NICU dislikes

suzanne4, RN · Oct 11, 2005

Parents that live in the area but never come to visit the baby. And only phone once every few days......but then wonder why their infant responds more to us than them, when they visit.

For the new nurse in NICU, you need to be able to make fast decisions and act on them right away. These infants do get quite ill at times, and will crash for whatever reason. They get a color change, not grey like adults do, but they turn black and it can be quite scary. You need to be able to bag and do compressions at the same time. Time is not in your favor during these times. This is not a dislike but a key factor that I believe that anyone thinking of working in an NICU should consider.

fergus51 · Oct 11, 2005

Even worse are the parents who come in and there is immediately an adversarial relationship between them and the staff. One of the hardest things for me is when I see staff giving 110% to the patients, but the parents don't see it and instead get very angry with the staff. I think a lot of them are just angry at the situation, but take it out on the nurses.

BlaineCM · Oct 11, 2005

Do parents get mad at the nurses very often? What types of things do they get mad about?

anneliese, RN · Oct 11, 2005

I think part of the problem with parents is the feeling they get of lose control. Most of the time (and sometimes it doesn't work) if I can get them involved in as much choices and infant care as possible, the parents become easier to work with. And that all is to the better for the infant

Gompers, BSN, RN · Oct 11, 2005

Some of the upsetting things you might encounter in the NICU...

Parents who want "everything done" to save their sick baby, yet they don't visit or even call to see how the baby is doing. True, sometimes it is because the parents are afraid to bond with the baby when it might not survive. But that's usually not the case...

Parents who want "everything done" for a baby that is really suffering.

Codes.

Taking care of babies that are doing great one day, but almost dying the next.

Watching parents who have struggled with infertility for years lose yet another baby.

Two heartbreaking words: necrotizing enterocolitis.

Two more heartbreaking words: intraventricular hemmorhage.

Babies who are bad IV sticks that constantly need new IVs and the docs won't start a central line.

Dealing with families who are manipulative and critical of everything we do.

Constantly worrying about lawsuits.

Murphy's Law: the fact that the nicest parents always have the sickest infants.

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You asked for the bad parts. There they are, at least some of them in my eyes. But I think you'll notice, reading through the NICU forum, that the good times by far outweigh the bad. These babies really are amazing little creatures, and their will to live is truly an inspiration. Nurses either hate the NICU or fall in love with it forever. Those of us who love it, we have such a passion for our jobs that it brings tears to my eyes just thinking about it.

Think of the it like that nursery rhyme about the girl with the little curl...

When the NICU is good, it is very very good.

And when it is bad, it is horrid!

fergus51 · Oct 11, 2005

Do parents get mad at the nurses very often? What types of things do they get mad about?

Anything and everything. Most of the time I think it is that they are just mad at the situation, but they take it out on the staff. I have seen parents start yelling because they didn't like the color of the pacifier their baby had, the nurse didn't fold the linen right, the nurse didn't run to the bedside the second the baby cried, the IV went out, the baby needs bloodwork, etc. Some people just get completely out of control in the unit despite all attempts to help them and involve them in care. If you work in a place where this sort of behavior from families is tolerated, it can get to be very draining.

Also, don't forget that some babies are in the NICU because of their parents poor coping abilities. Women who are doing crack throughout their pregnancy won't necessarily become great at dealing with stress when their baby is born.

TiffyRN, BSN, PhD · Oct 11, 2005

Perfect example of parents misdirecting their fear/anger over their child's situation. . . Former 23 weeker crashes around 2 months old with a real bad A&B and is successfully resucitated with bagging and stimming. It happened on night shift. Mom comes in to visit the next evening, same nurse back on again. Mom looks at the nurse and in a very accusing tone states "You bagged my baby!!" The nurse appropriately responds back "Would you rather I NOT have bagged him?". This mom continues with many of these behaviours and for some reason I haven't taken it personally, I see through her fear. Her child is the problem, will likely never be right, has had too many complications, too many codes, too many surgeries, was DNR for several weeks in his early life but pulled through that and will be lucky if he is discharged home. The mom cannot be angry at her beloved baby (and shouldn't) but she feels tremendous anger about the unfairness of the situation and has chosen the nurses and other healthcare providers to direct her anger at. Fortunately a few nurses have learned how to refocus her and acknowledge that her situation isn't right or fair. Fortunately she has a wonderful husband who really seems to get it and though he comes off as country bumpkin is actually quite intelligent and in touch with his feelings and reality.

So my dislike is parents who get mad at the nurses over things we have no control over like how well the infant nipples, stays warm or gains weight. Mostly the infant just isn't mature enought to accomplish those goals and nothing will change that except time. Once more the parents are really frustrated/mad over something they have no control over.

KES · Oct 11, 2005

I want to thnak everyone who has replied to me. It has put another perspective on the NICU. I still love the idea of working in the NICU, because like some of you have said: the good far outways the bad. Does anone know if hospitals have NICU internships?

CarVsTree · Oct 11, 2005

I want to thnak everyone who has replied to me. It has put another perspective on the NICU. I still love the idea of working in the NICU, because like some of you have said: the good far outways the bad. Does anone know if hospitals have NICU internships?

I'm starting in January as a GN in a 6+month NICU internship at Lehigh Valley Hospital in Allentown, PA.

Good luck with wherever you decide.

Sue Z

Deidre Shiobhan · Oct 12, 2005

I totally agree with all the things you've mentioned, to add on the list the most heartbreaking part is having a baby died after spending time in NICU for 1 solid year. These babies are like my own kids, you feel that all the efforts have been wasted and gone down the drain. SIGH!

**canoehead, BSN, RN** · Oct 12, 2005

My sister's baby was in the NICU for over a month last year ( at about this time). She was so stressed by times that it was difficult to have a conversation with her, she was angry with everyone. After it was all over she praises the nurses very highly, which tells me they must have made a huge effort to help and support the whole family. Thank goodness we have people that are willing to put themselves out there and be a safe place for the babies and their parents no matter what. Thank you all.