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adpiRN, BSN, RN 9,335 Views

Joined Nov 2, '08 - from 'South Carolina'. She has '3' year(s) of experience and specializes in 'L&D'. Posts: 380 (28% Liked) Likes: 229

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  • Jun 19

    general rule of thumb is you should be scent free at work. I don't think scented shampoo/conditioner is usually strong enough to cause a problem, but besides that I would avoid it.

  • Jun 17

    Hi all!

    I recently graduated from nursing school and I have accepted my first nursing position as a NICU nurse.

    Since I don't start for a few weeks. Does anyone have any advice of what to do until I start, or articles/books or topics I should read related to the NICU? Thanks!

  • Jun 7

    Quote from Irish_Mist
    I'm actually of afraid of doing pediatrics. I LOVE kiddos so much that seeing them sick, abused or neglected would break my heart and I wouldn't handle it well emotionally. I am doing my pediatrics rotation at Children's Medical Center Dallas in July and I'm so nervous about it.

    I know I wouldn't hate it. Don't get me wrong. I care a great deal about my patients but it is easier for me to "separate" myself with the adult ones.
    Lol, another reason to love NICU nursing: you get the satisfaction of watching parents bond with kids and enabling parents to feel confident in doing cares, yet still have the peace of mind because nobody has had the opportunity to harm these kids in any way (generally, although we do get some very tough neonatal drug withdrawal cases). They're in your unit from birth, so we can ensure that they're safe, fed, and have their basic needs met.

    Also, as an FYI, you may encounter more neonatal losses in L&D than a place like NICU (that's the case in my hospital). Infants are most vulnerable and likely to pass away in the transition phase immediately after labor, including difficult preterm/term resuscitation in the delivery room and cases where the baby is simply too early (<22 weeks) and no resuscitation attempt is made. If you're seriously interested in L&D, I'd talk to current L&D nurses about coping with maternal/perinatal loss. You mention that you're worried about bonding with families/kids on peds and then watching the kids get sick; in L&D, it's very possible that you could care for a healthy mom, stay by her side through every step of her labor, have a baby is born with meconium aspiration, and after an unsuccessful resuscitation watch that baby pass away in the delivery room.

    I get what you mean about separating yourself from patients, and I think that to some degree it's necessary in any field of nursing. The very fact that life is so precious makes our jobs totally satisfying at times, but devastating at others. It sounds cliche, but people find ways to cope with patient loss; otherwise, there would be no peds/L&D/neo/trauma/ICU nurses. You can't know unless you try. Self-care is really important, and it helps if you have support from you coworkers (after my first loss, I spent over an hour after my shift ended talking and crying with an amazing coworker who has 40+ years of NICU experience). If it turns out you really hate the unit you're on, there are always more specialties out there.

    One other thing you can do is to talk to nurses on the units you apply to about these topics. Some new grad jobs will have a peer interview process, or a chance for you to shadow nurses on the unit. Talk to them about how often loss/abuse/neglect/difficult cases occur, and how people handle them; this is especially pertinent if you're working L&D or ICU.

  • Jun 7

    So, a couple of strategies from a current NICU nurse:

    1. Shadow if at all possible. In theory, I thought I'd love adult ICU nursing (high level critical thinking, low patient ratios, etc.) It took about two shifts in adult critical care for me to realize that it was not for me. Shadowing allows you to see what nurses within a unit actually do, unlike in school where you learn the theories/patho behind what its done. For example, part of adult ICU is vented patients with code browns--you teachers aren't talking about that when they're discussing ARDS and vent settings.

    2. Similarly, you have to think about what you really enjoy doing, what what you don't. I volunteered in an ED where I enjoyed the pace (sometimes slower, sometimes totally crazy) and loved the patho behind all of the cases; I considered ED. However, I've since discovered that even though I like ED in theory, I get really stressed out when I can't start my shift with a definitive schedule and game plan for the day. Therefore, ED probably wouldn't be a good fit for me. Figuring out what you really do an don't enjoy in a professional setting is a process, and it requires some self-reflection. Think about what events in clinical made you happiest, what made you miserable, and most importantly why.

