After 26 years in NICU, and 13 years at the same last unit(I had worked in 8), I was feeling stagnant and insignificant and knew I did not want to end my career on this note. I decided to experience travel nursing (we don't use travelers in my home unit) to see what it was like and to find out "if I had the stuff". I took a $10/hr pay cut to do this and have a huge mortage at home. I'm traveling to look at practice, design, and developmental care and to serve in the units I visit. I am now in my third unit at one of the top NICU's in the country and I have real concerns about how orientation is done and just how travelers are received.
As travelers, once we are done with our 2-5 days of required general hospital orientation, we then get two 12 hour shifts on the unit with a mentor. As experienced, (hopefully!),NICU nurses we know the pt and the conditions they present with, what we need to get down in those two days is your system, charting, where to find stuff, who to call, and identify who to go to with questions. Finding a friend to eat with would be a real plus! So it makes sense to me to pair me with a nurse who is good at communicating the above and give her a patient load that facilitates this. Then, when I fly solo my first few shifts, I would also hope to have a sane assignment, which doesn't mean 3 feeder/growers, but rather a stable vent or two, so I can pull my great orientation into my practice and get my feet on solid ground.
This is how I experienced things in one unit with helpful staff who made it clear they were glad I was there, so they wouldn't have to work as much overtime. The other two units were vastly different! My mentor either had the sickest infant, who coded at the end of the shift, or my mentor was asked if I could take the new 23 weeker on my first night solo, or I was assigned what would be considered a horrible assignment in my home unit ( and was in this unit also.) I have been told by other travelers and by unit staff that this is done deliberately to 'test' the traveler . . . "sink or swim", but I don't see the value. It is not safe for the pt, not reassuring for the family, and to me, smacks of "slapping the hand that is there to help you." I would like to challenge any NICU nurse reading this to be dropped into my home unit and be at the top of their game and without angst and have mastered a new computer and med system, new protocols,
new ways of pain mgmt, etc in two days!!! What the unit we go to does not realize is that there are 10 different ways to approach preemie care, as is clearly evidenced from posts in this forum. So when I say, "how do you do this here?" , it doesn't mean I am ignorant, it only means that I want to do it YOUR WAY and understand why you chose it?
So, my friends, if you work with travelers tell me how you orient, and how travelers are viewed in your unit. I really want to put my best foot forward wherever I go. I may end up in your unit and I hope you receive me well and beg me to stay!!
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