Is NICU predictable?

preemieRNkate, RN · Nov 8, 2006

I don't mean is it the same day in and day out but is it more predictable than say the ER? I think I would really love to work NICU when I graduate but I don't think I would do well in an environment like the ER due to the complete unpredictability & hectic nature of what is coming in/going on. Thanks for any info.

Sometimes we get the heads-up from L&D that they have a potential admit for us (mom in PTL that will most likely deliver that shift or a baby with something diagnosed in utero) and we can set up the warmers in advance but then a woman could walk in off the street and deliver 25 week twins and we don't know anything about them until we're standing in the OR for the section. Also, a baby on the unit could be doing real well all day and then by 7a the next morning could've developed NEC and perf'd. You really can't predict NICU, but I doubt you can really predict anything on any unit. If you really want to work in NICU, maybe you can do an internship or your senior practicum there to get a better feel for it. Or even get a job as a clerk just to see what the unit is like day-to-day. Good luck!!

EricJRN, MSN, RN · Nov 8, 2006

As an EMS provider (who has spent a lot of time in various ER's related to clinicals and patient transports) and a NICU nurse, I would say that you'll find the NICU to be somewhat more predictable than ER. Although each kiddo will respond to interventions a little differently and the delivery room resuscitations can bring surprises, you're generally dealing with less variety in the NICU, diagnosis-wise. The vast majority of our patients are dealing with the effects of prematurity and/or respiratory distress.

I don't mean to say that it's less exciting in the NICU, because it's not. I love it there. NICU nurses still have to perform well under lots of stress, but if you're looking for a place where your care will mostly center around a few diagnoses, the NICU may be it.

RainDreamer, BSN, RN · Nov 8, 2006

I actually wish it was more predictable than it is, lol!

I sometimes like having my nice little assignment. I have my sheet all filled out with the times I need to do things and then I just enjoy some down time in between. Those nights are nice ..... they're not too slow and boring, but they're not crazy and hectic. But, you never know what'll happen. For the most part the kids stay stable and just fine throughout the shift, but not always. A while ago I had a nice 2 baby assignment ...... both stable vents. Well by the end of the night I had a baby on a jet and a baby on an oscillator. What happened there?? I wasn't far off orientation either, so I wasn't forced to keep the assignment ..... and no one should have 2 HFVs, not even a vent with a HFV. So that right there shows you how unpredictable it can be. But that's usually a rare occurance.

Usually there is something going on though in the unit to keep you busy. Even if you have a "quiet" assignment, then you can help out with admits or go on high risk deliveries, etc.

Like was mentioned above, we're always in very close communication with L&D about any possible babies coming our way. But when that high risk phone rings and says "there are 24 week twins in an ambulance somewhere, coming your way" (happened to us last weekend) .... that'll get your adrenaline going!

2curlygirls · Nov 8, 2006

I always say anything can happen at anytime. Being prepared keeps the unpredictablilty tolerable.