    3. Talk to nurses in those specialties. Find out what they love about their jobs, what they hate, and why. I first began looking into NICU because I heard so many awesome things from NICU nurses. Nearly every NICU nurse I met told me "I love this job, I can't imagine doing anything else, and I want to be doing this until the day I retire." The main reason I found people leaving the NICU was because of burnout due to management and unit politics, not the nature of the nursing care.

    4. Research. I literally used academic databases to look up journal articles on nursing satisfaction in various specialties, the exact same way you look up articles to write a paper. There are hundreds, if not thousands, of papers on nursing burnout, including papers that look at job satisfaction and burnout by specialty. I think I found the ones I used via Google Scholar. You should be able to access them through your campus network if your school pays for access to the journal article databases, and a handful are free to anyone online. Evidence-based practice, anyone?

    Of course I have a bias, but I think you might enjoy NICU. You get the joy/satisfaction of seeing new families achieve milestones together, along with awesome elements of ICU (high level skills, critical thinking, low patient ratio). Unlike in L&D, where soon after birth the couplets are whisked away, you get to care for, nurture, and bond with families over days, weeks, and even months. You can take care of a tiny 2 lb peanut, and four months later experience the joyous 'victory lap' around the unit before the family takes their healthy NICU graduate out the door and into the world. It is also pretty easy to get cross-trained in L&D and NICU (since they generally get floated to one another), so you can have the best of both worlds. But like I said, I'm pretty biased because I absolutely love NICU nursing.

  • Jun 6

    I didn't accept the job. I wouldn't feel comfortable and it seems dangerous. It just seems crazy that it's allowed. I wanted to hear what everyone else thought.

  • Jun 4

    I was hired in L&D one month after passing NCLEX. Days.

    I actually considered switching to nights and my manager said "are you sure with your daughter at home???"

    I stayed on days.

  • Jun 4

    Probably not, because it would mean you'd go into overtime for one or the other.

  • Jun 4

    I just don't get "unsafe". If all the nurses on NOC are new, then THAT is unsafe.

  • Jun 4

    I think it can be unsafe to have an entire ICU shift made up of all novice nurses, but I'm not sure why it would be safer to have most of your novice nurses working on night shift rather than evenly distributing them between both shifts. Is day shift already full of novice nurses?

  • Jun 2

    Quote from Grasshopper11
    I actually like working in a place where all RN's wear one color and CNA's wear another. This way the staff and the patients know who is who. When I worked in a facility where anybody can wear anything, a patient told me that she was talking to "somebody" about her medical tests and the "somebody" was giving her wrong instructions about her diagnosis. Turns out the "somebody" was a CNA. The patient stated she did not know because everybody looked alike.
    Your patient population must have unusually high IQ and attention to detail because I have never worked anywhere that they were able to know who was who from a color scheme, even with the color code in their hands and on the giant flat screen TV on the wall right in front of them.

  • Jun 2

    Quote from she244
    Hi! I am so jealous of those who can wear anything. I am in a position wear I have to wear a uniform everyday. When I asked if we had dress down Fridays here I was told NO! My Medical Director is old school and said I had to wear a uniform as I was hired as a Nurse and patients needed to separate Nurses from Physicians who wear regular clothes with white scrub jackets. So here I sit in my uniform. I can wear any color or style it just has to be a Nursing uniform. I have a new Medical Director. I may wear something different and see what happens.
    What the heck is a nursing uniform if it can be any color or style? Sounds to me as if you can wear pretty much anything you want.

  • Jun 1

    I feel so much better and less guilty now that I know I'm not the only crazy scrubaholic! You guys make my 20 scrub collection look like peanuts! Love you guys!!

  • May 29

    Dangit, now I am watching several pairs of Danskos on eBay. Lol.

  • May 29

    Quote from adpiRN
    Thanks to this thread I just bought another pair of Danskos on eBay...


    I bought a pretty pair of handpainted Danskos on eBay a few years ago — they look like Starry Night by Van Gogh.

  • May 29

    There is no "average dollar amount extra" Depends on geographical location and the facility.
    Your main concern should be the orientation you will be provided with.

    What is each facility offering?


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