAP Trainers Meeting ISSN: 2689-2650 (online) All published items have a unique document identifier (DOI) The official publication of the NIDCAP Federation International published on-line three times a year. ©2024. The statements and opinions contained in this publication are solely those of the individual authors and contributors and not necessarily of the NIDCAP Federation International. Articles from the Developmental Observer, duly acknowledged, may be reprinted with permission. Please contact us at: developmentalobserver@nidcap.org. 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