3 Day Orientation to NICU??

Specialties NICU

Published

Specializes in ED, Trauma/Surgical/Neuro ICU.

Hey guys,

So the NICU manager at my hospital offered me a chance to orient to that unit so I could work on call. I was excited, until my third day orienting. She said that was all she could budget for. I'm an experienced adult ICU nurse, but I have no neonatal experience. The plan was to have me work with the feeder/growers. But I feel it's too soon. Is it crazy to feel this way, or have other people had adult nurses cross train to NICU in 3 days? I'm feeling like I want to quit, don't want to risk my license in case something happens that I won't know how to handle...

Thanks for your advice!

Specializes in NICU.

So you would *only* work with feeder/growers? The problem is that as an ICU nurse, you're probably not used to being responsible for 3-4 patients at a time and most hospitals give you that kind of assignment for feeder/growers (we usually have only 2 at my place, but that's the exception) and it's a different sort of time management.

Have you ever worked with babies at all? If not, 3 days is not enough because they're too specialized and require total care that you're not used to, like PO feeding difficult feeders, and the norms for babies are not the same as adults.

Specializes in NICU, Infection Control.

What is this? Drive-by orientation?

I'll bet you are an awesome adult ICU nurse, and the fact that you're interested in NICU makes you one of my favorite nurses of all time! But babies are like a whole 'nother species. All your adult "frames of reference" (I mean that gut feeling when you look @ a pt and KNOW something is wrong, even if you can't quite figure it out yet) are out the window. VS are different, diseases are different (adults don't aspirate meconium, and when they get jaundiced, you can't put them under a UV light to make it go away); even term babies don't metabolize drugs the way grown-ups do.

"Feeders and growers" shouldn't ever be considered to be "done" being sick until they are out the door. They can and do turn bad on a dime, find a germ, get septic, decide they don't feel like breathing and staying warm today, much less digest their food.

Unless they can give you a decent orientation and a preceptor, I don't think you should do it--@ least not @ that facility. If NICU interests you (and imo, that would be a good thing), I would look for an educational opportunity @ a hospital that will nurture you properly!

I wish you all the best and hope you find a home in a NICU!

Specializes in NICU, Infection Control.
Specializes in NICU, PICU, PACU.

Unfortunately, since you are already employed at the hospital, they will not pay for a full orientation. I have been thru this when I was in management. I would talk to her and tell her you aren't comfortable yet. What we did was only give the person 2 feeders with a resource person, it worked out, but we never gave them anything but bigger kids who were just hanging out waiting to go home, but it is hard if we only used the person once every month. IMHO, it isn't worth it.

Specializes in PICU, Sedation/Radiology, PACU.

Unfortunately the reality is that the hospital simply cannot afford to pay you for several weeks of training when you'll only be working on that unit a couple of times per month. They would never recoup their money. This is the same reason why traveling bourses and per diem nurses often get such poor orientations. In my PICU, traveling nurses get 3 days of orientation. Per diem nurses get about 2 weeks. You either sink or swim, and our unit doesn't hesitate to say, "Sorry, but you haven't picked up on things quickly enough. You're just not a good fit here." But a full time employee with previous experience will get 6 weeks.

Specializes in ED, Trauma/Surgical/Neuro ICU.

Hi all,

Thank you for your advice! I decided not to continue, I can appreciate how difficult it is to get a NICU position but putting both a baby's life and my license on the line is not worth it. I work in a level one adult trauma and ecmo ICU and get to learn so much and take care of just sick as heck patients. I haven't felt ready to leave that behind for babies (though someday I'll get there). The manager never told me that I would only get 3 days, she only said she would orient me. The unit complains about being short staffed yet seem to be unwilling to adequately train extra help when they need it. I sure hope someday I will get the opportunity to do it again, I really did enjoy the 3 days I was there!

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