parent buddy program - mount sinai hospital · buddy, please fill in the referral form, or speak...
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Neonatal Intensive Care Unit
Parent Buddy Program
Parents Helping Parents
Name(s)ofBaby(ies) D.O.B.1. ...................................... ................................2. ....................................... ................................3. ....................................... ................................
Weight: Gestation:1. ....................................... ................................2. ....................................... ................................3. ....................................... ................................Are you pumping to breastfeed? Yes ☐ No ☐
Reason(s) for preterm delivery ................................................................................... ...................................................................................
Baby’s medical history and current status ................................................................................... ...................................................................................
Is there a history of losses? Yes ☐ No ☐
Please specify? ......................................................... ...................................................................................
Other Children: Names and birth dates ...................................................................................
Other relevant family information ................................................................................... ...................................................................................
Special quality requested for Parent Buddy matching: ................................................................ ...................................................................................
I agree to have a Parent Buddy contact me: (please sign and date)
...................................... Date: ............................Verbal consent obtained:
...................................... Date: ............................Assigned Parent Buddy (name) ...................................................................................
SocialWorkDepartmentMount Sinai Hospital600 University Avenue
Toronto, Ontario, CanadaM5G 1X5
416-586-4800 ext. 5201www.mountsinai.on.ca
2438
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06/0
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Whatparentsaresaying“Having someone confirm the way I was feeling was a normal response to an abnormal situation.”
“She gave me so much hope that this roller coaster ride would come to a happy end.”
“She understood… We went through the same things.”
“It was great to have someone to talk to in my own language.”
As parents who have had a preterm baby in the Neonatal Intensive Care Unit (NICU), we understand this is a stressful time.
You may:Not have expected to deliver for several monthsBe worried about your baby’s / babies’ medical conditionBe wondering what you can do for your baby/babiesNot know anyone else who has had a pre-term baby
HowwillaParentBuddyhelpme?You may be interested in speaking to another parent who has had a similar experience. We can link you to a “Parent Buddy” who also had a preterm baby in the NICU. Trained Parent Buddies offer support, understanding, a sympathetic ear, and can share their own experiences in getting through this time.
Parents tell us that they find it helpful to talk to their buddy because they understand and have been through a similar experience.
Research has shown that parents who have a Parent Buddy are more confident in their parenting in the NICU. Four months following birth, they report being less anxious, less depressed, and feel that they have better social support than mothers who did not have Parent Buddies.
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HowiscontactmadewithmyParentBuddy?Contact will primarily be by phone or e-mail, though the Buddy may also arrange to meet you during your baby’s hospital stay. Your Parent Buddy is available to you during your baby’s hospital stay and during the first few months at home.
Arethereotherlanguagesavailable?Yes. If your first language is not English, you may want to be matched with a Buddy who shares your language. Parent Buddies are available in more than 20 different languages.
HowcanIspeaktoaParentBuddy?If you would like to speak with a Parent Buddy, please fill in the referral form, or speak with your nurse or social worker. You can also call Frida Ardal, co-coordinator, Parent Buddy Program, at 416-586-4800 ext. 5213, or [email protected].
ReferralformforParentBuddyPlease return completed form to Frida Ardal 416-586-4800 ext. 5213, Room 475 (please print)
MotherDo you wish to speak with Parent Buddy? Yes ☐ No ☐Name: ......................................................................☑ Select preferred method of contact
☐ Home Phone: ...................................................
☐ Cell Phone: .......................................................
☐ E-mail: ...............................................................
Address: ..................................................................
Language(s) spoken: ..............................................
Age: ..........................................................................
FatherDo you wish to speak with Parent Buddy? Yes ☐ No ☐Name: ......................................................................☑ Select preferred method of contact
☐ Home Phone: ...................................................
☐ Work Phone: ....................................................
☐ Cell Phone: .......................................................
☐ E-mail: ..............................................................
Language(s) spoken: ..............................................
Age: ..........................................................................
Do you have a partner for support?
Yes ☐ No ☐When is a good time to call? ................................ ...................................................................................