[nolaRN]

What does a typical shift consist of? I am a telemetry/med surg RN of seven years and I have an offer to transfer to the nursery. I will be working nights. Any input would be appreciated.

[nell]

As with anything in nursing, there are differences from facility to facility – in fact most hospitals in my area don’t have a newborn nursery – they do mother-baby couplets on maternity…

We maintain a newborn nursery so that our parents have a choice of 24 hr rooming in, out for demand feedings or feed in the nursery (parents can decide at any time what they want to do). Another facility in this area with mother-baby opens a “holding nursery” only at night when they have parents who want the baby to stay in the nursery for all or part of the night.

In our hospital, well baby nurses have 6-8 babies. Each baby gets VS and a head-to-toe assessment at the beginning of each shift – night shift weighs them as well. Babies less than 24 hours old get VS/assessment every 4 hours. Our nursery nurses are very good and pick up subtle changes that have turned out to be cardiac and other birth defects. They are much better at judging jaundice levels than me also.

There is a lot of parent teaching – breast and/or bottle feeding, basic baby care, signs and symptoms to look for after discharge, etc.

Our WBN keeps bili babies, so there is phototherapy to deal with. Also, occasionally a baby will be on prophylactic antibiotics for hydronephrosis or pelviectasis or on HIV meds.

Newborn nursery nurses usually attend deliveries and need to know NRP (Neonatal Resucitation) for that reason and also because a baby can code anywhere/anytime. Newborns may need suctioning, oxygen, chest PT, blood sugar checks and labwork after admission or other times during their hospital stay.

Most people think WBN nurses just feed and diaper babies, but there is much more than that. Besides all of the teaching, it is the nurse who finds abnormalities, monitors labwork, initiates treatments (like checking blood sugar when baby is “jittery”) and often his/her actions, observational skills or intuition that saves a baby’s life.

Newborns are very different critters from adults or even pedi patients. Good luck with your decision.

nell

[rnin02]

I did tele for 4.5 years, and moving to WBN was a great decision for me! Its a huge adjustment, but its worth it. At my hospital, we do assessments every 8 hour shift, vital signs with assessments, and weights during the night shift. Our parents have the choice of rooming in, or letting the baby stay in the nursery and come out for feeds. Alot of our bottle fed babies stay with us the whole night. So keeping up with that keeps us busy at night. Like the previous poster said, there is a lot of teaching (well, from 7-11 at least), we also have some OBs that like to do circumscions in the middle of the night (gee, thanks!) so we assist with that, and teach parents how to take care of it afterwards. We also help with breastfeeding quite a bit. At my hospital we try to do the PKU and other labs during the night shift if possible. And the usual chart checks, stocking of supplies, that sort of thing.
A big adjustment for me was that its a little harder to be organized in WBN vs working on a tele/med-surg unit. Its hard to explain, but it was just a bit harder. Worth it though!

[nolaRN]

Thank you both so much for the input...very informative! I think I'm going to make the change.