need help from seasoned NICU nurses

SteveNNP, MSN, NP · Mar 19, 2007

We were all where you are at one point in our careers, and we all still have those OMG!!! moments. I swear I developed a stress ulcer those first 6 months. You need to see the big picture, but you also have to care for your babies the best that you can. Organize your care at the beginning of the shift, with meds, IV's, feeds, etc. Hone your assessment skills so you can detect abnormalities quickly. Help out with each admission/code/resuscitation that you can so you can watch others in action, and learn by doing. Things will start to become second nature, and you'll find your groove. You never really get comfortable in NICU, you just LOOK comfortable. The day you feel completely comfortable caring for babies, is the day you need to do something else.

preemieRNkate, RN · Mar 20, 2007

One thing that I found very helpful when I was a new nurse was to seek out a variety of assignments. I never was a primary for my first year or so. If I took care of a really sick baby for a few days, the next few days I would try to find some feeders and would be on admit. In my hospital, for the first year after orientation, we don't send new nurses to the DR by themselves (I mean besides with the doc or the NNP). All new nurses get assigned a resource person to go to when they need help, including going over for deliveries. I tried to be on admit as much as possible during my first year, and when it came time for me to go by myself, I felt fairly confident (it helps knowing that NICU is next door and only a phone call away if I needed help!).

Also, if someone else had an interesting assignment, or was doing a procedure, I would try to go and observe and ask questions (I still do that!). There has got to be at least one NNP or doc that likes to teach. Find them!

Keep your neonatal handbook and that NRP book handy, and don't ever be afraid to ask for help. That's what I love about NICU, we work as a team and always have each other's backs!

Best of luck to you, you're lucky to be where you are in NICU!

nicumom · Mar 20, 2007

Hey Guys....

Thanks so much for the posts. I just have to realize that some days are gonna be beter than others. I have had the chance to do so many things on orientation that many others havent and I fells really lucky. Yesterday I got to watch a PDA ligation at the bedside...it was AWESOME!!! I just need to realize that it will take a year(s) for me to begin to feel confident and each day will get alittle better. Thank you all for your support. I just really want to take care of these little miracles to the best of my abilities!!!!!

Jokerhill · Mar 26, 2007

Know what normal is! When I get to precept someone the first time we just cover normals. I don't care if they can identify the problem, that is really what the MD is there for (they have to do something), just tell me that it is not normal. Once you know normal you will start to identify other problems as they come in but that is a skill that takes more time to develop. When you are slow set up admit beds, to have them ready,Set each one up the same way each time then you will know if something is missing and you will get comfortable knowing where everything is and if you need to do it fast you can do it. Help with everything you can but don't deprive your assignment. And don't go out and read your handbook or other book from front to back, the babies can't read and don' follow the chapters for you. Each time you have a baby come in with something you don't know look it up then and then talk to someone about once you have a basic understanding. If you just ask someone first you will get a very short concise answer (like jaundice is cause by the breakdown of fetal blood cells) when we all know so there is much more. If you can follow up with a question about at when you have to start photo, or how it is excreated from the body you will get much more help because you have shown some true interest and not just curiosity.